Objective: To report the management of a large uterine leiomyoma with diffuse cystic degeneration in a patient
with autosomal dominant polycystic kidney disease (ADPKD).
Design: Case Report.
Setting: Cleveland Clinic Florida, Department of Gynecology, Section of Minimally Invasive Gynecologic surgery,
Weston Florida.
Patient(s): A 52-year old woman with ADPKD with a large abdominal mass, abnormal uterine bleeding and
symptomatic anemia. Imaging revealed a giant intramural cystic lesion of the uterus compressing the inferior
vena cava.
Intervention(s): Uterine artery embolization and blood transfusion followed by a computed tomography guided
cyst aspiration were performed on admission to alleviate anemia and abdominal pain and distension. Total laparoscopic
hysterectomy with bilateral salpingectomy was performed in an outpatient setting.
Main Outcome Measure(s): Management of large cystic degeneration of leiomyoma.
Results: Normal recovery from definitive surgery. Surgical pathology confirmed a benign, cystically dilated
leiomyoma.
Conclusion: This case demonstrates the management of giant intramural cyst lesion of the uterus using a minimally
invasive surgical approach, as opposed to emergency surgery via laparotomy.
Capsule: Large uterine leiomyoma with diffuse cystic degeneration in a patient with autosomal dominant polycystic
kidney disease, in which step-wise treatments allows successful minimally invasive hysterectomy.
© 2016 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license