Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2022; 10(29): 10728-10734
Published online Oct 16, 2022. doi: 10.12998/wjcc.v10.i29.10728
Recurrent atypical leiomyoma in bladder trigone, confused with uterine fibroids: A case report
Jeonghwa Song, Heekyoung Song, Yong-Wook Kim
Jeonghwa Song, Heekyoung Song, Yong-Wook Kim, Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Incheon St. Mary’s Hospital, Incheon 21431, South Korea
Author contributions: Song J and Song H contributed equally to this work as first authors; Song J and Song H reviewed all medical records, examined relevant literature, summarized the case findings, and contributed to manuscript drafting; Kim YW reviewed the literature and interpreted the imaging findings, and were responsible for the revision of the manuscript for important intellectual content in the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Yong-Wook Kim, MD, PhD, Professor, Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Incheon St. Mary's Hospital, 56 Dongsu-ro, Bupyeong-gu, Incheon 21431, South Korea.
Received: May 31, 2022
Peer-review started: May 31, 2022
First decision: August 4, 2022
Revised: August 18, 2022
Accepted: September 7, 2022
Article in press: September 7, 2022
Published online: October 16, 2022

Tumors originating from the posterior bladder wall can be challenging to diagnose because they may mimic a mass from the uterine cervix. Atypical leiomyoma of the bladder trigone is extremely rare, with few reported cases, and requires caution during surgery to avoid damage to the adjacent ureter. Diagnostic surgery and confirmational pathology are essential to assess whether the tumor is malignant and relieve clinical symptoms. Herein, we describe a case of recurrent leiomyoma with focal atypia in the bladder trigone.


A 29-year-old woman with a uterine fibroid incidentally found at a regular checkup was referred to our hospital. Based on magnetic resonance imaging, either urinary bladder leiomyoma or protrusion of pedunculated uterine cervical fibroid into the bladder was suspected. This leiomyoma in the trigone of the bladder was completely excised by laparotomy, and the patient was discharged without complication. Follow-up outpatient ultrasonography identified tumor recurrence after four years. As focal atypia was identified previously, laparotomy was performed to confirm the pathology. A round solid mass was resected from the posterior bladder wall without injuring either ureteric orifice. This tumor was pathologically diagnosed as a leiomyoma without atypia. Three-year follow-up ultrasonography has revealed no recurrence.


Atypical leiomyoma in bladder trigone is rare and could be easily mistaken for fibroid in the uterine cervix. To confirm histopathology, surgical excision is mandatory and regular follow-up is necessary to detect recurrence.

Keywords: Case report, Cervix uteri, Leiomyoma, Recurrence, Trigone, Urinary bladder

Core Tip: Diagnosis of a tumor originating from the bladder trigone is challenging because it may mimic a mass from the uterine cervix. Magnetic resonance imaging is considered superior to computed tomography or ultrasonography for assessing bladder leiomyoma. Leiomyoma in bladder trigone requires caution during surgery because it can cause damage to the adjacent ureter. Surgical removal is mandatory for histopathological confirmation since it can be atypical fibroids or sarcomas. Regular follow-up is essential to detect recurrence.