Retroperitoneal benign leiomyoma is a challenging diagnosis in gynecology: report of two cases

Background: Leiomyomas represent rare primary retroperitoneal tumors. Preoperative diagnosis is challenging due to the low incidence, non-specific clinical presentation, and atypical radiological features. Case Report: The authors describe two cases of retroperitoneal tumors that resulted to be rare retroperitoneal leiomyomas. The degenerating process of the tumors created atypical conditions that explained the difficult diagnosis at imaging and the absence of compression syndrome. MRI has not been useful in this case to highlight preoperative diagnosis. Diagnosis was only made postoperatively based on final anatomopathological results. Complete surgical excision was achieved in both cases and patients are free of recurrence after a very long period of follow up. Conclusion: The very low incidence and non-specific clinical presentation of retroperitoneal leiomyomas make the diagnosis challenging. Preoperative imaging can be misleading mostly when tissue degeneration exists. The treatment consists in complete surgical excision. Histopathological analysis is essential to diagnosis. Conclusions: Retroperitoneal leiomyomas are rare retroperitoneal tumors. Diagnosis is challenging due to the low incidence, poor clinical presentation, and atypical radiologic features. Tissue degeneration is common in retroperitoneal leiomyomas. This partially explains the absence of compression syndrome and atypical features on radiology.

Leiomyosarcoma; MRI; Retroperitoneal leiomyoma

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