Myxoid degeneration of a leiomyoma

Last revised by Ellinor Roos on 6 Sep 2023

Myxoid degeneration of leiomyoma is one of the rarer types of degeneration that can occur in a uterine leiomyoma. This term is related but not identical to the term myxoid uterine leiomyoma.

While this type of degeneration is generally considered rare, the highest prevalence for this type of degeneration has been reported as up to 50% of all degenerations of leiomyomas 5.

Fibroids (i.e. uterine leiomyomas) that have undergone myxoid degeneration are filled with a gelatinous material and can be difficult to differentiate from cystic degeneration; however, they typically appear as more complex cystic masses. They appear hypocellular with a myxoid matrix 6.

On pelvic MRI, the myxoid material usually demonstrates 2:

  • T1: low signal intensity 
  • T2: usually high signal intensity 2,3 with a peripheral low signal intensity 6
  • T1 C+ (Gd): there is minimal or no enhancement 2,3

The above signal changes are of intralesional change 4 on a background of low T2 signal of non-myxoid components.

Certain malignant uterine tumors also show myxoid degeneration, e.g.leiomyosarcoma 2.

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Cases and figures

  • Case 1
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  • Case 2
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