# The Differential Diagnosis of Abdominal Mass: A Case of Uterine Leiomyoma

## TL;DR

This case report describes a postmenopausal woman diagnosed with a uterine fibroid after presenting with abdominal pain, highlighting the importance of accurate diagnosis and timely surgical management.

## Contribution

The paper presents a clinical case emphasizing the diagnostic process and surgical management of uterine leiomyoma in a postmenopausal patient.

## Key findings

- A 53-year-old postmenopausal woman presented with right-sided abdominal pain and was diagnosed with a uterine fibroid.
- MRI confirmed the diagnosis, and surgical management included hysterectomy and bilateral salpingo-oophorectomy.
- Intraoperative findings confirmed the presence of a benign uterine leiomyoma.

## Abstract

The most common benign neoplastic uterine tumors that grow monoclonally from the smooth muscle cells of the uterus are uterine fibroids or leiomyomas, which may occur as a single lesion or as multiple lesions with variation in size from microscopic to large macroscopic extent. The majority are diagnosed in the preclinical routine reliably, despite challenges due to the possibility of multiple differential diagnoses. Hence, this report highlights a case of a postmenopausal female of 53-year-old working as a staff nurse at the same hospital and who visited the outpatient department of obstetrics and gynecology with chief complaints of pain in the right side of the abdomen for four hours (presentation similar to that of appendicitis). Per abdomen examination resulted in a non-tender mass with flank fullness and firmness with a smooth surface and approachable lower border. It clinically appeared as a large uterine fibroid. The built of the patient was obese due to which neither the patient nor relatives were ever able to make out any evident symptoms. The diagnostic investigation involved a magnetic resonance imaging (MRI) that confirmed the diagnosis of two parity with both living, and two were aborted (P2L2A2) with uterine fibroid. The management of the fibroid consisted of exploratory laparotomy along with a hysterectomy and bilateral salpingo-oophorectomy. The intraoperative findings and frozen section report confirmed the presence of benign uterine leiomyoma. Therefore, the utilization of physical examinations and diagnostic tests may assist in preventing a delay in the detection and management of curable conditions such as fibroids, which can be treated without complications with surgery.