A Tale of 5Ms: Massive Uterine Leiomyoma Mimicking Ovarian Malignancy along with Multiple Fibroids displaying Multiple Degenerations

Abstract

Background: Leiomyomas are by far the commonest uterine neoplasms in the female reproductive age group. Giant leiomyomas are quite scarce and when longstanding tend to undergo various degenerations owing to decreased blood supply which on imaging may simulate malignancy owing to compromised blood supply and may simulate malignancy on imaging.
Case Presentation: We present a case of a 48-year-old post-menopausal multiparous woman complaining of intermittent lower abdominal pain for a month. Suspected as an ovarian tumor clinically and on ultrasound, this was seconded by raised serum CA125 levels. Histopathological examination gave a definitive diagnosis of a giant uterine leiomyoma along with multiple fibroids exhibiting multiple degenerations.
Conclusion: Degenerated leiomyomas can masquerade malignancy and hence should be one of the first differentials in women of reproductive age group presenting with complex abdominopelvic masses.