This 63 year old female patient presents with history of lower back pain.
Note the three calcific densities present within the pelvic basin. The round, cystic calcified mass has a very dense peripheral margin and a radiolucent center. This is one form or type of uterine fibroid.
The remaining two large irregular calcifications represent a different pattern of calcification found in benign uterine fibroids.
Uterine fibroids (leiomyomas) represent the most common tumor of women. Twenty-five percent (25%) of women will develop these. These tumors are composed of smooth muscle bundles. The most common site in the uterus is the fundus and corpus. Less than three percent (3%) occur in the cervix. Seventy-five percent (75%) are symptomatic. Vaginal bleeding is the most common symptom. Malignant degeneration to a leiomyosarcoma occurs in less than one percent (1%) of cases, Only ten percent (10%) will calcify and can be seen on an x-ray.
There are three patterns of calcifications:
1) Densely packed flocculent.
2) Non-confluent flocculent.
The circumferential-Cystic and densely packed flocculent presentation is noted in this case study.
Reference - Yochum Tr, Yochum and Rowe, LJ, Essentials of Skeletal Radiology, Masqueraders of Musculoskeletal Disease, Chapter 18 Lippincott, Williams and Wilkin s, 2005.