Diffuse uterine leiomyomatosis

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Infertility. The ultrasound exam (not shown) revealed a diffusely enlarged heterogeneous uterus.

Patient Data

Age: 30 years
Gender: Female

The uterus is diffusely enlarged showing multiple innumerable ill-defined leiomyomatous nodules without discrete margins mainly of intramural and subserosal location. They display an iso-to-low signal to the myometrium on T1 and, a low signal on T2 with moderate heterogeneous enhancement.

Normal appearance of both ovaries containing small follicles.

Moderate effusion in the Douglas pouch.

Case Discussion

Diffuse uterine leiomyomatosis is an extremely rare benign condition in which the uterus is symmetrically enlarged as a result of the almost complete replacement of the myometrium by innumerable poorly defined, confluent leiomyomatous nodules. The exact etiology of these neoplasms is incompletely understood. 

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