Presentation
Pelvic discomfort.
Patient Data
Large, heterogeneous solid and cystic mass filling the uterus.
Very large mass filling the uterus, with heterogeneous enhancement and central cystic spaces. The endometrial stripe is displaced along the posterior and leftward aspect. Small ascites. No adenopathy.
Case Discussion
Transabdominal biopsy confirmed benign, degenerating fibroid. Key teaching point, in this case, is that cystic degeneration of fibroids can look very large and alarming and raise the concern for a malignant mass. While leiomyosarcoma is possible, it is rare compared to degenerating fibroids. Notice how the endometrial stripe is displaced along the posterior/leftward aspect of the mass, indicating that this is a large anterior and exophytic fibroid undergoing degeneration.
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