Large Intraligamental Leiomyoma of the Uterus With Cystic Degeneration Mimicking an Ovarian Cyst: A Case Report

Intraligament uterine leiomyomas, particularly those associated with cystic degeneration, are rare and represent a diagnostic challenge.We report the case of a 51-year-old patient with a large intraligament uterine leiomyoma and extensive cystic degeneration who was referred to the gynecology department of the hospital because of abdominal pain.Transvaginal ultrasonography and magnetic resonance imaging revealed a pelvic mass of mixed composition; however, it could not be accurately determined whether the mass originated from the uterus or the ovaries.The patient underwent laparotomy.Intraoperatively, a large intraligament uterine leiomyoma with a smooth external surface and fibroelastic consistency was identified.Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed.Histopathological examination confirmed the diagnosis of a degenerative uterine leiomyoma.The patient was discharged from the department on the fourth postoperative day.In this article, following the presentation of our case, we provide a brief literature review regarding the diagnosis and management of intraligament uterine leiomyomas.Particular emphasis is placed on cases in which the leiomyoma was large and associated with extensive cystic degeneration, making its differentiation from an ovarian cyst difficult.