Abstract：ObjectiveTo investigate the diagnostic features of giant multilocular cystic leiomyoma of uterus. MethodsThe clinical data of a newly diagnosed patient with a giant pelvic cavity mass admitted to the Gynecology Department of Shandong Provincial Hospital on August 5, 2023 were collected, and the literature was reviewed to summarize the diagnostic features of giant multilocular cystic leiomyoma. ResultsThe patient, a 36-year-old female, had experienced abdominal enlargement for more than 2 years, with worsening symptoms over the past 2 months, accompanied by frequent urination, ascites, and weight gain. Ultrasound examination revealed a large cystic-solid mass in the abdominal pelvic cavity, initially suspected as an ovarian malignancy, and a cystic mass in the right adnexal area, suspected to be a teratoma, and subserous myoma of the uterus. Enhanced CT of the pelvis and abdomen initially suggested ovarian cystadenocarcinoma. The pathological diagnosis was giant multilocular cystic leiomyoma in the pelvic cavity, with a maximum transverse diameter of 49.2cm, complicated with mature cystic teratoma of the ovary and leiomyoma of the uterus. The patient was followed up for 17 months after resection without recurrence. ConclusionGiant multilocular cystic leiomyoma, characterized by rare cystic changes and large size, is difficult to diagnose by imaging examination and needs to be confirmed by histopathology and immunohistochemistry.
张茜茹 袁迎雪 曹智新. 巨大多房囊性子宫平滑肌瘤的诊断学特征并文献复习[J]. 中华诊断学电子杂志, 2025, 13(1): 32-37.
Zhang Xiru, Yuan Yingxue, Cao Zhixin.. Diagnostic features and literature review of giant multilocular cystic leiomyoma of the uterus. zhzdx, 2025, 13(1): 32-37.
［1］娄诤，李春明，周坚红.子宫肌瘤病因与预防［J］.实用妇产科杂志，2024，40(2):81-84.
［2］Jonas HS，Masterson BJ.Giant uterine tumors：case report and review of the literature［J］.Obstet Gynecol，1977，50(1 Suppl):2s-4s.
［3］管庆美，杜欣.经脐单孔腹腔镜剔除径长27cm子宫肌瘤1例并文献复习 ［J］.中国计划生育和妇产科，2024，16(9)：18-20.DOI:10.3969/j.issn.1674-4020.2024.09.06.
［4］Yamamoto A，Suzuki S.Successful surgical treatment of a giant uterine leiomyoma：a case report［J］.Int J Surg Case Rep，2021（87）:106416.DOI：10.1016/j.ijscr.2021.106416.
［5］Mathew RP，Francis S，Jayaram V，et al.Uterine leiomyomas revisited with review of literature［J］.Abdom Radiol (NY)，2021，46(10):4908-4926.DOI：10.1007/s00261-021-03126-4.
［6］Mongan S，Wibowo A.Giant uterine leiomyoma with surgical difficulty［J］.J Med Cases，2021，12(10):386-390.DOI：10.14740/jmc3764.
［7］Arnolds K，Senderey E，Sprague ML，et al.Giant cystic degeneration of a uterine leiomyoma in a patient with autosomal dominant polycystic kidney disease［J］.Case Rep Womens Health，2016(10):1-3.DOI：10.1016/j.crwh.2016.04.001.
［8］Yaguchi A，Ban K，Koshida Y，et al.Pseudo-Meigs syndrome caused by a giant uterine leiomyoma with cystic degeneration：a case report［J］.J Nippon Med Sch，2020，87(2):80-86.DOI：10.1272/jnms.JNMS.2020_87-205.
［9］Akkour K，Alhulwah M，Alqahtani N，et al.A giant leiomyoma with massive cystic hydropic degeneration mimicking an aggressive neoplasm：a challenging case with a literature review［J］.Am J Case Rep，2021(22):e929085.DOI：10.12659/AJCR.929085.
［10］Omori M， Ogawa T， Nara M， et al. Umbilical endometriosis with giant degenerated uterine leiomyomas：a case report［J］.Gynecol Oncol Case Rep，2014(9):18-20.DOI：10.1016/j.gynor.2014.04.004.
［11］Wang X，Ren J，Chen G，et al.Giant abdominal leiomyoma of male：a case report and literature reviews［J］.Int J Clin Exp Pathol，2015，8(7):8532-8535.
［12］Sotomayor CG， Parra C， Miranda M， et al. Hyaline and cystic degeneration of uterine leiomyomas：CT and MR imaging with histopathological sample analyses［J］.Diagnostics (Basel)，2023，13(20):3230.DOI：10.3390/diagnostics13203230.
［13］Pijnenburg L，Felten R，Javier RM.A review of avascular necrosis，of the hip and beyond［J］.Rev Med Interne，2020，41(1):27-36.DOI：10.1016/j.revmed.2019.10.332.
［14］Babacan A，Kizilaslan C，Gun I，et al.CA 125 and other tumor markers in uterine leiomyomas and their association with lesion characteristics［J］.Int J Clin Exp Med，2014，7(4):1078-1083.
［15］Yamaguchi T，Kyozuka H，Kochi Y，et al.Hydropic leiomyoma-like ovarian tumor：a case report［J］.Fukushima J Med Sci，2024，70(2):93-98.DOI：10.5387/fms.2023-22.
［16］Tanaka T，Noguchi S，Wada Y，et al.Computed tomography and magnetic resonance imaging findings in dogs with vaginal leiomyoma and leiomyosarcoma［J］.Vet Med Sci，2022，8(6):2337-2344.DOI：10.1002/vms3.930.
［17］Cong L，Wang S，Yeung SY，et al.Mature cystic teratoma：an integrated review［J］.Int J Mol Sci，2023，24(7):6141.DOI：10.3390/ijms24076141.
［18］Qu Y，Chen L，Guo S，et al.Genetic liability to multiple factors and uterine leiomyoma risk：a Mendelian randomization study［J］.Front Endocrinol (Lausanne)，2023(14):1133260.DOI：10.3389/fendo.2023.1133260.
［19］Wang J，Yang Q，Zhang N，et al.Uterine angiomyolipoma：a clinical analysis of 8 cases and literature review［J］.Arch Gynecol Obstet，2021，304(1):171-177.DOI：10.1007/s00404-021-05992-1.
［20］Sparic＇ R，Andjic＇ M，Babovic＇ I，et al.Molecular insights in uterine leiomyosarcoma：a systematic review［J］.Int J Mol Sci，2022，23(17).DOI：10.3390/ijms23179728.
