Is it an Adnexal Mass or a Broad Ligament Leiomyoma?

Is it an Adnexal Mass or a Broad Ligament Leiomyoma?

Uterine Leiomyomas and adnexal masses are the most common causes of pelvic masses arising from the female urogenital system. We present a case that demonstrates the similarity between the leiomyoma and malign adnexal cyst. A 51 year-old, post-menopausal women presented with lower abdominal pain and a pelvic mass (6x7 cm diameter). The sonographic appearance of the mass was multi-cystic with some solid area, indistinct margin on the right side of the uterus and intra-abdominal fluid, similar to typical malign ovarian cysts. We performed exploratory laparotomy and found that the mass was a pedunculated subserosal myoma arising from right side of the uterine corpus, which extending between the folds of the broad ligament. Histopathological examination revealed subserosal leiomyoma with cystic degeneration. Postmenopausal cystic degenerative leiomyoma can be a good imitation of ovarian neoplasms, resulting in diagnostic confusion.