Red degeneration of a leiomyoma

Changed by Yahya Baba, 3 Oct 2021

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Red or carneous degeneration is one of four main types of degeneration that can involve a uterine leiomyoma. While it is an uncommon type of degeneration, it is thought to be the most common form of degeneration of a leiomyoma during pregnancy ³.

Clinical presentation

Patients with a leiomyoma undergoing red degeneration may present with abdominal pain (particularly during pregnancy). It may also give systemic symptoms such as fever and leucocytosis.

Pathology

Carneous degeneration is a subtype of haemorrhagic infarction of leiomyomas that often occurs during pregnancy. On gross pathology, it is characterised by a red (haemorrhagic) appearance of the leiomyoma. Red degeneration primarily occurs secondary to venous thrombosis within the periphery of the tumour or rupture of intratumoral arteries ⁴.

Radiographic features

MRI

Unusual signal intensity patterns have been described on pelvic MR imaging ^1,4:

T1
- can have peripheral (rim) or diffuse high signal intensity
- high signal intensity on T1-weighted images is likely secondary to the proteinaceous content of the blood or the T1-shortening effects of methaemoglobin
T2
- variable signal intensity with or without a low-signal-intensity rim
- when high signal intensity is isolated to the rim of the leiomyoma, it has been hypothesised that the blood products are confined to thrombosed vessels that surround the tumour
- when it shows rim - peripheral changes these findings were thought to correspond to numerous dilated vessels filled with red blood cells at the periphery of the lesion
- the signal characteristics of the rim are best explained as an effect of abundant intracellular methaemoglobin in these vessels
T1 C+ (Gd): variable enhancement

+</ul><h4>See also</h4><ul>
+<li><a title="hyaline degeneration of a leiomyoma" href="/articles/hyaline-degeneration-of-a-leiomyoma">hyaline degeneration of a leiomyoma</a></li>
+<li><a title="myxoid degeneration of a leiomyoma" href="/articles/myxoid-degeneration-of-a-leiomyoma">myxoid degeneration of a leiomyoma</a></li>
+<li><a title="cystic degeneration of a leiomyoma" href="/articles/cystic-degeneration-of-a-leiomyoma-1">cystic degeneration of a leiomyoma</a></li>

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Red degeneration of a leiomyoma

Updates to Article Attributes

Clinical presentation

Pathology

Radiographic features

MRI

See also