We Report an unusual case of very large uterine subserosal leiomyoma mimicking ovarian mass on diagnostic modalities. A 70 year old postmenopausal woman presented with gradual distension of abdomen and diffuse pain in abdomen since 2 months. Ultrasonography was suggestive of large extrauterine mass of 20 cm × 15 cm × 18 cm displacing uterus anteriorly not separately visualised from either ovaries neoplastic origin likely ovary. While on Computed tomography scan was suggestive of 21 cm × 16cm × 19 cm mass of benign etiology possibility of subserosal fibroid with Histopathology correlation. Exploratory laparotomy with removal of huge subserosal fibroid with total abdominal hysterectomy with bilateral Salpingoophrectomy is the surgery done in our case. The majority of uterine leiomyomas are confidently diagnosed sonographically. However, large, degenerated tumours like in our case may be a diagnostic challenge and postmenopausal uterine leiomyoma with degeneration and Mockenberg’s calcification in a postmenopausal woman is rare and Computed Tomgraphy may help further characterize large pelvic masses and determine their organ of origin. As in our case its diagnosed in computed tomography.
Rajshree Dayanand Katke