Diffuse uterine leiomyomatosis
Irregular menstrual cycle and abdominal distension.
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The uterus is markedly enlarged and studded with multiple innumerable fibroids distributed in a predominantly interstitial and subserous location. They elicit predominantly low T1 and T2 signal. The enlarged uterus is indenting the bladder fundus. No definite endometrial cavity encroachment.
Preserved follicular activities of both ovaries
Normal MR appearance of the cervix and vagina
Diffuse uterine leiomyomatosis is a benign and extremely rare condition. The etiology remains incompletely understood. The uterus is the seat of innumerable small leiomyomas that produce a symmetrical enlargement of the uterus, replacing most of the uterine parenchyma.
These nodules blend with one another and almost replace the uterine parenchyma completely. Unfortunately, hysterectomy - regardless of the patient’s reproductive age - remains the only curative treatment. Uterine artery embolization might be an alternative option to preserve patient reproductive status.
Case courtesy of Dr. Ahmed Abd El-Karim, MD. Lecturer of Diagnostic and Interventional Radiology, Cairo University Hospitals.