Hydropic leiomyoma of the uterus presenting as a giant abdominal mass.
We describe a case of a 35-year-old woman with a pedunculated uterine leiomyoma with diffuse hydropic degeneration presenting as a giant abdominal mass. The patient was admitted in the emergency department because of diffuse abdominal bloating and discomfort. Ultrasonography (US) showed a heterogeneous abdominopelvic mass. Magnetic resonance imaging (MRI) was performed to further characterise and revealed a myometrial pedunculated tumour. Despite its marked T2-signal heterogeneity and volume, there were no other suspicious findings to suggest a malignant nature; therefore, fertility-sparing myomectomy was performed. Leiomyomas frequently undergo degenerative changes altering their imaging appearances. Leiomyomas with uncommon degenerative changes may be difficult to differentiate from malignant myometrial tumours, based solely on imaging. To the best of our knowledge, a diffuse hydropic degeneration imaging appearance has only been described twice in the literature. We describe the imaging appearance of this rare form of leiomyoma drawing attention to its differential diagnosis.
Department of Radiology, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Mariana
M
Horta
Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal.
Teresa Margarida
TM
Cunha
Department of Pathology, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Rita
R
Oliveira
Department of Surgery, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Paula
P
Magro
D000328:Adult; D003937:Diagnosis, Differential; D004487:Edema; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D063186:Uterine Myomectomy; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014599:Uterus / Q000473:pathology* / Q000601:surgery