Abdominopelvic leiomyoma with large ascites: a case report and literature review

Abstract BackgroundLeiomyoma of the uterus is relatively common, but uterine leiomyoma of the greater omentum is rare. Case presentationHere, we report a case of a 22-year-old woman who presented with a 3-month history of progressive abdominal distension and a hypervascular abdominopelvic mass. Due to a high serum concentration of CA125, the preoperative diagnosis was unclear. During surgery, 5 L of ascites was removed. An 18.8-cm solid mass, which was pedunculated from the uterine fundus and exhibited complex adhesion to the greater omentum, was removed. The CA125 level was reduced postoperatively, and a pathologic study confirmed that the mass was a leiomyoma that originated in the uterus.ConclusionUterine leiomyoma can share vessels with the greater omentum. This case highlights the difficulty of diagnosing pseudo-Meigs syndrome and the importance of imaging and laboratory examinations.