Differential diagnosis of retroperitoneal lymphangioma mimicking an ovarian tumor in the right adnexal region in a woman with a giant fibroid: a case report and literature review.
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BACKGROUND: Lymphangiomas are rare benign tumors typically occurring in children's head andneck regions. Pelvic lymphangiomas in adults are extremely uncommon and often mimic ovariantumors, making preoperative diagnosis challenging in peri- and postmenopausal women. CASE PRESENTATION: A 53-year-old Japanese woman with a duodenal ulcer history developed amulticystic right adnexal mass during follow-up for uterine fibroid (initially diagnosed at age43). The uterine fibroid measured 11 cm on imaging at the start of follow-up, with no abnormalitiesdetected in the adnexa. Magnetic resonance imaging (MRI) performed at age 52 revealed a58×37 mm multicystic mass in the right adnexa, which enlarged to 80 mm over the followingyear. MRI revealed a multicystic mass near the right ovarian vessels ; the left adnexa appearednormal. Surgery included right adnexectomy, total hysterectomy, and left salpingo-oophorectomy.Intraoperatively, a well-defined multicystic lesion was identified along the infundibulopelvicligament with normal right ovary appearance. Histopathological examination confirmed lymphangioma,with positive immunostaining for D2-40 and CD31. The postoperative course was uneventful,with no recurrence at the 3-year follow-up. CONCLUSION: Pelvic lymphangioma should be considered in the differential diagnosis of multilocularpelvic masses. Comprehensive imaging and histopathological analysis are crucial for accurate diagnosisand management.