(1) Department of Surgery, Post graduate Institute of Medical Sciences, Rohtak, Haryana, India-124001
(2) Department of Pathology, Post graduate Institute of Medical Sciences, Rohtak, Haryana, India-124001
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This paper reports a case of pedunculated leiomyoma of the uterus presenting as a large abdominal mass.
A middle-aged pre-menopausal woman presented with pain and a large intra-abdominal lump in the lower abdomen. Ultrasonography showed a large, rounded, hypoechoic mass with septations. Contrast-enhanced CT scan of the abdomen demonstrated a large heterogeneous, predominantly hypodense mass lesion in the abdomen and pelvis with heterogeneous irregular enhancing hypodensity within it. However, the organ of origin could not be identified with investigations and the patient was explored with the possibility of pseudopancreatic cyst or mesenteric cyst. Operative findings revealed a large pedunculated fibroid arising from the uterine fundus and occupying almost whole of the abdomen and pelvis.
Although fibroids usually have a characteristic appearance on sonography, degenerating fibroids can have variable patterns and pose diagnostic challenges.