Giant uterine leiomyoma: A diagnostic dilemma

Contrast-enhanced computed tomography (CE-CT) of the abdomen was performed in a 43-year-old woman presenting with abdominal distention with no remarkable medical history. CE-CT revealed a well-defined lobulated lesion extending from the pelvis to the top of the diaphragm, with diameters of 24.0 cm × 14.0 cm × 27.4 cm and inhomogeneous mild enhancement. The bowel was pushed to the side, and the uterus below was indistinguishable from the mass. Moreover, the lesion was supplied by the left common iliac artery (Fig. A–D). We initially speculated that this lesion originated from the uterus or retroperitoneal neoplastic lesions. Abdominal hysterectomy and bilateral salpingo-oophorectomy were subsequently performed, revealing that the mass was indistinct from the uterus and adherent to the left ovary. Postoperative histopathological analysis confirmed a uterine leiomyoma (Fig. E). After surgery, the patient received routine anti-inflammatory medication administered via analgesic intravenous infusion. The patient was in good health at the 3-month follow-up.