Presentation
Long history of painful periods and heavy menstrual bleeding.
Patient Data
The uterus appears bulky and shows large well-demarcated submucosal mass, measuring 4 X 3 cm, seen largely projecting into the endometrial cavity at the level of the uterine fundus. This mass demonstrates predominantly homogeneous hypointense signal on T2WI, isointense on T1WI and shows homogeneous enhancement post Gad administration. No evidence of extra-uterine extension, sizable suspicious lymphadenopathy or pelvic collection.
A small rounded subserosal mass is also seen in the left anterior aspect of the uterus.
Case Discussion
Submucosal leiomyoma is the least common form of uterine leiomyomas, however, it is the most symptomatic type. It commonly presents with heavy menstrual bleeding and painful periods. In the presence of submucosal fibroids, Hysteroscopic resection is a simple, safe and effective treatment for heavy menstrual bleeding and reduces the need for more major surgery, such as hysterectomy.
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