Leiomyoma is a benign tumor of the uterus. It typically does not present with weight loss, massive ascites, gastrointestinal symptoms, elevated CA125
, and elevated alpha fetoprotein.
This was a rare case of a 48-year-old nullipara, emaciated with grossly distended abdomen, huge abdominal mass corresponding to 36 weeks’ gestation, associated anorexia, easy satiety, constipation and vomiting that had TAH and BSO for suspected ovarian malignancy, which histology report revealed leiomyoma.
Abdominal ultrasound scan done noted huge right ovarian mass, possibly malignant, with massive ascites. Findings at surgery, revealed a large, firm mass with necrotic patches, attached to the uterine fundus by a thin stalk 5 x 3 cm thick and to the omentum by large dilated blood vessels and adhesions. Mass weighed 5.8 kg. Eleven (11) liters of ascitic fluid was aspirated, sent for cytology and report showed no malignant cells. Histology confirmed a degenerated leiomyoma with no evidence of malignancy.
Atypical presentation of leiomyoma can mimic that of malignancy. This knowledge will help Clinicians and Gynaecologists to have a high index of suspicion with such clinical features, in making prompt diagnosis and instituting appropriate management.