Submucosal uterine leiomyoma with complete cystic degeneration mimicking an empty gestational sac: a case report and literature review - Report - MDSpire
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Submucosal uterine leiomyoma with complete cystic degeneration mimicking an empty gestational sac: a case report and literature review
Clinical Report: Cystic Degeneration of Submucosal Uterine Leiomyoma
Background
Uterine leiomyomas are the most common benign tumors in women, with submucosal variants posing unique diagnostic challenges. Cystic degeneration of these tumors is rare and can lead to misinterpretation as pregnancy-related conditions. Accurate diagnosis is crucial for appropriate management and treatment.
Data Highlights
Measurement
Value
Lesion Size
65 mm × 45 mm
Ki-67 Index
Near 5%
PHH3-positive Cells
Scarce
Key Findings
A 42-year-old woman presented with irregular vaginal bleeding and abdominal pain.
Transvaginal ultrasonography revealed a large unilocular cystic lesion in the uterine cavity.
Negative serum b2-hCG testing was pivotal in ruling out anembryonic pregnancy.
Hysteroscopy confirmed a giant cystic tumor, which was excised and diagnosed as a degenerated submucosal leiomyoma based on histopathological evaluation.
Immunohistochemistry showed positivity for SMA, Desmin, h-Caldesmon, CD10, and FH.
Follow-up imaging at 3 months showed no recurrence.
Clinical Implications
Cystic submucosal leiomyomas should be included in the differential diagnosis of intracavitary cystic lesions, particularly when imaging suggests an empty gestational sac. Hysteroscopy is essential for both diagnosis and treatment.
Conclusion
This case illustrates the diagnostic complexity of cystic submucosal leiomyomas and the critical role of histopathological evaluation in confirming the diagnosis.
