INTRODUCTION: Benign metastasizing leiomyomas represent benign lesions
consisted by leiomatosous tissue and could be observed in positions away
from their usual localization, the human uterus. They commonly affect
women that have undergone total hysterectomy. Approximately 100 similar
cases have been reported in the literature, so the case we present is
rare and reviewing the literature and needs to be reported.
PRESENTATION OF CASE: We report a case of a 55 year old Greek woman,
gravida five and para three, who attended our unit 3 years ago
complaining of occasionally lower abdominal pain and irritation the last
months. Fourteen years ago she underwent abdominal hysterectomy and left
salpingo-oophorectomy due to a 13 cm uterine leiomyoma. In the meantime
she underwent two surgical procedures for recurrent benign leiomyomas.
DISCUSSION: When patient was admitted at this time, clinical examination
revealed a palpable mass of 5 cm. The transvaginal ultrasonography
revealed 3 masses in the lower pelvis of unknown origin. The patient
underwent a new laparotomy revealing three masses of benign leiomyomas
with low mitotic activity.
CONCLUSION: Our case supports the recurrent appearance of leiomyomas in
pelvis after total abdominal hysterectomy and is one of few reports in
literature where the tumors appear in the same patient both in estrogen
rich and estrogen poor environment. Additionally, we show the importance
of transvaginal ultrasonography and 3 dimensional power Doppler in the
differential diagnosis of pelvic masses. Thus, transvaginal
ultrasonography seems to be a pivotal tool for the diagnosis and follow
up of these challenging lesions. (C) 2018 The Authors. Published by
Elsevier Ltd on behalf of IJS Publishing Group Ltd
