[Menorrhagia due to cystic degeneration of a uterine leiomyoma].

A 47-year-old female patient presented with increasing menorrhagia. On ultrasound examination a smooth-walled intra-uterine enlargement with multiple clear areas was found. As these cystic changes were reported to be 'most likely blood vessels' the enlargement was expected to be a uterine leiomyoma, and drug therapy was started. Due to unsatisfactory results of this therapy and continuing growth of the mass, it was finally decided to perform a total abdominal hysterectomy. The pathology revealed cystic degeneration of uterine leiomyoma. Degeneration of uterine leiomyoma is common and can easily be confused with other abnormalities of the uterus or even other abdominal organs. Diagnosis can best be made by (transvaginal) ultrasonography, if necessary complemented by CT or MRI.