Case report of asymptomatic peritoneal leimyomas.

Eur J Obstet Gynecol Reprod Biol. 2010 Feb;148(2):205-6. Epub 2009 Nov 5. Case report of asymptomatic peritoneal leiomyomas. Pezzuto A, Pontrelli G, Ceccaroni M, Ferrari B, Nardelli GB, Minelli L. We would like to report the history of a fertile 45-year-old woman, referred for persistent metrorrhagia with sonographic evidence of multiple uterine myomas. An endometrial biopsy was performed and a normal endometrium was found from a histological point of view. In due time, she underwent laparoscopic-assisted vaginal hysterectomy with preservation of the ovaries. During surgery, evidence of several intramural fibroids was recorded along with two large pedunculated myomas. After colpotomy, two further myomas of 5 and 3 cm were identified as completely detached from the uterus. They appeared pedunculated (with their vascularization) to the perirectal peritoneum (Fig. 1). Therefore the two fibroids were removed and extracted through the vagina after diathermy coagulation of their vascular stems. From a histological point of view these fibroids were identical to a normal leiomyoma, consisting of fascicles of smooth muscle cells without mitotic figures or nuclear pleomorphism.