Submucosal uterine leiomyoma
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View Ashesh Ishwarlal Ranchod's current disclosures- Submucosal leiomyoma
- Sub-mucosal fibroid
- Sub-mucosal fibroids
- Submucosal fibroids
- Submucosal fibroid
- Sub-mucosal uterine leiomyoma
- Sub mucosal uterine leiomyoma
- Submucosal uterine leiomyoma
- Submucosal uterine fibroid
- Sub-mucosal leiomyoma of the uterus
- Intracavitary fibroid
- Intracavitary fibroids
Submucosal leiomyomas of the uterus refer to a subtype of uterine leiomyoma that primarily projects into the endometrial cavity; when the fibroid is predominantly within the cavity it is often called an intracavitary fibroid 7. They are the least common, albeit the most symptomatic, type of leiomyoma.
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Clinical presentation
Submucosal leiomyomas can be a common source of abnormal uterine bleeding and may also present with reproductive dysfunction, including recurrent miscarriages, infertility, premature labor, and fetal malpresentation. Submucosal leiomyomas can grow rapidly in pregnancy.
More common in premenopausal women, they are also a recognized cause of infertility.
Radiographic features
It is typically seen as a subendometrial mass indenting and distorting the endometrium. Please, refer to the main article on uterine leiomyomas for a detailed discussion on leiomyomas imaging features.
Ultrasound
On ultrasound, submucosal fibroids are typically seen as broad-based, hypoechoic, well-defined, solid masses with shadowing. Submucosal fibroids typically have an overlying layer of the echogenic endometrium, which helps confirm their subendometrial location and helps distinguish them from endometrial polyps. Also, as opposed to polyps, submucosal fibroids often distort the interface between the endometrium and myometrium and show acoustic attenuation.
When internal vessels are seen, a submucosal fibroid will typically have multiple feeding vessels, as opposed to the single vascular pedicle for an endometrial polyp 6.
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Differential diagnosis
General imaging differential considerations include:
See also
Quiz questions
References
- 1. Straub H, Chohan L, Kilpatrick C. Cervical and Prolapsed Submucosal Leiomyomas Complicating Pregnancy. Obstet Gynecol Surv. 2010;65(9):583-90. doi:10.1097/OGX.0b013e3181fc5602 - Pubmed
- 2. Murase E, Siegelman E, Outwater E, Perez-Jaffe L, Tureck R. Uterine Leiomyomas: Histopathologic Features, MR Imaging Findings, Differential Diagnosis, and Treatment. Radiographics. 1999;19(5):1179-97. doi:10.1148/radiographics.19.5.g99se131179 - Pubmed
- 3. Garcia C & Tureck R. Submucosal Leiomyomas and Infertility. Fertil Steril. 1984;42(1):16-9. doi:10.1016/s0015-0282(16)47951-3 - Pubmed
- 4. Panageas E, Kier R, McCauley T, McCarthy S. Submucosal Uterine Leiomyomas: Diagnosis of Prolapse into the Cervix and Vagina Based on MR Imaging. AJR Am J Roentgenol. 1992;159(3):555-8. doi:10.2214/ajr.159.3.1503024 - Pubmed
- 5. Davis P, O'Neill M, Yoder I, Lee S, Mueller P. Sonohysterographic Findings of Endometrial and Subendometrial Conditions. Radiographics. 2002;22(4):803-16. doi:10.1148/radiographics.22.4.g02jl21803 - Pubmed
- 6. Gupta A, Desai A, Bhatt S. Imaging of the Endometrium: Physiologic Changes and Diseases: Women’s Imaging. Radiographics. 2017;37(7):2206-7. doi:10.1148/rg.2017170008 - Pubmed
- 7. Caserta M, Bolan C, Clingan M. Through Thick and Thin: A Pictorial Review of the Endometrium. Abdom Radiol (NY). 2016;41(12):2312-29. doi:10.1007/s00261-016-0930-5 - Pubmed
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- Pedunculated submucous uterine fibroid protruding into the vagina
- Submucosal leiomyoma
- Prolapsed endometrial polyp
- Intracavitary fibroid
- Submucosal uterine fibroid
- Submucosal uterine leiomyoma
- Endometrial polyp
- Submucosal uterine fibroid
- Submucosal uterine fibroid
- Submucosal fibroid on MRI
- Prolapsing uterine leiomyoma
- Placental chorioangioma
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