Li J, Zhu-Ge YY, Lin KQ. Torsed retroperitoneal leiomyomas: A case report and review of literature. World J Clin Cases 2024; 12(21): 4762-4769 [PMID: 39070816 DOI: 10.12998/wjcc.v12.i21.4762]
Corresponding Author of This Article
Kai-Qing Lin, PhD, Chairman, Surgeon, Department of Gynecology and Obstetrics, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, No. 208 East Huancheng Road, Hangzhou 310000, Zhejiang Province, China. linkaiqing@zju.edu.cn
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 26, 2024; 12(21): 4762-4769 Published online Jul 26, 2024. doi: 10.12998/wjcc.v12.i21.4762
Torsed retroperitoneal leiomyomas: A case report and review of literature
Jin Li, Yi-Yi Zhu-Ge, Kai-Qing Lin
Jin Li, Yi-Yi Zhu-Ge, Department of Gynecology, Hangzhou Women’s Hospital, Hangzhou 310000, Zhejiang Province, China
Kai-Qing Lin, Department of Gynecology and Obstetrics, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Author contributions: Li J contributed to manuscript writing and editing and data collection; Zhu-Ge YY contributed to data analysis; Lin KQ contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Supported byMedical and Health Science and Technology Project of Zhejiang Province of China, No. 2022KY274.
Informed consent statement: The patient provided informed written consent prior to study enrolment.
Conflict-of-interest statement: None of the authors have any conflicts of interest to declare. There are no conflicts of interest in this study. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai-Qing Lin, PhD, Chairman, Surgeon, Department of Gynecology and Obstetrics, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, No. 208 East Huancheng Road, Hangzhou 310000, Zhejiang Province, China. linkaiqing@zju.edu.cn
Received: March 24, 2024 Revised: May 11, 2024 Accepted: June 4, 2024 Published online: July 26, 2024 Processing time: 99 Days and 19.4 Hours
Abstract
BACKGROUND
Retroperitoneal leiomyomas (RLs) are rare benign tumours that can occur in the pelvic and/or abdominal parietal retroperitoneum. Once torsion occurs, it causes acute abdominal pain and can even lead to serious consequences such as gangrene, peritonitis, haemoperitoneum and shock if not identified and treated promptly. Therefore, a better understanding of the characteristics of RL torsion is needed. Here, we present a case of acute pedicle torsion of an RL in the posterior peritoneum followed by a literature review.
CASE SUMMARY
Herein, we report the case of a 42-year-old woman with RL torsion. The patient visited our hospital complaining of lower abdominal pain for 6 d. Pelvic examination revealed a tender mass superior to the uterus. Pelvic magnetic resonance imaging (MRI) revealed an anterior uterine mass, multiple uterine fibroids and slight pelvic effusion. MRI suggested the possibility of a subserosal myoma of the anterior uterine wall with degeneration. Intraoperative exploration revealed a 10 cm pedunculated mass arising from the posterior peritoneum, with the pedicle torsed two times. Pathological examination confirmed a torsed RL.
CONCLUSION
In the case of a pelvic mass complicated with acute abdomen, the possibility of torsion should be considered.
Core Tip: Retroperitoneal leiomyoma torsion is extremely rare. We report a case of acute pedicular torsion of a leiomyoma in the posterior peritoneum, followed by a literature review. The review suggested that RL torsion mainly occurs in female patients, and the most prominent clinical symptom is abdominal pain. The possible imaging features of torsed retroperitoneal leiomyomas include a well-circumscribed mass separate from the uterus and adnexa, no enhancement, a torsed pedicle, and ascites. If the diagnosis is unclear, surgical exploration should be considered to confirm the diagnosis in a timely manner to reduce the risk of other complications.
