Broad ligament leiomyoma
While in most cases broad ligament leiomyomas are asymptomatic, patients may present pelvic pain or a palpable pelvic/abdominal mass. Pelvic pain may be as a result of pressure effects on adjacent organs or a complicating torsion.
It is a type of extra-uterine leiomyoma that arises from the broad ligament, often by a stalk.
A leiomyoma occurring in this location poses greater diagnostic difficulty than when it occur in the uterus. In uncomplicated cases (e.g no degeneration) it is seen as a solid adnexal mass which is separate from both the uterine body as well as the ovary.
Usually seen as an hypoechoic, solid, well-circumscribed adnexal mass, although that can be heterogeneous when large. There is generally no interface between tumour and uterus and no straight relation to the ipsilateral ovary.
Signal characteristics in uncomplicated cases are essentially similar to a uterine leiomyoma
- T1: iso to low signal
- T2: typically low signal
- T1 C+: most enhance similarly to the myometrium while larger leiomyomas tend to enhance less and heterogeneously
Torsion of the leiomyoma can occur is pedunculated
General considerations include
- other unusual leiomyomas
- solid ovarian neoplasms: particularly those with dominant fibrous components
- other ligamentous mesenchymal tumours
- neurofibroma in the pelvis
- 1. Gowri V, Sudheendra R, Oumachigui A et-al. Giant broad ligament leiomyoma. Int J Gynaecol Obstet. 1992;37 (3): 207-10. - Pubmed citation
- 2. Spencer JA, Ghattamaneni S. MR imaging of the sonographically indeterminate adnexal mass. Radiology. 2010;256 (3): 677-94. doi:10.1148/radiol.10090397 - Pubmed citation
- 3. Pelsang RE, Sorosky J, Woods T. Sonographic evaluation of a leiomyoma of the broad ligament of the uterus. J Clin Ultrasound. 1999;27 (7): 402-4. J Clin Ultrasound (link) - Pubmed citation
- 4. Eurorad teaching files : Case 7530