A Bolt from the Blue A Rare Case of Peritoneal Vascular Leiomyoma in A Middle -Aged Woman
Leiomyomas are benign tumors of muscle cell origin, often called fibroids or fibromyomas. In the uterus, they may be intramural, subserous or submucosal type in location however, rare cases such as extrauterine leiomyomas and that of a vascular leiomyoma are also reported. These unusual locations and presentations make their indentifications more challenging both clinically and radiologically. There are only a few cases of retroperitoneal angioleiomyoma reported in the literature. Paal and Miettinen reported a large series of retroperitoneal tumors including 56 patients; only one of them had prominent vascular pattern, that of a solid variant of angioleiomyoma. Presented is a rare case of a Vascular type of peritoneal leiomyoma in a 42 year old woman who complained of an on and off right lower quadrant pain in a year prior to surgery. She underwent total hysterectomy with excision of the peritoneal mass with a final histopathology report of a spindle cell tumor favor vascular leiomymoa with myxomatous degeneration peritoeal mass, proliferative endometrium, foci of adenomyosis, corpus uteri, chronic endocervicitis with squamous metaplasia and nabothian cysts. An in depth analysis of a vascular type of leiomyoma, its presentation, etiology, differential diagnosis and its management are likewise discussed in this paper.