Surgery: The patient received urgent total abdominal hysterectomy and bilateral salpingo-oophorectomy.  Histology was sent.

Histopathology:
Cervix, right pelvic sidewall, endometrium and left fallopian tube were within normal limits.
The large mass arising from the uterus demonstrated features of benign leiomyoma with hydropic features.

Final diagnosis: Benign leiomyoma with hydropic features.

Discussion: This case demonstrates an unusual presentation of a fibroid. It was very large and showed cystic features. Hydropic features on microscopy are very rare with scant correlative imaging features described in the literature.