Broad ligament myoma: a case managed by vaginal hysterectomy and broad ligament myomectomy

Abstract

The broad ligament is the commonest extra uterine site for leiomyoma but with low incidence rate. We present a patient with complaints of lower abdominal pain and premenstrual spotting per vaginum. Abdominal examination revealed a huge firm mass arising from the pelvis corresponding to 10–12-week 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 broad ligament fibroid. Laparoscopy was planned but vaginal hysterectomy was attempted considering the expertise of the surgeon and previous 2 vaginal deliveries. 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.