Rare recurrence of a multilocular cystic leiomyoma following myomectomy

Multilocular cystic leiomyomas rarely develop following myomectomy. To the best of our knowledge, there are no published reports on recurrent multilocular cystic leiomyoma following myomectomy. We here present such a case. A 45-year-old woman visited our outpatient clinic because of heavy vaginal bleeding. She underwent laparoscopic myomectomy for a solid mass in the uterine cavity. Subsequent pathological examination of the operative specimen revealed a tumour with well-demarcated borders and spindle cells arranged in intersecting fascicles. Seven days postoperatively, ultrasonography revealed a cystic lesion. Magnetic resonance imaging performed 28 months postoperatively revealed a large, well-defined, multilocular cystic mass that was homogeneously hyperintense on T2-weighted images on the exterior of the uterus. Abdominal hysterectomy was performed. On pathological examination of the operative specimen, she was found to have a leiomyoma with marked cystic degeneration. Incomplete excision of a multilocular cystic leiomyoma may result in recurrence in the form of a large cystic mass. Clinical differentiation between a multilocular cystic leiomyoma and an ovarian tumour may be difficult. Complete resection of a uterine multilocular cystic lesion prevents recurrence.