Diffuse uterine leiomyomatosis

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis almost certain

Presentation

Pelvic mass with dysmenorrhea and menorrhagia. For infertility workup.

Patient Data

Age: 40 years
Gender: Female
ultrasound

There is a bulky and enlarged uterus with multiple ill-defined leiomyomas. These appear predominantly intramural and subserosal. There is a solitary fundal pedunculated leiomyoma. There is evidence of hyaline degeneration. The ovaries are not identified on trans pelvic ultrasound.

Sonographer: Ms S. Mashiane

ultrasound

Cine loops demonstrate diffuse uterine leiomyomatosis more convincingly. The heterogeneous uterine appearance is dramatic.

Case Discussion

Leiomyomas are often encountered during infertility workups. This case represents the sonographic appearance of suspected diffuse uterine leiomyomatosis with near-total replacement of the normal uterine myometrium by multiple, ill-defined, scattered and confluent leiomyomas. Identification of circumscribed calcification suggests developing hyaline degeneration. Static ultrasound images do not convey the extent of the diffuse nature of the leiomyomas. The cine loops assist significantly in appreciating the heterogeneous uterine architecture due to the diffuse replacement of the myometrium by the leiomyomas.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.