A case of cystic leiomyoma mimicking an ovarian malignancy

Abstract

Introduction: We report an unusual case of a large cystic, pedunculated uterine leiomyoma mimicking a primary malignant ovarian tumour on sonography and computed tomography (CT). Clinical Picture: A 56-year-old post-menopausal woman presented with a right pelvi-abdominal mass. Sonography and CT examination showed a large extrauterine mass arising from the right adnexa and extending into the abdomen. The mass was predominantly cystic with a solid component at the periphery. A preoperative diagnosis of a primary malignant ovarian tumour was made. Treatment: The patient underwent laparotomy. The large mass was found to arise from the uterine fundus; the ovary was not involved. The mass was resected, followed by total hysterectomy and bilateral salpingo-oophorectomy. Histology was that of a leiomyoma with extensive cystic degeneration. Outcome: The patient made an uneventful recovery. Conclusion: A pedunculated, subserosal uterine leiomyoma with extensive cystic degeneration can mimic an ovarian tumour on imaging and should be considered in the differential diagnosis of an adnexal mass.