Cystic Lymphangiomyoma of the Uterus Mimicking an Ovarian Cyst: A Case Report

Abstract

Background: Cystic lesions of the uterus are rare and are frequently misdiagnosed as adnexal pathology on imaging. Cystic lymphangiomyoma is an uncommon benign lesion characterized by dilated lymphatic channels within the uterine wall. Because imaging features are nonspecific, diagnosis generally requires histopathological confirmation supported by immunohistochemistry.

Case presentation: We report the case of a 34-year-old woman who presented with a pelvic cystic mass initially presumed to be of ovarian origin. Pelvic ultrasound and MRI suggested a paratubal cyst. Laparoscopy revealed a 6-cm intramural uterine cyst arising from the uterine wall. Laparoscopic cystectomy was performed with meticulous dissection to preserve the myometrium. Histopathological examination demonstrated multiple cystic spaces lined by flattened endothelial cells, consistent with uterine cystic lymphangiomyoma.

Conclusion: The postoperative course was uneventful. This rare case highlights the diagnostic challenge of distinguishing uterine cystic lesions from adnexal pathology based solely on imaging. Accurate diagnosis relies on histopathological and immunohistochemical evaluation, while complete surgical excision ensures definitive cure.