Pedunculated subserous uterine leiomyoma

Case contributed by Dr Imran Ahmad Khan

Presentation

Pain and heaviness in lower abdomen with dysmenorrhea and menorrhagea.

Patient Data

Age: 35 years
Gender: Female

MRI Pelvis (selected images)

MRI

Axial and sagittal T2 images shows a large circumscribed juxta-uterine pelvic mass. It is attached to the anterior wall of uterus through a broad stalk. Multiple curvilinear flow voids are seen crossing from the anterior myometrium to the mass. These features are consistent with a pedunculated subserous uterine leiomyoma. The 'Bridging vessel sign' is well demonstrated in this case. Multiple small intramural leiomyomas are also noted.

Case Discussion

Bridging vessel sign refers to an appearance of multiple vessels crossing from uterus to a juxta-uterine pelvic mass and it helps to differentiate a subserosal leiomyoma from other pelvic masses. 

This case clearly demonstrates multiple curvilinear flow voids extending from the anterior myometrium of uterus through the broad stalk into the subserosal leiomyoma.

The diagnosis was achieved based on the typical imaging features. 

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