Abstract

 Introduction: Fibroid is the most common tumour of the female genital tract and is usually easily diagnosed. However, at times, due to certain morphological changes, fibroid can be a diagnostic challenge to the physician. Here, we present a case of a pedunculated fibroid misdiagnosed as ovarian neoplasm, which on laparotomy revealed an unusual morphology.

Case Report: A peri-menopausal lady presented with heavy menstrual bleeding and a large, non-tender and firm supra-pubic mass. Abdominal imaging revealed the mass to be solid and arising from the right adnexa. Hence, the diagnosis of ovarian neoplasm was suspected. The patient underwent staging laparotomy, after a thorough clinical and diagnostic evaluation. Intra-operatively the mass was well defined, glistening white and was adherent to the right cornual region of the normal sized uterus, by a fleshy pedicle. Both the ovaries and tubes were normal. The patient was diagnosed to be a case of pedunculated fibroid and underwent total abdominal hysterectomy with bilateral salpingo-oophrectomy. The diagnosis was confirmed on histopathological examination.

Conclusion: Atypical morphology of fibroid can occur. Subserous/pedunculated fibroids should be considered as a differential in the evaluation of adnexal masses.