Type:
Educational Exhibit
Keywords:
Neoplasia, Epidemiology, Surgery, Education, Ultrasound, MR, CT, Genital / Reproductive system female, Anatomy, Abdomen
Authors:
C. G. Linares Villavicencio, B. Diaz-Barroso, M. Camargo Montanari, M. Del Palacio Salgado, F. cabrera canal, M. A. Cruz Díaz; Alcalá de Henares. Madrid/ES
DOI:
10.1594/ecr2018/C-3212
Background
Uterine leiomyomas,
also known as myomas or fibroids,
are the most common gynecologic neoplasm,
affecting up 20% to 50% of women in reproductive age.
They are benign monoclonal tumors arising from the smooth muscle cells of the myometrium.
Typically present with menorrhagia,
pelvic pain and mass effect,
and in some cases,
may cause reproductive or sexual dysfunction.
These tumours occur in different sites within the uterus and can be classified as submucosal,
intramural or subserosal. As they enlarge they may outgrow their blood supply,
resulting in subsequent degeneration that can produce different imaging appearances.
Diagnosis of leiomyomas,
for the majority of patients,
is made with clinical and ultrasound examination.
For patients with symptoms,
medical or surgical treatment may be indicated,
so they will require more accurate evaluation of location,
size and extent of disease.
MRI is the most accurate examination for the detection and characterization of leiomyomas.
The differential diagnosis includes non-myometrial lesions such as polyps,
focal adenomyosis and adenomyoma.
Also includes malign tumors such us and uterine leiomyosarcoma as well as ovarian tumors such as fibroma/thecoma.
MRI can provide useful diagnostic clues in distinguishing between these entities,
with improved detection rates of adenomyosis.
Unfortunately is unable to predict accurately the presence of malignancy because of the imaging findings associated with degenerating leiomyomas can often overlap,
so the definitive diagnosis may requires histology confirmation.