Case Report

Massive Multilocular Cystic Leiomyoma of the Uterus: An Extreme Example of Hydropic Degeneration

Authors: Kathleen Coard, MBBS, DM (Path), Joseph Plummer, MBBS, DM, (Surg)

Abstract

A 49-year-old woman underwent laparotomy for an undiagnosed, extremely large abdominal mass. At surgery, this was discovered to be a uterine tumor and she was subjected to a subtotal hysterectomy. Pathologic examination of the uterus revealed a multilocular cystic mass containing over 18 L of fluid that was established on histology to be a markedly hydropic leiomyoma. This case describes a very uncommon growth pattern of leiomyoma of the uterus that has only been occasionally described previously. We propose the name multilocular, cystic leiomyoma for this variant.


Key Points


* Leiomyomas are the most common tumors of the uterus.


* Most leiomyomas are easily identified, with typical gross and microscopic appearances.


* A number of less common gross and microscopic variants exist.


* Although rare, these tumors may become massive with extensive cystic degeneration.


* Unusual leiomyomas must be considered in the differential diagnosis of intra-abdominal masses in all female patients.

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