Subscribe to RSS
DOI: 10.4103/ijri.IJRI_214_17
Hydropic degeneration of leiomyoma in nongravid uterus: The “split fiber” sign on magnetic resonance imaging
Subject Editor: Financial support and sponsorship Nil.
Abstract
Extensive hydropic degeneration in uterine leiomyoma is a rare occurrence and is commonly reported in association with pregnancy. It is a close mimicker of malignancy due to rapid growth and atypical imaging appearances. Awareness of the imaging features helps in diagnosis, avoids unnecessary patient anxiety, and hence reassurance especially when encountered in pregnancy. We report two cases of extensive hydropic degeneration of leiomyoma in nonpregnant females with imaging and histopathology correlation. We also propose the “split fiber” sign as a useful magnetic resonance imaging feature for diagnosing this condition.
Publication History
Article published online:
26 July 2021
© 2018. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Clement PB, Young RH, Scully RE. Diffuse, perinodular and other patterns of hydropic degeneration within and adjacent to uterine leiomyomas. Am J Surg Pathol 1992; 16: 26-32
- 2 Murase E, Siegelman ES, Outwater EK, Perez-Jaffe LA, Tureck RW. Uterine leiomyomas: Histopathologic features, MR imaging findings, differential diagnosis, and treatment. Radiographics 1999; 19: 1179-97
- 3 Jordan LB, Al-Nafussi A, Beattie G. Cotyledonoid hydropic intravenous leiomyomatosis: A new variant leiomyoma. Histopathology 2002; 40: 245-52
- 4 Zaloudek CJ, Hendrickson MR, Soslow RA. Mesenchymal tumors of the uterus. In: Kurman RJ, Ellenson LH, Ronnett BM. Blaustein’s pathology of the female genital tract. New York, NY: Springer; 2011
- 5 Heffernan E, Köbel M, Spielmann A. Hydropic leiomyoma of the uterus presenting in pregnancy: Imaging features. Br J Radiol 2009; 82: 164-7
- 6 Awad EE, El-agwany AS, Elhabashy AM, El-zarka A, Abdel Moneim AS. A giant uterine myometrium cyst mimicking an ovarian cyst in pregnancy: An uncommon presentation of hydropic degeneration of uterine fibroid. Egyptian J Radiol Nucl Med 2015; 46: 529-34
- 7 Moore L, Wilson S, Rosen B. Giant hydropic uterine leiomyoma in pregnancy: Unusual sonographic and Doppler appearance. J Ultrasound Med 1994; 13: 416-8
- 8 DiPoce J, Liu-Jarin X, Newhouse J. Case 225: Leiomyoma. Radiology 2016; 278: 297-301
- 9 Amant F, Gabriel C, Timmerman D, Vergote I. Pseudo-Meigs’ syndrome caused by a hydropic degenerating uterine leiomyoma with elevated CA 125. Gynecol Oncol 2001; 83: 153-7
- 10 Dunn Jr JS, Anderson CD, Method MW, Brost BC. Hydropic degenerating leiomyoma presenting as pseudo-Meigs syndrome with elevated CA 125. Obstet Gynecol 1998; 92: 648-9
- 11 Coard K, Plummer J. Massive multilocular cystic leiomyoma of the uterus: An extreme example of hydropic degeneration. South Med J 2007; 100: 309-12
- 12 Horta M, Cunha TM, Oliveira R, Magro P. Hydropic leiomyoma of the uterus presenting as a giant abdominal mass. BMJ Case Rep 2015; DOI: 10.1136/bcr-2015-211929.
- 13 Coad JE, Sulaiman RA, Das K, Staley N. Perinodular hydropic degeneration of a uterine leiomyoma: A diagnostic challenge. Hum Pathol 1997; 28: 249-51
- 14 Yamashita Y, Torashima M, Takahashi M, Tanaka N, Katabuchi H, Miyazaki K. et al. Hyperintense uterine leiomyoma at T2-weighted MR imaging: Differentiation with dynamic enhanced MR imaging and clinical implications. Radiology 1993; 189: 721-5