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 pelviabdominal 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.
Uterine leiomyomas are the most common gynaecological tumour. Typical appearances of leiomyomas are easily recognised on imaging.
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