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Prolapsed submucosal uterine leiomyoma

Case contributed by Dr Mohamed Saber

Presentation

Severe perimenopausal abnormal uterine bleeding

Patient Data

Age: 45 years
Gender: Female

MRI study shows:

  • a bulky uterus of irregular contour shows multiple variable-sized interstitial leiomyomas seen involving both anterior and posterior walls as well as the fundal region measure up to 3.5 cm
  • a left anterolateral wall leiomyoma measures 3 cm is seen extending to a submucosal location indenting the endometrial stripe and displacing it to the right
  • a pedunculated leiomyoma is seen descending through the orifice of the uterus to distend the cervical canal measures 4x6x5 cm
  • few small subserous lesions are seen, the largest is anterior fundal measures 3 cm
  • all lesions elicit intermediate signal intensity in T1 and low signal in T2 with mild enhancement in the post-contrast study, except one lesion at the right lateral uterine wall, elicits high signal in T2 and poor enhancement in the post-contrast study likely related to degeneration
Annotated image

The annotated images clarify the prolapsed leiomyoma.

Case Discussion

Here is a case of prolapsed submucosal uterine leiomyoma into the cervical canal with associated multiple interstitial, subserous and submucosal leiomyomas.

Differential diagnosis is leiomyoma of the uterine cervix that is an unusual variation.

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Case information

rID: 89764
Published: 19th May 2021
Last edited: 21st May 2021
System: Gynaecology
Inclusion in quiz mode: Included
Institution: Faculty of medicine Al-Azhar University

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