Cystic degeneration of a uterine leiomyoma masquerading as a postmenopausal ovarian cyst. A case report.

BACKGROUND

Leiomyomas are the most common of uterine neoplasms and a major cause of visits to gynecologists. While most often straightforward in their presentation and management, they can undergo various kinds of asymptomatic degeneration that drastically alters their appearance and muddies the process of diagnosis.

CASE

A 51-year-old woman was referred with a large adnexal mass that appeared on ultrasound to be a simple ovarian cyst. Because of its 10-cm diameter in a postmenopausal patient who could not guarantee close follow-up, surgery was performed. Normal ovaries were encountered, along with a large uterine cyst, identified as a degenerative leiomyoma.

CONCLUSION

Our case appears to be the largest simple cystic degenerative uterine leiomyoma reported and illustrates the possible diagnostic confusions. Subtle clues may differentiate uterine from adnexal cystic structures sonographically, but this case illustrates that while extremely valuable, sonographic evaluation in gynecology is not infallible.