Abstract
Although broad ligament myomas are the most common of the extrauterine myomas, they are rare, with an incidence of approximately 1%. Their location can cause unusual presentations and potentially compromise the accuracy of a preoperative diagnosis. Because the location is peculiar due to the complex anatomy in this region (i.e., ureters and internal iliac and obturator vessels and nerves), the surgeon must pay close attention during dissection.
References
Sparic R, Mirkovic L, Malvasi A, Tinelli A. Epidemiology of uterine myomas: a review. Int J Fertil Steril. 2016;9(4):424–35.
Rein MS, Barbieri RL, Friedman AJ. Progesterone: a critical role in the pathogenesis of uterine myomas. Am J Obstet Gynecol. 1995;172(1 Pt 1):14–8.
Andersen J. Growth factors and cytokines in uterine leiomyomas. Semin Reprod Endocrinol. 1996;14(3):269–82.
Fields KR, Neinstein LS. Uterine myomas in adolescents: case reports and a review of the literature. J Pediatr Adolesc Gynecol. 1996;9(4):195–8.
Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol. 1990;94(4):435–8.
Ryan GL, Syrop CH, Van Voorhis BJ. Role, epidemiology, and natural history of benign uterine mass lesions. Clin Obstet Gynecol. 2005;48(2):312–24.
Lippman SA, Warner M, Samuels S, Olive D, Vercellini P, Eskenazi B. Uterine fibroids and gynecologic pain symptoms in a population-based study. Fertil Steril. 2003;80(6):1488–94.
Sparic R, Hudelist G, Berisavac M, Gudovic A, Buzadzic S. Hysterectomy throughout history. Acta Chir Iugosl. 2011;58(4):9–14.
Farquhar CM, Steiner CA. Hysterectomy rates in the United States 1990–1997. Obstet Gynecol. 2002;99(2):229–34.
Merrill RM. Hysterectomy surveillance in the United States, 1997 through 2005. Med Sci Monit. 2008;14(1):CR24–31.
Lurie S, Piper I, Woliovitch I, Glezerman M. Age-related prevalence of sonographically confirmed uterine myomas. J Obstet Gynaecol. 2005;25:42–8.
Laughlin SK, Baird DD, Savitz DA, Herring AH, Hartmann KE. Prevalence of uterine leiomyomas in the first trimester of pregnancy: an ultrasound-screening study. Obstet Gynecol. 2009;113(3):630–5.
Chen CR, Buck GM, Courey NG, Perez KM, Wactawski-Wende J. Risk factors for uterine fibroids among women undergoing tubal sterilization. Am J Epidemiol. 2001;153(1):20–6.
Borgfeldt C, Andolf E. Transvaginal ultrasonographic findings in the uterus and the endometrium: low prevalence of leiomyoma in a random sample of women age 25–40 years. Acta Obstet Gynecol Scand. 2000;79(3):202–7.
Marino JL, Eskenazi B, Warner M, Samuels S, Vercellini P, Gavoni N, Olive D. Uterine leiomyoma and menstrual cycle characteristics in a population-based cohort study. Hum Reprod. 2004;19(10):2350–5.
Wise LA, Palmer JR, Stewart EA, Rosenberg L. Age-specific incidence rates for self-reported uterine leiomyomata in the black Women’s health study. Obstet Gynecol. 2005;105:563–8.
Kjerulff KH, Langenberg P, Seidman JD, Stolley PD, Guzinski GM. Uterine leiomyomas. Racial differences in severity, symptoms and age of diagnosis. J Reprod Med. 1996;41:483–90.
Ross RK, Pike MC, Vessey MP, Bull D, Yeates D, Casagrande JT. Risk factors for uterine fibroids: reduced risk associated with oral contraceptives [Published correction appears in Br Med J (Clin Res Ed) 1986;293:1027]. Br Med J (Clin Res Ed). 1986;293:359–62.
Ligon AH, Morton CC. Leiomyomata: heritability and cytogenetic studies. Hum Reprod Update. 2001;7:8–14.
Chiaffarino F, Parazzini F, La Vecchia C, Marsico S, Surace M, Ricci E. Use of oral contraceptives and uterine fibroids: results from a case-control study. Br J Obstet Gynaecol. 1999;106:857–60.
Lumbiganon P, Rugpao S, Phandhu-fung S, Laopaiboon M, Vudhika-mraksa N, Werawatakul Y. Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case-control study. Br J Obstet Gynaecol. 1996;103:909–14.
Kurman RJ, editor. Blaustein’s pathology of the female genital tract. 5th ed. New York: Springer; 2002.
Pallavee P, Ghose S, Begum J, et al. Fibroid after hysterectomy: diagnostic dilemma. J Clin Diagn Res. 2014;8:1–3.
Bhatla N. Tumours of the corpus uteri. Jeffcoats principles of gynaecology. 6th ed. London: Arnold Printers; 2001. p. 470.
Harrison BT, Berg RE, Mittal K. Massive ovarian edema associated with a broad ligament leiomyoma: a case report and review. Int J Gynecol Pathol. 2014;33:418–22.
Song JY. Laparoscopic resection of a rare, large broad ligament myoma. J Minim Invasive Gynecol. 2015;22(4):530–1.
Amant F, Coosemans A, Debiec-Rychter M, et al. Clinical management of uterine sarcomas. Lancet Oncol. 2009;10:1188.
Schwartz LB, Zawin M, Carcangiu ML, et al. Does pelvic magnetic resonance imaging differentiate among the histologic subtypes of uterine leiomyomata? Fertil Steril. 1998;70:580.
Goto A, Takeuchi S, Sugimura K, et al. Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus. Int J Gynecol Cancer. 2002;12:354.
Tanaka YO, Nishida M, Tsunoda H, et al. Smooth muscle tumors of uncertain malignant potential and leiomyosarcomas of the uterus: MR findings. J Magn Reson Imaging. 2004;20:998.
Baird DD, Dunson DB, Hill MC, et al. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188:100.
Brooks SE, Zhan M, Cote T, Baquet CR. Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989–1999. Gynecol Oncol. 2004;93:204.
Fang Z, Matsumoto S, Ae K, et al. Postradiation soft tissue sarcoma: a multi-institutional analysis of 14 cases in Japan. J Orthop Sci. 2004;9(3):242.
Giuntoli RL 2nd, Metzinger DS, DiMarco CS, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol. 2003;89(3):460.
Wickerham DL, Fisher B, Wolmark N, et al. Association of Tamoxifen and uterine sarcoma. J Clin Oncol. 2002;20:2758.
Wysowski DK, Honig SF, Beitz J. Uterine sarcoma associated with tamoxifen use. N Engl J Med. 2002;346:1832.
Moinfar F, Azodi M, Tavassoli FA. Uterine sarcomas. Pathology. 2007;39:55.
Launonen V, Vierimaa O, Kiuru M, et al. Inherited susceptibility to uterine leiomyomas and renal cell cancer. Proc Natl Acad Sci U S A. 2001;98(6):3387.
Toro JR, Nickerson ML, Wei MH, et al. Mutations in the fumarate hydratase gene cause hereditary leiomyomatosis and renal cell cancer in families in North America. Am J Hum Genet. 2003;73(1):95.
CL Y, Tucker MA, Abramson DH, et al. Cause-specific mortality in long-term survivors of retinoblastoma. J Natl Cancer Inst. 2009;101(8):581.
Sener AB, Seçkin NC, Ozmen S, et al. The effects of hormone replacement therapy on uterine fibroids in postmenopausal women. Fertil Steril. 1996;65(2):354.
Polatti F, Viazzo F, Colleoni R, et al. Uterine myoma in postmenopause: a comparison between two therapeutic schedules of HRT. Maturitas. 2000;37(1):27.
Ang WC, Farrell E, Vollenhoven B. Effect of hormone replacement therapies and selective estrogen receptor modulators in postmenopausal women with uterine leiomyomas: a literature review. Climacteric. 2001;4(4):284.
Yang CH, Lee JN, Hsu SC, et al. Effect of hormone replacement therapy on uterine fibroids in postmenopausal women—a 3-year study. Maturitas. 2002;43(1):35.
Song JY. Laparoscopic resection of the large broad ligament fibroid. Washington, D.C.: Surgical video session presented at the meeting of the American Association of Gynecologic Laparoscopists; 2013.
Hasson HM, Rotman C, Rana N, et al. Open laparoscopy: 29-year experience. Obstet Gynecol. 2000;96(5 P 1):763–6.
Hasson HM, Rotman C. Laparoscopic myomectomy. In: Sanfilippo JS, Levine RL, editors. Operative gynecologic endoscopy. 2nd ed. New York: Springer; 1996. p. 89–103.
Song JY, Borncamp E, Mehaffey P, Rotman C. Large abdominal wall endometrioma following laparoscopic hysterectomy. JSLS. 2011;15(2):261–3.
Rotman C, Rana N, Song JY, et al. Laparoscopic tubal anastomosis. In: Rizk B, Garcia-Velasco J, Sallam H, Makrigiannakis A, editors. Infertility and assisted reproduction. Cambridge: Cambridge University Press; 2008. p. 91–8.
Kashani BN, Centini G, Morelli S, et al. Role of medical management for uterine leiomyomas. Best Pract Res Clin Obstet Gynaecol. 2016;34:85–103.
Conforti A, Mollo A, Alviqqi C, et al. Techniques to reduce blood loss during open myomectomy: a qualitative review of literature. Eur J Obstet Gynecol Reprod Biol. 2015;192:90–5.
Zhang Y, Sun L, Guo Y, et al. The impact of preoperative gonadotropin-releasing hormone agonist treatment on women with uterine fibroids: a meta-analysis. Obstet Gynecol Surv. 2014;69(2):100–8.
Bassaw B, Mohammed N, Jaqqat A, et al. Experience with a gonadotropin-releasing hormone agonist prior to myomectomy-comparison of twice vs. thrice monthly doses and a control group. J Obstet Gynaecol. 2014;34(5):415–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
(MP4 139573 kb)
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Song, J.Y., Rotman, C., Yordan, E.L. (2018). The Broad Ligament Fibroid. In: Moawad, N. (eds) Uterine Fibroids. Springer, Cham. https://doi.org/10.1007/978-3-319-58780-6_11
Download citation
DOI: https://doi.org/10.1007/978-3-319-58780-6_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-58779-0
Online ISBN: 978-3-319-58780-6
eBook Packages: MedicineMedicine (R0)