DOI: 10.36347/sjmcr.2015.v03i07.016

Pages: 608-610

Cystic degeneration of uterine leiomyoma is a rare complication of leiomyoma that may present with clinical and imaging findings resembling ovarian mass and the final diagnosis is based on the operative and histological confirmation. Here we report a rare case of giant pedunculated leiomyoma which presented as ovarian neoplasm on clinical examination, sonography and computed tomography (CT). A 50yr old postmenopausal woman presented with complaints of lower abdominal distension and pain. On examination, a predominantly cystic mass with solid areas in between corresponding to 32 weeks gravid uterus was palpable more towards the right side. USG and CT scan revealed a predominantly cystic mass with solid components adherent to fundus and posterior surface of uterus probably arising from the right adnexa. A preoperative diagnosis of ovarian tumour was suspected. Proceeded with staging laparotomy as per protocol. Laparotomy revealed multiple leiomyomas, the largest one was of size of 30 X 28 cm size which had undergone cystic degeneration. Proceeded with Total abdominal hysterectomy and bilateral salpingo-oopherectomy. Histology revealed leiomyoma with cystic degeneration. Postoperative period was uneventful. A pedunculatedsubserosal uterine leiomyoma with cystic degeneration can oftenbe mistaken for an ovarian neoplasm especially in a postmenopausal woman hence should always be considered in the differential diagnosis while evaluating an adnexal mass.