Pseudo-Meig's syndrome: parasitic leiomyoma with ascites in a 52-year old lady

Abstract

There is a possibility that a pedunculated subserous leiomyoma loses its vascular connection with the uterus and gets new blood vessel supply from other pelvic or nearby structure and continues its parasitic growth. A 52-year-old lady presented with abdominal distension of 12 years duration and laparotomy was done with preoperative diagnosis of possible malignant ovarian tumour. Intraoperative finding was very big non-specific but well demarcated and easily excisable mass located partly in the utero-vesical pouch with blood supply entirely from the greater omentum and anterior abdominal wall. There was about 3600 ml clear ascitic fluid in the paracolic gutters. The mass was sent for histo-pathologic examination and the report was compatible with leiomyoma of uterine origin. Patient's recovery was quiet dramatic and subsequent out patient follow-ups were uneventful. The presence of ascites of different amount doesn't necessarily signify malignancy of any visceral primary or secondary origin. Therefore, benign tumours of ovarian or uterine origin should be included in the differential diagnosis of pelvic or abdominal mass with ascites to come up with scientifically sound deduction and intervention that may bring about remarkable impact on ameliorating mortality and morbidity.