Submucosal Leiomyoma in a Woman with Post-menopausal Bleeding – Diagnostic Dilemma, Ultrasound vs MRI: A Case Report

摘要

Introduction: We are reporting a case of submucosal leiomyoma in a post-menopausal women with a history of bleeding, which mimicked endometrial hyperplasia on ultrasound and was considered as a case of endometrial carcinoma. Case Presentation: A 44-year-old female who had attained menopause 04 yrs back, presented with on and off bleeding per vagina since one month. An ultrasound which was done outside our hospital, reported a markedly hypertrophied endometrium (24mm). She was not on any hormonal medications. Endometrial carcinoma was considered as a cause. Dilatation and curettage was done and the histopathology report showed atypical cells which were suggestive of malignancy. She was referred for MRI of the pelvis for further evaluation. The MRI was suggestive of a large, pedunculated, submucosal leiomyoma which protruded into the endometrium. A panhystrectomy was performed and the histopathology reports confirmed the leiomyoma. Conclusion: Ultrasound, as an initial modality of imaging, was not able to differentiate between the marked endometrial hypertrophy which was considered as endometrial carcinoma and the submucosal leiomyoma. MRI was helpful in reaching the diagnosis.