Presentation
Pelvic pain.
Patient Data
Well-defined pedunculated submucosal mass arising from the fundus well-demonstrated on coronal T2, and prolapsing into the vagina. It appears isointense to the myometrium on T1, hypointense on T2 with moderate heterogeneous enhancement.
Unilocular right ovarian cyst of homogeneous fluid content of low signal on T1 and high signal on T2 with a thin peripheral enhancement suggestive of benign simple cyst.
Case Discussion
The MRI features are most consistent with pedunculated submucosal uterine leiomyoma prolapsing into the vagina.
MRI is the most reliable imaging technique for detection of the uterine leiomyomas, and rule out in such case a prolapsed endometrial polyp or neoplasm of the cervix extending to the upper vagina.