Abstract
A 72-year-old postmenopausal and nullipar woman presented with abdominopelvic pain and a palpable mass in the right lower quadrant. Ultrasonography showed a large, hyperechoic, solid mass. Contrast-enhanced computed tomography (CT) of the abdomen demonstrated a well-circumscribed mass. Rutine laboratuary tests and tumour markers revealed as normal. Total abdominal hysterectomy and bilateral salpingo-oophorectomy is the surgery of choice in this case. Histopathological examination confirmed a calcified leiomyoma. The majority of uterine leiomyomas are confidently diagnosed sonographically. However, large, degenerated tumourslike in our case may be a diagnostic challenge and postmenopausal uterine leiomyoma with degeneration mimicking ovarian malignancy. A calcified pedunculated subserous leiomyoma in a postmenopausal woman is rare and CT may help further characterize large pelvic masses and determine their organ of origin.
Highlights
Fibroids are classified by their location in the uterus and subserosal fibroids, which originate from the serosal surface of the uterus, can be pedunculated
Leiomyomas arise from overgrowth of the smooth muscle and connective tissue of the uterus
Leiomyomas decrease in size because their growth is thought to be estrogen dependent, but leiomyomas may still be newly diagnosed in postmenopausal women
Summary
Fibroids are classified by their location in the uterus and subserosal fibroids, which originate from the serosal surface of the uterus, can be pedunculated. Per abdominal examination revealed a mobile hard pelvic mass in the right lower quadrant. Abdominal ultrasound examination showed a 15x10x8cm, hyperechoic, solid mass in the right lower quadrant. The removed omental parasite vascular supply with pedunculated subserous mass (Figure 2).
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