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Massive Leiomyoma of the Broad Ligament

BACKGROUND: A primary broad ligament leiomyoma weighing greater than 50 kg presented unique perioperative complications. CASE: A postmenopausal nulligravida presented to the emergency department for a fractured patella with an incidental finding of a massive abdomen. The patient underwent laparotomy to remove a 51-kg broad ligament leiomyoma. Extensive vascularization from the tumor caused a caput medusae effect and significant bleeding from the anterior abdominal wall. The size of the mass required extensive preoperative planning. CONCLUSION: When removing a pelvic mass, consider primary broad ligament leiomyoma for its unique vascular pathophysiology and size complications.