Diagnostic Dilemma In Massive Cellular Leiomyoma With Cystic Degeneration: A Case Report

Massive cellular leiomyoma with cystic degeneration is a rare and often misdiagnosed type of uterine leiomyoma. We report findings of such pathology in a 29-year-old asymptomatic, nulliparous Chinese woman. MRI revealed the 22.0 x 20.0 x 16.0 cm mass to be thick-walled and predominantly cystic. A diagnosis of ovarian tumor was initially suspected and a laparotomy was arranged. Her increscent uterus measured 20 x 18 x 16 cm. About 5000 ml of straw colored fluid was aspirated from the cystic cavity. The massive, cystic cavity arising on the left side of the uterus did not share a clear boundary with the normal myometrium. The patient underwent myomectomy and subsequent histopathological examination confirmed the diagnosis of a cellular leiomyoma with cystic degeneration.