S C A Low1, C L Chong. 1. Department of Diagnostic Imaging, KK Women's and Children's Hospital, Singapore.
Abstract
INTRODUCTION: We report an unusual case of a large cystic, pedunculated uterine leiomyoma mimicking a primary malignant ovarian tumour on sonography and computed tomography (CT). CLINICAL PICTURE: A 56-year-old post-menopausal woman presented with a right pelviabdominal mass. Sonography and CT examination showed a large extrauterine mass arising from the right adnexa and extending into the abdomen. The mass was predominantly cystic with a solid component at the periphery. A preoperative diagnosis of a primary malignant ovarian tumour was made. TREATMENT: The patient underwent laparotomy. The large mass was found to arise from the uterine fundus; the ovary was not involved. The mass was resected, followed by total hysterectomy and bilateral salpingo-oophorectomy. Histology was that of a leiomyoma with extensive cystic degeneration. OUTCOME: The patient made an uneventful recovery. CONCLUSION: A pedunculated, subserosal uterine leiomyoma with extensive cystic degeneration can mimic an ovarian tumour on imaging and should be considered in the differential diagnosis of an adnexal mass.
INTRODUCTION: We report an unusual case of a large cystic, pedunculated uterine leiomyoma mimicking a primary malignant ovarian tumour on sonography and computed tomography (CT). CLINICAL PICTURE: A 56-year-old post-menopausal woman presented with a right pelviabdominal mass. Sonography and CT examination showed a large extrauterine mass arising from the right adnexa and extending into the abdomen. The mass was predominantly cystic with a solid component at the periphery. A preoperative diagnosis of a primary malignant ovarian tumour was made. TREATMENT: The patient underwent laparotomy. The large mass was found to arise from the uterine fundus; the ovary was not involved. The mass was resected, followed by total hysterectomy and bilateral salpingo-oophorectomy. Histology was that of a leiomyoma with extensive cystic degeneration. OUTCOME: The patient made an uneventful recovery. CONCLUSION: A pedunculated, subserosal uterine leiomyoma with extensive cystic degeneration can mimic an ovarian tumour on imaging and should be considered in the differential diagnosis of an adnexal mass.