Presentation
Pain in the lower abdomen with dysmenorrhea.
Patient Data
There is a 5 x 7 x 10 cm well-circumscribed pedunculated subserosal mass arising from the uterine fundus, of iso signal to the myometrium on T1, heterogenous high signal on T2 with a post-contrast heterogenous enhancement in keeping with a pedunculated subserosal leiomyoma with cystic degeneration which made a pressure effect and displaced uterus posteriorly.
This mass is in very close proximity to the anterior surface of the uterine fundus, connected to the uterus by a short pedicle, with multiple curvilinear flow voids crossing from the anterior myometrium to the mass.
Small bilateral ovarian follicles are noted.
The mild fluid signal at col du sac space.
Few nabothian cysts along with uterine cervix .
Case Discussion
MRI appearances of a pedunculated subserosal leiomyoma with a bridging vessel sign. This sign refers to the appearance of multiple vessels crossing from the uterus to a juxta-uterine pelvic mass and it helps to differentiate a subserosal leiomyoma from other pelvic masses.
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