The occurrence of internal hernia through a defect in the broad ligament is a very rare condition, which may cause small bowel obstruction. This is a case of a 50-year-old woman who developed intestinal obstruction induced by internal hernia and who had undergone laparoscopic myomectomy 7 years prior to visiting our emergency room. Abdominopelvic computed tomography showed luminal narrowing of the ileum and dilatation of the pelvic loop of the small bowel at the left side of the uterus. We detected internal hernia through the defect in the broad ligament and managed it successfully by performing a laparoscopic procedure using a barbed suture, V-Loc (Covidien, Mansfield, MA).
Broad Ligament* ; Dilatation ; Emergency Service, Hospital ; Female ; Hernia* ; Humans ; Ileum ; Intestinal Obstruction ; Laparoscopy ; Middle Aged ; Phenobarbital ; Sutures* ; Uterus*

Hernias through the broad ligament are rare with a reported incidence of only 4-7% of cases of internal hernias. Here, we report on a rare case of incarcerated internal hernia through a spontaneous defect in the broad ligament which was repaired using a laparoscopic technique. A 41-year-old female was admitted with colic abdominal pain. Laparoscopic exploration was performed for the diagnosis of intestinal obstruction. Laparoscopic examination confirmed an approximately 10-cm-long ileal loop herniated in the anterior to posterior direction through a left broad ligament defect. A large defect in the broad ligament was closed by an intracorporeal continuous running suture. The patient was highly satisfied with the cosmetic result. In conclusion, laparoscopy could be particularly helpful during pelvic surgery, which usually requires large skin incisions to ensure a good field of view. This approach was cosmetically effective, decreased the postoperative complications, and promoted early recovery to usual activity.
Abdominal Pain ; Adult ; Broad Ligament* ; Colic ; Diagnosis ; Female ; Hernia* ; Humans ; Incidence ; Intestinal Obstruction ; Laparoscopy* ; Postoperative Complications ; Running ; Skin ; Sutures

Lipoleiomyoma is an uncommon neoplasm of the uterus, composed of smooth muscles intermixed with mature adipocytes. These tumors are considered a benign variant of uterine leiomyomas. Herein, we report six cases of lipoleiomyoma experienced in our institution from January 2005 to March 2015. The patients ranged in age from 45 to 70 years; the etiology may be related to estrogen deficiency occurring after menopausal transition. Except for one lipoleiomyoma in the broad ligament, all others were found in the uterine corpus. The presenting symptoms were nonspecific, and most cases were incidentally diagnosed during surgery for other reasons. We performed preoperative imaging studies, including abdominal and pelvic computed tomography and magnetic resonance imaging. Preoperatively, four patients were diagnosed as having a pelvic mass and one patient was diagnosed as having a right ovarian mature teratoma. In one case, we found a gynecologic malignancy (cervical cancer 1A1). Histologically, there was no gross or microscopic contiguity between the lipoleiomyoma and the malignancy. Lipoleiomyomas seem to have a benign clinical course. In our study, there were no recurrences of or deaths attributed to the lipoleiomyomas during a mean follow-up period of 16.17 +/- 23.80 months.
Adipocytes ; Broad Ligament ; Estrogens ; Female ; Follow-Up Studies ; Humans ; Leiomyoma ; Magnetic Resonance Imaging ; Muscle, Smooth ; Myofibroma ; Perimenopause ; Postmenopause ; Recurrence ; Teratoma ; Uterus

Leiomyomas are very common benign tumors in the uterus and it is rare condition to present the retroperitoneal leiomyoma. The author reported a 48-year-old female patient who presented right pelvic mass with urinary incontinence and lower abdominal discomfort. Based on the preoperative imaging, provisional diagnosis was mesenchymal sarcoma. In the intraoperative findings, huge mass abutting to the uterus was observed in retroperitoneal space beneath the right broad ligament. After the exposure the retroperitoneal space, we encountered the well-demarcated tumor measuring 8 x 6 cm in diameter and this tumor attached the right surface of the uterus with fibrotic tissue. Pathologic findings demonstrated retroperitoneal uterine leiomyoma.
Broad Ligament ; Diagnosis ; Female ; Humans ; Leiomyoma* ; Middle Aged ; Retroperitoneal Neoplasms ; Retroperitoneal Space ; Sarcoma* ; Urinary Incontinence ; Uterus*

A broad ligament pregnancy is an extremely rare condition. Diagnosis is often missed and finally made during laparotomy. We present a case which remained undiagnosed throughout her pregnancy till she reached term and unfortunately had intrauterine foetal demise when she reported to our hospital. On clinical suspicion, ultrasound and magnetic resonance imaging evaluation was done which picked up the diagnosis of abdominal pregnancy. On laparotomy a broad ligament pregnancy was found with a rent in the previous Cesarean scar towards the gestational sac in the broad ligament.
Rare Diseases ; Broad Ligament* ; Cicatrix ; Diagnosis ; Female ; Gestational Sac ; Laparotomy ; Magnetic Resonance Imaging ; Pregnancy ; Pregnancy, Abdominal ; Pregnancy, Ectopic* ; Ultrasonography

Disseminated peritoneal leiomyomatosis is rare condition characterized by multiple subperitoneal nodules of benign smooth muscle proliferations. It is associated with high level of estrogen such as pregnancy, oral contraceptives or estrogen producing ovarian tumor, and occasionally associated with operation history of myomectomy or hysterectomy. Clinical course of disseminated peritoneal leiomyomatosis is usually benign, but malignant changes also rarely have been reported. We experienced a case of disseminated peritoneal leiomyomatosis who has history of laparoscopic myomectomy 10 years ago. The patient was a 35-year-old woman, and her chief complaint was palpable masses in lower abdomen. She underwent laparoscopic surgery which revealed numerous solid masses on the surface of peritoneum, descending colon, rectosigmoid colon, uterus, round ligament, and broad ligament. We present it with a brief review of literature.
Abdomen ; Adult ; Broad Ligament ; Colon ; Colon, Descending ; Contraceptives, Oral ; Estrogens ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Leiomyomatosis ; Muscle, Smooth ; Peritoneum ; Pregnancy ; Round Ligament of Uterus ; Uterus

Lipoleiomyoma is a very rare tumor which is composed of adipocytes and smooth muscle cells. It is most commonly located in uterine corpus although cervical, ovarian, and retroperitoneal locations were also reported. Lipoleiomyoma located in broad ligament is extremely uncommon and only five cases were reported to date. Here, we report the sixth case of lipoleiomyoma of broad ligament which was diagnosed in a postmenopausal woman who was subjected to exploratory laparotomy with a preoperative diagnosis of a solid adnexal mass suggesting an ovarian malignancy.
Adipocytes ; Broad Ligament ; Female ; Humans ; Laparotomy ; Myocytes, Smooth Muscle ; Ovarian Neoplasms

Female adnexal tumors of probable Wolffian origin (FATWO) are rare. Although the histological features of the benign tumors are recognized, features of malignancy are not well defined in published work because these tumors are particularly rare. In this study, we report a 52-year-old woman with a High malignant FATWO. The frozen biopsy of the fragile uterine mass, located at the left broad ligament, revealed a malignant FATWO with high mitotic figure (up to 36/10 HPF). The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and paraaortic and pelvic lymph node dissection. Pathologic findings were consistent with malignant FATWO infiltrating to the unilateral salpinx without lymph node metastasis. The patient received three cycles of adjuvant treatment with paclitaxel and carboplatin. There was no clinical evidence of recurrence during the 12 months of follow-up; the patient is currently still being followed-up.
Adenoma ; Adnexal Diseases ; Biopsy ; Broad Ligament ; Carboplatin ; Fallopian Tubes ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Paclitaxel ; Recurrence

Primary broad ligament tumors are a rare entity, although secondary involvement of broad ligament by a malignancy arising elsewhrere in the abdomen/pelvis is common. Among the primary broad ligament tumors, leiomyoma is the most frequent histopathological type followed by serous papillary cystadenoma of borderline malignancy. Primary sarcomas and high-grade carcinomas have been extremely rarely reported. Because of the rarity of disease, its treatment policy, follow-up strategy and prognosis are yet to be established and it is managed as an ovarian malignancy. We had experienced a case of clear cell adenocarcinoma arising from broad ligament and report this case with a brief review of literature.
Adenocarcinoma, Clear Cell ; Broad Ligament ; Cystadenoma, Papillary ; Female ; Follow-Up Studies ; Leiomyoma ; Prognosis ; Sarcoma

Paratubal cysts come from paraovarium of the broad ligament between the fallopian tube and ovary. Overall, these cysts constitute 10% of all adnexal masses and are commonly incidental findings upon surgical exploration for other reasons. They more commonly occur in women between 30 and 40 years of age. We report two cases of rapidly growing, huge paratubal cysts in young women, which are presented with brief review of literature.
Broad Ligament ; Fallopian Tubes ; Female ; Humans ; Incidental Findings ; Ovary ; Parovarian Cyst