Patient underwent abdominal resection of the mass and pathology revealed a leiomyoma with mixed fibrous and cystic areas in keeping with hydropic changes.

Hydropic degeneration in a leiomyoma is rare and may present with rapidly enlarging mass due to extensive edema. It is usually seen with pregnancy.

Leiomyosarcoma should be considered in postmenopausal patients with rapidly enlarging myoma.

Case courtesy: Prof. Dr. Yasser Ragab.