ABSTRACT In this paper, we report the case of a left round ligament fibroid in a 24 year-old, gravida 0, female that was successfully managed laparoscopically. Operative findings also included severe adnexal adhesions bilaterally, severe adhesions of the liver to the anterior abdominal wall (Fitz-Hugh-Curtis syndrome), pigmented areas on the left tube, uterus and posterior broad ligament (that proved to be endometriosis), and low capacity bladder (450 cc at 70 cm water pressure) with florid glomerulations and Hunner’s ulcers consistent with typical interstitial cystitis. Beside the feasibility of laparoscopic management of intra-ligamentous tumors this case highlights the common multifactorial nature of chronic pelvic pain and the frequent association of endometriosis and interstitial cystitis.
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nullHeaton, R. and Walid, M. (2011) Intra-ligamentous fibroid removed laparoscopically. Open Journal of Obstetrics and Gynecology, 1, 136-138. doi: 10.4236/ojog.2011.13025.
 Michel, P. and Viola, D. (2003) Abdominopelvic leiomyoma of the round ligament: Contribution of computed tomography and magnetic resonance imaging. Journal of Gynecology and Obstetric Biology Reproductive, 32, 571-574.
Vignali, M., Bertulessi, C., Spreafico, C. and Busacca, M. (2006) A large symptomatic leiomyoma of the round ligament. Minimally Invasive Gynecology, 13, 375-376.
Grossman, S.L. and Cheung, V.Y. (1999) Round ligament fibroid. Journal of Obstetrics and Gynaecology of Canadian, 29, 109-110.
Warshauer, D.M. and Mandel, S.R. (1999) Leiomyoma of the extra-peritoneal round ligament: CT demonstration. Clinical Imaging, 23, 375-376.
 Losch, A., Haider-Angeler, M.G., Kainz, C., Breitenecker, G. and Lahodny, J. (1999) Leiomyoma of the round ligament in a post-menopausal woman. Maturitas, 31, 133-135.
Walid, M.S. and Heaton, R.L. (2010) Endometriosis/adenomyosis is associated with more typical cystoscopic findings of interstitial cystitis in patients with elevated PUF scores. Gynecological Surgery, 7, 353-357.
Glemain, P., Rivière, C., Lenormand, L., Karam, G., Bouchot, O. and Buzelin, J.M. (2002) Prolonged hydrodistention of the bladder for symptomatic treatment of interstitial cystitis: Efficacy at 6 months and 1 year. European Urology, 41, 79-84. doi:10.1016/S0302-2838(01)00006-9
 Uimari, O., Jarvela, I. and Ryynanen, M. (2011) Do symptomatic endometriosis and uterine fibroids appear together? Journal of Human Reproductive Science, 4, 34-38. doi:10.4103/0974-1208.82358
Kitawaki, J., Obayashi, H., Ishihara, H., Koshiba, H., Kusuki, I., HKado, N., Tsukamoto, K., Hasegawa, G., Nakamura, N. and Honjo, H. (2001) Oestrogen receptoralpha gene polymorphism is associated with endometriosis, adenomyosis and leiomyomata. Human Reproductive, 16, 51-55. doi:10.1093/humrep/16.1.51
Walid, M.S. and Heaton, R.L. (2009) Dyspareunia: A complex problem requiring a selective approach. Sex Health, 6, 250-253. doi:10.1071/SH09033
Rigaud, J., HDelavierre, DH., Sibert, L. and Labat, J.J. (2010) Hydrodistension in the therapeutic management of painful bladder syndrome. Prog Urology, 20, 1054-1059.