Giant pedunculated subserosal leiomyoma with bridging vessel sign
Presentation
The patient presented for follow-up. She is a known case of pelvic mass.
Patient Data
The contrast-enhanced abdominal computed tomography demonstrates a large pelvi-abdominal mass occupying the suprapubic region and extending upwards to the level of the umbilicus, indenting the dome of the urinary bladder. The mass appears isodense to the uterine myometrium, demonstrates enhancement, and exhibits areas of cystic change. The posterior inferior portion of the mass connects to the right side of the uterine fundus via a pedicle approximately 1 cm long, with blood vessels traversing the pedicle, consistent with the bridging vessel sign. This is evident in the axial, sagittal, and coronal oblique MPR images.
Case Discussion
The patient has had a diagnosis of uterine leiomyoma for many years. Her sole current complaint is pelvic swelling, typically assessed by ultrasound and occasionally by computed tomography. The mass on imaging appears isodense to the uterus and exhibits the characteristic bridging vessel sign. This sign aids in differentiating a pedunculated subserosal leiomyoma from other pelvic masses.
Acknowledgment: Nusaibah Ghaleb Yousef Alnahari
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