Shubhdeep KaurBombay Hospital and Medical Research Institute, India
Title: Broad Ligament Myoma : A Case managed by Vaginal Hysterectomy and Broad Ligament Myomectomy
Background: One of the commonest site of extra uterine leiomyoma is broad ligament fibroid but with low incidence rate. We present a patient with complaints of lower abdominal pain, back pain and premenstrual spotting per vaginum.
Result: Abdominal examination revealed a huge firm mass arising from the pelvis corresponding to 10-12week size. Cervix was deviated to right and elevated but felt separable of the mass. Ultrasonographic examination showed left adnexal 9 cm fibroid beside the uterus suggesting pedunculated fundal leiomyoma. Laparoscopy was planned but vaginal hysterectomy was attempted considering the expertise of the surgeon and previous 2 vaginal deliveries. Surprisingly it turned out to be a broad ligament fibroid.
Conclusion: Non descending vaginal hysterectomy was done to increase the space and working field for performing the broad ligament myomectomy. Extreme care was taken to avoid the ureteric injury. This case was reported because of the rare incidence of broad ligament leiomyoma and the difficulty in its operative management.
Dr Shubhdeep Kaur is persuing her Masters in surgery at the age of 25 years from Bombay Hospital Institute of Medical Sciences, India. She is final year resident in the department of Obstetrics and Gynaecology. She has over 5 publications. She has written a lesson on secondary Polycystic Ovarian Syndrome in the year book of obstetrics and gynaecology 2020. She completed her MBBS from Grant Government Hospital and Sir JJ group of hospitals, Mumbai.