Presentation
Asymptomatic; a hyperechoic uterine mass as an incidental finding on TVUS
Patient Data
Solid intramural formation of the uterine body with well-circumscribed oval morphology that indents and thins the endometrial cavity. It is characterized by a predominantly hyperintense signal in T1 and T2 sequences, except for some thin linear low-signal bands likely attributable to smooth muscular or fibrotic tissue, hypointense in fat-sensitive sequences and without contrast enhancement. The finding is suggestive of a lipomatous uterine tumor, likely lipoleiomyoma.
Further smaller oval hypointense intramural and subserous masses are compatible with ordinary leiomyomas.
Accessory finding: urinary debris with layering in the bladder.
Case Discussion
Adipose degeneration of ordinary leiomyomas leads to the development of lipoleiomyomas, a benign and almost always asymptomatic finding. The detection of adipose tissue masses in the uterus is highly specific for diagnosis.
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