The relation between the presence of a giant primary ovarian leiomyoma and the occurrence of epilepsy as a paraneoplastic syndrome

Case Report: Primary Ovarian Leiomyoma: A Clinical Analysis of Case Series and Literature Review

Ovarian leiomyoma accounts only for 0.5–1% of all benign ovarian tumors, and almost no preoperative diagnosis has been achieved. Commonly, these tumors are small in size and asymptomatic. However, they can become symptomatic as their size increases; thus, it is important to recognize this entity and differentiate them from ovarian malignant tumors. Radical surgeries with total hysterectomy and salpingo-oophorectomy are usually performed. However, ovary-preserving surgery has been suggested to young women, especially those desiring fertility in the future. In this study, we shared seven cases of primary ovarian leiomyomas and one inherent ligament leiomyoma, reviewed related articles to provide some new information about leiomyoma of the ovary, and discussed their proper surgical management.

A 36 kg Giant Ovarian Fibroma with Meigs Syndrome: A Case Report and Literature Review of Extremely Giant Ovarian Tumor

Ovarian tumors can get extremely giant to occupy the whole abdominal cavity. We report a case of 36 kg solid ovarian tumor, which was the largest ovarian solid tumor that have been ever reported. A 54-year-old woman presented to our hospital with a chief complaint of markedly distended abdominal wall. Preoperative imaging examinations revealed that most of the tumor was uniform and its density was like that of subcutaneous fat. Pleural effusion was detected in the right thoracic region. We organized a multidisciplinary team and successfully resected the right adnexa. The patient had an uneventful postoperative course, and she was discharged on the 7^th postoperative day and diagnosed with a fibroma of the ovary with Meigs syndrome. A comprehensive literature search revealed 48 cases of extremely giant ovarian tumor in these 20 years. Six out of 48 cases are solid. Twelve out of 48 cases are malignant or borderline malignant, and patients' age and tumor size/weight were not related to the frequency of malignancy/borderline malignancy. As many as 4 out of 48 patients died before their first hospital visit or early after surgery. Clinicians should consider a considerable high mortality and frequency of severe surgical complications when planning the treatment strategy for extremely giant ovarian tumors.

Large ovarian leiomyoma in young woman

Leiomyoma is benign mesenchymal tumor, that frequently occur in uterus but it rarely happens in ovary. Ovarian leiomyomas are seen concomitantly with uterine leiomyoma in about 78% of cases. They often discover incidentally but their most clinical manifestations are abdominal pain and palpable mass. Herein, we reported a large ovarian leiomyoma in a 22-year-old woman with abdominal pain and palpable mass at lower abdominal region. Computed tomography scan revealed large adnexal mass. Microscopic appearance was typical for leiomyoma but because its rarity in ovary the immunohistochemical staining was done. Major differential diagnostic considerations for this tumor in ovary are fibroma/thecoma, sclerosing stromal tumor, and leiomyosarcoma. The immunohistochemical staining with desmin, inhibin, and α-smooth muscle actin are helpful to rule out this differential diagnosis.

Ovarian leiomyoma as a potential cause of compromised fertility

OBJECTIVE

To analyze cases of ovarian leiomyomas and to discuss the proper surgical management.

DESIGN

A case series and discussion.

SETTING

General university hospital and healthcare center.

PATIENT(S)

Nine patients who were diagnosed with ovarian leiomyomas after surgery between 1993 and 2009.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

A preoperative diagnosis that was matched to the postoperative diagnosis and the type of surgery.

RESULT(S)

In all cases, ovarian leiomyoma was misdiagnosed preoperatively as pedunculated uterine myoma, ovarian fibroma, or even ovarian endometrioma. Seven (77.8%) of the nine patients underwent a salpingo-oophorectomy or an oophorectomy with or without hysterectomy, and only two (22.2%) patients were submitted to an ovary-preserving surgery (i.e., a cystectomy or ovarian wedge resection).

CONCLUSION(S)

Because of their extreme rarity, ovarian leiomyomas are seldom suspected intraoperatively or preoperatively. However, most of these tumors appear at reproductive age and have a benign nature, similar to uterine myomas. Therefore, surgeons should perform ovary-preserving management, especially in young patients.