Retroperitoneal myoma and chronic pelvic pain: case report and literature review

We present a case of a postmenopausal diabetic hypertensive female with a solitary retroperitoneal myoma (2,025 g) and no smooth muscle (myomatic) nodules on visceral and parietal peritoneum. She complained of chronic pelvic pain in absence of internal female genitalia (except uterine cervix), high frequency of urination, pelvic discomfort, and feeling of heaviness. The patient had undergone hysterectomy with bilateral adnexectomies 13 years ago and she had not had any exposure to exogenous hormones during her reproductive and postmenopausal period of life (oral contraception and hormone-replacement therapy). Several suppositions were made, supporting hormonal genesis of myoma with retroperitoneal localization in postmenopausal age and the significance of eventual presence of concomitant metabolic disturbance for its origin in that age was also emphasized. The known risk factors for growth and development of myoma were also affected by the presence of collateral dismetabolic conditions, which influenced and aggravated the disturbed hormonal balance. That is why they could be considered as a possible additional risk factor.