ABSTRACT
Leiomyomas are common tumors that usually have a typical sonographic appearance. With
degeneration, however, the sonographic findings may be completely uncharacteristic.
We report a case of a multicystic anterior uterine wall mass detected at antenatal
sonography in an asymptomatic patient. Differential diagnosis included myoma, varicosity,
hematoma, abscess, uterine anomaly, and pelvic neoplasm. At cesarean section, the
mass was confirmed to be a myoma. Postoperatively, an ultrasound was performed by
the radiology service during evaluation of suspected endometritis and the mass was
interpreted as an endometrial abscess. This case illustrates that myomas can present
with sonographic features consistent with a number of pathologic disorders. This variable
pattern of echogenicity may sometimes create difficulty in establishing a correct
diagnosis. The case also demonstrates the importance of communication between services
and the need for not only antenatal but also postpartum and gynecologic ultrasound
studies to be performed by physicians trained in sonographic findings of the abnormal
uterus.
