Large fibroid with myxoid degeneration

Case contributed by Michael P Hartung


Pelvic pain.

Patient Data

Age: 40 years
Gender: Female

Large heterogeneous mass filling the majority of the pelvis, displacing the uterus and ovaries anteriorly. Based on sagittal reformats it appears to be arising from the posterior lower uterine segment, from which its blood supply arises. 

Case Discussion

At first glance, this is a very alarming case. However, careful inspection indicates that this mass is arising from the uterus, and thus the differential quickly narrows to a degenerating pedunculate fibroid or leiomyosarcoma.

This patient proceeded to surgery where they confirmed it arising from the lower uterine segment, with final pathology demonstrating a benign leiomyoma with gelatinous material (characteristic of myxoid degeneration). 

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