Abstract
A 48-year-old woman presented with abdominal fullness and a palpable "mass" in the left lower quadrant. Ultrasonography showed a large, rounded, hypoechoic mass. Contrast-enhanced helical CT of the abdomen demonstrated a well-circumscribed, heterogeneously but vividly enhancing mass. The uterus had a leiomyomatous configuration on CT. Uterus and mass revealed the same enhancing pattern. Thin section CT revealed a long, thin stalk connecting the mass with the body of the uterus. Surgical removal of both uterus and the mass confirmed the diagnosis of a pedunculated subserosal leiomyoma originating from a leiomyomatous uterus.
Highlights
A 48-year-old woman presented with a sensation of fullness in the abdomen and a palpable mass in the left lower quadrant of the abdomen
The uterus was enlarged with a deformed uterine contour consistent with leiomyomatous uterus (Fig 4)
Thin section CT targeted at the mass, revealed a 2 cm-long, thin stalk connecting the mass with the upper left body of the uterus (Fig 5)
Summary
Leiomyoma (or fibroid) is the most frequently diagnosed gynecologic tumor, occurring in 20–30% of women older than 30 years. Pedunculated uterine leiomyomas occur when the fibroid is in continuity with the uterus with a stalk and they may grow either within the uterine cavity (submucosal) or outside of the uterus (subserosal) simulating ovarian neoplasms [6]. They can become twisted and cause a kink obstructing blood vessels feeding the tumor that requires prompt surgery. Magnetic resonance imaging is used as a problem solving tool to characterize uterine and adnexal pathology [9,10]
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