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Sub-mucosal leiomyoma of the uterus

A sub-mucosal leiomyoma of the uterus refers to a sub type of uterine leiomyoma that primarily projects into the endometrial cavity. They are least common albeit most symptomatic type of leiomyoma.

Clinical presentation

Submucosal leiomyomas can be a common source of abnormal uterine bleeding and may also present with reproductive dysfunction, including recurrent miscarriages, infertility, premature labour and / or fetal malpresentations. 

Pathology

Associations

Radiographic features

General

It is typically seen as a sub endometrial mass indenting and distorting the endometrium.

Ultrasound 

On ultrasound submucosal fibroids are typically seen as broad-based, hypo-echoic, well-defined, solid masses with shadowing. Submucosal fibroids typically have an overlying layer of echogenic endometrium, which helps confirm their subendometrial location and helps distinguish them from endometrial polyps. In addition, as opposed to polyps, submucosal fibroids often distort the interface between the endometrium and myometrium and show acoustic attenuation.

MRI
  • T2 - typical homogenous hypointensity is seen. 
    • atypical findings may include hyperintensity due to edema.

Differential diagnosis

General imaging differential considerations include

See also

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