Leiomyoma of the anterior abdominal wall in a pregnant woman - a rare case report

Abstract

Fibroid or leiomyoma is the commonest benign tumor of the female reproductive tract, arising most commonly from the uterus. Other sites include the broad ligament,  ovaries, and vagina. Rarely fibroid may arise in the anterior abdominal wall following seedling after surgical resection of uterine fibroids. A 28 years old woman, G2P1L1, previous LSCS, 38 weeks gestation was referred as fibroid  complicating pregnancy in labour for further management. A hard ballotable mass of 6x6 cm was felt superficially in  suprapubic and right iliac fossa region which was suspected to be a subserous fibroid. Repeat LSCS was planned and abdomen was opened through a RPM incision, as there was a mass in the lower portion of the abdomen. Intra operatively there was no fibroid in the uterus or broad ligament. LSCS was proceeded in usual way. A hard mass 10x10 cm was found in the right rectus abdominis muscle and its sheath with no intraabdominal attachements. The mass was well   circumscribed and capsulated with good plane of cleavage and the same was enucleated. Provisional diagnosis of           desmoid tumor was made but the HPE turned out to be leiomyoma. There are very few reported cases of isolated abdominal wall fibroids in the literature without previous  surgeries for myomectomies. To our knowledge this is the first case of leiomyoma of the anterior abdominal wall in a   pregnant woman reported in literature. Our patient had no previous history of gynecological surgery.