Intra-ligamentous fibroid removed laparoscopically

Richard L. Heaton, M. Sami Walid
In: Open Journal of Obstetrics and Gynecology · 2011 · vol. 01(03) , pp. 136–138 · doi:10.4236/ojog.2011.13025 · W2001331442
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-08 ⓘ

This report details a successful laparoscopic removal of a left round ligament fibroid in a young woman, also highlighting the common co-occurrence of endometriosis and interstitial cystitis in chronic pelvic pain.

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The paper reports a case of a 24-year-old gravida 0 woman with a left round ligament (intra-ligamentous) fibroid who was successfully treated laparoscopically, with operative findings including severe bilateral adnexal adhesions, severe adhesions of the liver to the anterior abdominal wall, pigmented areas on the left tube, uterus, and posterior broad ligament that proved to be endometriosis, and findings consistent with interstitial cystitis (a low-capacity bladder with glomerulations and Hunner’s ulcers). The main finding is that laparoscopic management of an intra-ligamentous tumor was feasible in the context of multiple coexisting chronic pelvic pain conditions. A key caveat is that the evidence is limited to a single case report. This paper is centrally about endometriosis — it documents intraoperative discovery and histologic confirmation of endometriosis alongside management of an intra-ligamentous fibroid.

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Abstract

In this paper, we report the case of a left round ligament fibroid in a 24 year-old, gravida 0, female that was successfully managed laparoscopically. Operative findings also included severe adnexal adhesions bilaterally, severe adhesions of the liver to the anterior abdominal wall (Fitz-Hugh-Curtis syndrome), pigmented areas on the left tube, uterus and posterior broad ligament (that proved to be endometriosis), and low capacity bladder (450 cc at 70 cm water pressure) with florid glomerulations and Hunner’s ulcers consistent with typical interstitial cystitis. Beside the feasibility of laparoscopic management of intra-ligamentous tumors this case highlights the common multifactorial nature of chronic pelvic pain and the frequent association of endometriosis and interstitial cystitis.
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Intra-ligamentous fibroid removed laparoscopically () Richard L. Heaton, M. Sami Walid DOI: 10.4236/ojog.2011.13025 PDF HTML 7,036 Downloads 11,859 Views Citations DOI: 10.4236/ojog.2011.13025 PDF HTML 7,036 Downloads 11,859 Views Citations In this paper, we report the case of a left round ligament fibroid in a 24 year-old, gravida 0, female that was successfully managed laparoscopically. Operative findings also included severe adnexal adhesions bilaterally, severe adhesions of the liver to the anterior abdominal wall (Fitz-Hugh-Curtis syndrome), pigmented areas on the left tube, uterus and posterior broad ligament (that proved to be endometriosis), and low capacity bladder (450 cc at 70 cm water pressure) with florid glomerulations and Hunner’s ulcers consistent with typical interstitial cystitis. Beside the feasibility of laparoscopic management of intra-ligamentous tumors this case highlights the common multifactorial nature of chronic pelvic pain and the frequent association of endometriosis and interstitial cystitis. Keywords Intra-Ligamentous, Round Ligament, Fibroid, Leiomyoma, Pelvic Pain, Endometriosis, Interstitial Cystitis Share and Cite: Heaton, R. and Walid, M. (2011) Intra-ligamentous fibroid removed laparoscopically. Open Journal of Obstetrics and Gynecology, 1, 136-138. doi: 10.4236/ojog.2011.13025. Conflicts of Interest The authors declare no conflicts of interest. | [1] | Michel, P. and Viola, D. (2003) Abdominopelvic leiomyoma of the round ligament: Contribution of computed tomography and magnetic resonance imaging. Journal of Gynecology and Obstetric Biology Reproductive, 32, 571-574. | | [2] | Vignali, M., Bertulessi, C., Spreafico, C. and Busacca, M. (2006) A large symptomatic leiomyoma of the round ligament. Minimally Invasive Gynecology, 13, 375-376. doi:10.1016/j.jmig.2006.03.008 | | [3] | Grossman, S.L. and Cheung, V.Y. (1999) Round ligament fibroid. Journal of Obstetrics and Gynaecology of Canadian, 29, 109-110. | | [4] | Warshauer, D.M. and Mandel, S.R. (1999) Leiomyoma of the extra-peritoneal round ligament: CT demonstration. Clinical Imaging, 23, 375-376. doi:10.1016/S0899-7071(98)00021-7 | | [5] | Losch, A., Haider-Angeler, M.G., Kainz, C., Breitenecker, G. and Lahodny, J. (1999) Leiomyoma of the round ligament in a post-menopausal woman. Maturitas, 31, 133-135. | | [6] | Walid, M.S. and Heaton, R.L. (2010) Endometriosis/adenomyosis is associated with more typical cystoscopic findings of interstitial cystitis in patients with elevated PUF scores. Gynecological Surgery, 7, 353-357. doi:10.1007/s10397-010-0587-y | | [7] | Glemain, P., Rivière, C., Lenormand, L., Karam, G., Bouchot, O. and Buzelin, J.M. (2002) Prolonged hydrodistention of the bladder for symptomatic treatment of interstitial cystitis: Efficacy at 6 months and 1 year. European Urology, 41, 79-84. doi:10.1016/S0302-2838(01)00006-9 | | [8] | Uimari, O., Jarvela, I. and Ryynanen, M. (2011) Do symptomatic endometriosis and uterine fibroids appear together? Journal of Human Reproductive Science, 4, 34-38. doi:10.4103/0974-1208.82358 | | [9] | Kitawaki, J., Obayashi, H., Ishihara, H., Koshiba, H., Kusuki, I., HKado, N., Tsukamoto, K., Hasegawa, G., Nakamura, N. and Honjo, H. (2001) Oestrogen receptoralpha gene polymorphism is associated with endometriosis, adenomyosis and leiomyomata. Human Reproductive, 16, 51-55. doi:10.1093/humrep/16.1.51 | | [10] | Walid, M.S. and Heaton, R.L. (2009) Dyspareunia: A complex problem requiring a selective approach. Sex Health, 6, 250-253. doi:10.1071/SH09033 | | [11] | Rigaud, J., HDelavierre, DH., Sibert, L. and Labat, J.J. (2010) Hydrodistension in the therapeutic management of painful bladder syndrome. Prog Urology, 20, 1054-1059. doi:10.1016/j.purol.2010.08.049 | Copyright © 2026 by authors and Scientific Research Publishing Inc. This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.

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