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Case Reports
. 2018 Mar 26;12(1):81.
doi: 10.1186/s13256-018-1617-z.

Management of a giant retroperitoneal leiomyoma: a case report

O Karray  1 , R Boulma  2 , A Abdi  3 , A Ben Miled  4 , A Dhaoui  5 , N Menif  4 , K Bellil  5 , H Khouni  2 , A Chouchen  3
Affiliations
Case Reports

Management of a giant retroperitoneal leiomyoma: a case report

O Karray et al. J Med Case Rep. .

Abstract

Background: Leiomyomas are benign tumors observed mainly in adult women. The retroperitoneum is a rare location for leiomyomas; almost 100 cases have been reported. Because retroperitoneal leiomyomas are paucisymptomatic and the tumor size at diagnosis is relatively large, surgical management is challenging. Regular follow-up is required because recurrence and malignant sarcomatous transformation have been described in a few cases.

Case presentation: We report a case of a 52-year-old North African woman with a 22-cm retroperitoneal leiomyoma. A preoperative embolization was performed 2 days before surgery. The clinical, therapeutic, and evolutive aspects of this rare entity are discussed.

Conclusions: Despite its benignity, retroperitoneal leiomyoma is a challenging diagnostic, therapeutic, and evolutive condition. Surgeons must consider mainly the tumor's vascularization. Regular follow-up is mandatory because malignant transformation cannot be excluded.

Keywords: Embolization; Leiomyoma; Retroperitoneal neoplasms; Surgery.

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Conflict of interest statement

Ethics approval and consent to participate

No ethics committee approval is required at our institution for a case report involving a limited number of patients.

Consent for publication

Written informed consent was obtained from the patient for the publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
A retroperitoneal tumor with a mass effect on the left kidney, the aorta, and the bowel. 1 = Tumor, 2 = left kidney, 3 = aorta, 4 = left kidney artery, 5 = iliac artery, 6 = pancreas
Fig. 2
Fig. 2
a Abundant and anarchic vascularization of the tumor, provided exclusively from the left renal artery. b Embolization of the renal artery led to complete disappearance of the tumor vascularization
Fig. 3
Fig. 3
Operative specimen. 1 = Tumor, 2 = left kidney, 3 = tumor capsule, 4 = left kidney capsule, 5 = the kidney’s hilum
Fig. 4
Fig. 4
Histological specimen showing mesenchymal proliferation and containing smooth muscle cells in a hypervascularized stroma
Fig. 5
Fig. 5
Immunohistochemical analysis revealed reactions that were (a) positive for desmin and (b) negative for HMB-45
See this image and copyright information in PMC

References

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