Search

Broad ligament adrenal rests are well known. A case of adrenal rest external to the surface of the broad ligament and adjacent to the fallopian tube is reviewed, with specific emphasis on its histogenesis. The rest is associated with a foreign body, and it is suggested that it has arisen as a secondary development of celomic epithelial metaplasia.

A very rare extraovarian hormone-producing thecoma, originated from the broad ligament, is described. Its preoperative diagnostic difficulty, clinical significance, differential diagnosis and histogenesis are discussed.

The clinical and pathological findings including light microscopic and ultrastructural features of two cases of borderline mucinous and serous cystadenomas that originated in the broad ligament are reported. The tumors did not involve the oviduct or ovary. They probably arose in pre-existing cysts of mesothelial and paramesonephric (primary Müllerian) origin. These rare tumors bear a close resemblance to the borderline epithelial tumors of the ovary and the same prognostic criteria may be applicable to the lesions presented here.

The clinical and pathological features of 25 serous papillary cystadenomas of borderline malignancy of the broad ligament were analyzed. The ages of the patients ranged from 19 to 67 (average, 32) years. The clinical presentation was lower abdominal pain, pelvic pain or both in five cases, accompanied by menometrorrhagia or amenorrhea in three cases. One patient was thought to have an acute abdominal disorder. The tumors of the remaining 19 patients were discovered either on routine gynecological examination or during an evaluation of the pregnancy status of the patient. In 14 cases the tumor was located in the left broad ligament and in 11 cases it was on the right side; all the tumors were entirely separated from the ipsilateral ovary. On gross examination the tumors were 1-13 cm in greatest dimension, had smooth outer surfaces, and contained straw-colored, watery fluid. The inner lining bore single or multiple 0.3-2.5 cm excrescences. Microscopic examination revealed that the cyst walls and their excrescences were lined by simple to pseudostratified, cuboidal to columnar, focally ciliated epithelium. Slight nuclear atypism, very rare mitotic activity, and focal psammoma body formation were also found. The stroma resembled ovarian stroma but no primary follicles or follicular derivatives were identified. Twenty-three of the patients were alive and well from 0.5 to 11 years after excision of the tumor, one patient was disease-free for 8.5 years but died of an open-heart surgical procedure; and two patients were lost to follow-up examination.

A 63-year-old Jamaican negress had an endometrial stromal sarcoma arising in a paramesonephric cyst of the broad ligament. Morphological evidence is presented to show that the tumour arose from an area of endometriosis within the cyst wall. Subsequent metastases responded for a few months to cyclophosphamide therapy and the patient died 14 months after the onset of symptoms.

One of the rare tumors causing virilization are the lipid cell tumors which are mostly located in the ovaries. We report here on a 13 year old girl with virilization due to a lipid cell tumor of the broad ligament. The patient showed increased levels of testosterone, androstenedione and 17 alpha-hydroxyprogesterone while normal values of dehydroepiandrosterone, cortisol, estrogens E1 and E2, and gonadotropins were recorded. The endocrinological and histological pictures, as well as the diagnostic aspects will be discussed.

Two further cases of 'female adnexal tumour of probable Wolffian origin' are described Both were retroperitoneal and presented a unique histology of uniformly close-packed bland spaces. solid islands, cords, and diffuse areas. A small hamartoma in a female fetus, part of which resembled the tumours, was traced to an area of near apposition with some paroophoron canals, providing further evidence of a Wolffian origin. The literature of this and some other putative Wolffian tumours is briefly reviewed, and the relation to rete adenomas is discussed.

A 55-year-old patient who presented with a pelvic mass was found to have a mixed mesenchymal sarcoma of the broad ligament. The histogenesis and diagnostic criteria of this rare tumour are discussed.

The main underlying pathology of the Allen Masters syndrome is based on lacerations of the broad ligament. This sometimes incapacitating disease is expressed by persistent pelvic pain, dyspareunia and menstrual disturbances. Treatment modes employed hitherto consisted of either suturing the peritoneal defect or of hysterectomy. We have treated four patients by simple fulguration of the peritoneal laceration, performed during laparoscopy. Results were excellent. It is suggested that this treatment mode may replace more extensive surgery.

Presented is a case of an isolated leiomyosarcoma of the broad ligament in a woman who had a synchronous ductal carcinoma of the breast. Carcinoma of the breast, thyroid, or colon is the most common second primary neoplasm in women with pelvic malignancy.