Broad ligament fibroid

Case contributed by Dr Shailaja Muniraj

Presentation

Chronic pelvic pain. Dysmenorrhea.

Patient Data

Age: 40 years
Gender: Female
MRI

There is large voluminous T1 and T2 hypointense lesion noted to project into the pouch of Douglas. However the uterus and ovaries are well visualized separately.  These features indicate broad ligament fibroid. No features of torsion.

The uterus is appearing bulky and shows multiple anterior and posterior myometrial intramural fibroids. 

Also seen is anterior, posterior and fundal subserosal fibroids. One of the fundal subserosal fibroid is pedunculated.

Left ovarian endometriotic cyst noted.

Case Discussion

Broad ligament fibroid is a type of extrauterine fibroid and occurs in less than 1% of females.

The main role of imaging is to differentiate from a possible pedunculated subserosal fibroid or ovarian tumor. Assessment for complications, such as torsion, should also be performed. 

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