Images in Gynecologic Surgery
Gossypiboma Misdiagnosed as Uterine Subserosal Myoma Tae-Hee Kim, MD, PhD, and Hae-Hyeog Lee, MD, PhD* From the Department of Obstetrics and Gynecology, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea (both authors).
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A 55-year-old postmenopausal woman was admitted with lower abdominal and back pain. She had undergone a bilateral tubal ligation 30 years earlier, a tubal reanastomosis 25 years earlier, and a transobturator tape procedure for urge incontinence 2 years earlier. A pelvic examination revealed a posterior cul-de-sac mass and cervix motion tenderness. Magnetic resonance imaging of the pelvis revealed a large calcified mass in the pelvic cavity, which
was a large calcified subserosal myoma or a calcified solid left ovarian tumor (Fig. 1A). The 9-cm long axis of the mass was covered with the small bowel, omentum, uterus, and both Fallopian tubes in the cul-de-sac area on laparoscopic findings. We performed adhesiolysis for the small bowel and uterus in the cul-de-sac and found a yellowishcolored mass of surgical towel, which was removed (Fig. 1B).
Fig. 1 (A) Magnetic resonance imaging reveals a 9 ! 5 ! 5 cm mixed echogenic mass in the posterior cul-de-sac area and severe adhesions to the uterus, left adnexa, and sigmoid colon. (B) Laparoscopic findings reveal glistening and an internal area whitish-colored mass in the cul-de-sac area.
The author declares no conflict of interest. Supported in part by the Soonchunhyang University Research Fund. Corresponding author: Hae-Hyeog Lee, MD, PhD, Department of Obstetrics and Gynecology, Soonchunhyang University Bucheon Hospital, 170 Jomaruro, Wonmi-gu, Bucheon-si, Gyeunggi-do, 420-767, Republic of Korea. E-mail: [email protected] Submitted November 3, 2014. Accepted for publication November 6, 2014. Available at www.sciencedirect.com and www.jmig.org 1553-4650/$ - see front matter Ó 2015 AAGL. All rights reserved. http://dx.doi.org/10.1016/j.jmig.2014.11.004
Gossypiboma Misdiagnosed as Uterine Subserosal Myoma Tae-Hee Kim, MD, PhD, and Hae-Hyeog Lee, MD, PhD* From the Department of Obstetrics and Gynecology, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea (both authors).
DISCUSS
You can discuss this article with its authors and with other AAGL members at http://www.AAGL.org/jmig-22-3-JMIG-D-14-00548
Use your Smartphone to scan this QR code and connect to the discussion forum for this article now* * Download a free QR Code scanner by searching for ‘‘QR scanner’’ in your smartphone’s app store or app marketplace.
A 55-year-old postmenopausal woman was admitted with lower abdominal and back pain. She had undergone a bilateral tubal ligation 30 years earlier, a tubal reanastomosis 25 years earlier, and a transobturator tape procedure for urge incontinence 2 years earlier. A pelvic examination revealed a posterior cul-de-sac mass and cervix motion tenderness. Magnetic resonance imaging of the pelvis revealed a large calcified mass in the pelvic cavity, which
was a large calcified subserosal myoma or a calcified solid left ovarian tumor (Fig. 1A). The 9-cm long axis of the mass was covered with the small bowel, omentum, uterus, and both Fallopian tubes in the cul-de-sac area on laparoscopic findings. We performed adhesiolysis for the small bowel and uterus in the cul-de-sac and found a yellowishcolored mass of surgical towel, which was removed (Fig. 1B).
Fig. 1 (A) Magnetic resonance imaging reveals a 9 ! 5 ! 5 cm mixed echogenic mass in the posterior cul-de-sac area and severe adhesions to the uterus, left adnexa, and sigmoid colon. (B) Laparoscopic findings reveal glistening and an internal area whitish-colored mass in the cul-de-sac area.
The author declares no conflict of interest. Supported in part by the Soonchunhyang University Research Fund. Corresponding author: Hae-Hyeog Lee, MD, PhD, Department of Obstetrics and Gynecology, Soonchunhyang University Bucheon Hospital, 170 Jomaruro, Wonmi-gu, Bucheon-si, Gyeunggi-do, 420-767, Republic of Korea. E-mail: [email protected] Submitted November 3, 2014. Accepted for publication November 6, 2014. Available at www.sciencedirect.com and www.jmig.org 1553-4650/$ - see front matter Ó 2015 AAGL. All rights reserved. http://dx.doi.org/10.1016/j.jmig.2014.11.004
