Laparoscopic Myomectomy – Converting to Laparotomy for a Suspicious Intraoperative Appearance with Subsequent Benign Histology – a Pre- and Intra-Operative Dilemma

Figures & data

Figure 1 Longitudinal view of the uterus with a single 12 cm subserosal fibroid on transabdominal ultrasound scan. Feeder pedicle vessels are demonstrated on Doppler examination.

Figure 2 Hysteroscopic view of the uterine cavity showing a 2cm endometrial polyp arising from the left posterolateral aspect of the cavity.

Figure 3 (A) Laparoscopic view of the pelvis and uterine mass. (B) Post surgical excision of the uterine mas. The multinodular mass weighed 482g with large surface vessels and a friable irregular contour. The cut surface was haemorrhagic, lobulated, tan and dark brown with areas of cystic cavities.

Figure 4 Histology slides from the specimen confirming the diagnosis of benign adenomyoma. (A) Endometrial glands and macrophages. (B) Endometrial glands and smooth muscle. (C) Endometrial glands with no atypia. (D) Areas of hyalinisation.