UTERINE FIBROIDS – A BIZARRE CALCIFIED MASS


Case History


This 63 year old female patient presents with history of lower back pain.


Radiographic Findings


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.

3) Circumferential-Cystic.


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.