Learning objectives
In this pictorial review we will:
Describe unusual extra-uterine presentations of leiomyomas (fibroids)
Explain key radiological features and differentials
Background
Leiomyomas are benign mesenchymal tumours of smooth muscle origin.
They mostly arise in the uterus in women of the reproductive age group.
Typical imaging findings vary depending on the modality used.
Ultrasound
Appearances are of a homogeneous hypoechoic mass,
with or without posterior acoustic shadowing depending on the contents.
On colour doppler,
they show marked peripheral flow,
with absent central flow.
CT
A leiomyoma is typically isodense to the myometrium on non contrast scan and display homogenous enhancement post contrast.
MRI
The mass is typically...
Findings and procedure details
Leiomyomas arethe most common gynaecological and uterine neoplasm,
affecting up to 20 to 30% of women over the age of 351.
Case 1:Urethral leiomyoma
Clinical history:
Patients may present with a long history of right iliac fossa pain and alternating bowel habit.
Imaging:
Ultrasound:This typically shows ahypoehocic mass noted posterolateral to the base of the bladder.
Fig. 1
CT: This typically shows amass arising from the pelvis which indents one side of the bladder,
can appear inferior to the uterusor may appear separate from it....
Conclusion
Extrauterine leiomyomasmay mimic malignant conditions and it is therefore important for a radiologist to be familiar with the potential extrauterine sites and theirultrasound,
CT and MRI imaging characteristics.
Personal information
Dr Amr Moussa,
Radiology Registrar,Department of Radiology,
Norfolk and Norwich University Hospital,
United Kingdom.
[email protected]
Dr Adeel Ejaz Syed,Radiology Registrar,Department of Radiology,
Norfolk and Norwich University Hospital,
United Kingdom.
[email protected]
Dr Iztok Caglic,Consultant Radiologist,
Department of Radiology,
Norfolk and Norwich University Hospital,
United Kingdom.
[email protected]
Dr Paul Malcolm,Consultant Radiologist,
Department of Radiology,
Norfolk and Norwich University Hospital,
United Kingdom.
[email protected]
Dr Sarah Scott-Barrett,Consultant Radiologist,
Department of Radiology,
Norfolk and Norwich University Hospital,
United Kingdom.
[email protected]
References
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Reiter RC.
Fertil Steril 1981;36(4):433–445.
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5)Benign...