Uterine leiomyoma with cystic degeneration

Case contributed by Dr Ammar Haouimi

Presentation

Pelvic pain with metrorrhagia.

Patient Data

Age: 35 years
Gender: Female

Large well-circumscribed uterine mass of anterior intramural location, eliciting an iso-to low signal to the myometrium on T1, mixed signal on T2 with central areas of high signal (cystic degeneration). The postcontrast sequences demonstrate a heterogeneous enhancement with central non-enhanced cystic spaces. 

another small intramural leiomyoma with endometrial contact well-demonstrated on sagittal and coronal T2 sequences.

No pelvic ascites or enlarged lymph nodes.

Case Discussion

MRI features of a large uterine leiomyoma (Figo 4) with cystic degeneration.

Intramural uterine leiomyoma is the considered the most common type of uterine leiomyoma in terms of location. 

Cystic degeneration of uterine leiomyomas is an uncommon type of degeneration and represents ~4% of all types of uterine leiomyoma degeneration.

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