Huge subserosal uterine leiomyoma (fibroid)

Case contributed by Dr Karwan T. Khoshnaw


Pelvic discomfort, ultrasound showed a large pelvic mass.

Patient Data

Age: 30
Gender: Female

Normal size anteverted uterus, homogeneous in texture and empty cavity with evidence of a large well defined round lesion occupying the posterior aspect of the uterus and compressing the uterus anteriorly confined totally within the serosa and causing a bulge on the surface of the uterus, measuring (12x10 cm), it shows low signal intensity on T1WIs and heterogeneously hypointense on T2WIs, the findings in favor of a huge subserosal leiomyoma (fibroid).

also, there is a small well-defined oval lesion in the mid segment of the anterior aspect confined partially within the serosa, measuring (13*8 mm), it shows low signal intensity on both T1 and T2WIs, the findings in favor of a subserosal leiomyoma (fibroid).

Clear left adnexa.

A well-defined round shaped unilocular cystic lesion is seen in the right adnexa measuring 37x37 mm in maximal transverse diameter. It shows fluid signal (hypointense in T1 and high signal in T2 weighted images) and it has a thin wall with no evidence of fatty tissue, no internal septations or mural nodule could be seen, the findings in favor of a simple ovarian cyst.

Case Discussion

Uterine fibroids (leiomyomas) are common benign uterine lesions. They are usually detected incidentally but if large enough, they can present as palpable masses, a leiomyoma is often called subserosal if >50% of the fibroid protrudes out of the serosal surface of the uterus. 

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Case information

rID: 62090
Published: 2nd Aug 2018
Last edited: 14th Aug 2019
System: Gynaecology
Inclusion in quiz mode: Included

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