E2121. When Fibroids Go Wild: A Multimodality Imaging Review on Acute Complications of Uterine Leiomyomas
Ana Paula Moura;
Despite being the most common benign tumor in women of reproductive age and having well established features on imaging, leiomyomas may pose diagnostic challenges for the radiologist in the setting of an acute complication (1-7).
Educational Goals / Teaching Points
The aim of this presentation is to review the spectrum of possible complications of leiomyomas, such as torsion, hemorrhage (intra-leiomyoma, acute vaginal, intra-peritoneal), infarction and necrosis; infection (pyomyoma); urological complications in cases of massive presentations, such as post-renal acute renal failure, hydronephrosis, and bladder compression; venous thrombosis in the pelvic region, etc.
A brief introduction will be provided describing these types of complications, followed by a case-based multimodality review with representative cases. The differential diagnoses will be discussed, finalizing with take-home messages.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The main imaging techniques addressed in this presentation will be US, CT and MRI.
Although rare, most of these conditions present as an acute abdomen and can be life-threatening, which highlights the importance of a prompt and accurate diagnosis. Given the rarity and imaging complexity of many of these complications, reviewing and knowing them is paramount for the radiologist. A radiological appraisal is also important because descriptions of such conditions are scattered mostly through gynecological and urological literature.