Abstract
A 69-year-old postmenopausal female with a spontaneously occurring uterine pyomyoma was described with emphasis on the MR imaging findings. On unenhanced T1- and T2-weighted MR images, a huge mottled mass suspected to contain blood products, necrotic tissue, or purulent or viscous fluid was demonstrated within anterior myometrial wall of uterine body. The mass was surrounded by a peripheral rim that was hyperintense on T1-weighted images and hypointense on T2-weighted images. On gadolinium-enhanced MR images, most of the mass was unenhanced, but the peripheral rim was equally enhanced with the surrounding myometrium. Pathological examination revealed an intramural uterine pyomyoma surrounded by fibrous capsules with abundant lymphocytes and neutrophils. Our findings indicate that pyomyoma should be considered when MR images demonstrate a myometrial cystic lesion accompanied by a peripheral rim.
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References
Kobayashi F, Kondoh E, Hamanishi J, et al. (2013) Pyomayoma during pregnancy: a case report and review of the literature. J Obstet Gynaecol Res 39:383–389.
Karcaaltincaba M, Sudakoff GS (2003) CT of a ruptured pyomyoma. AJR Am J Roentgenol 181:1375–1377.
Shukla PA, Kumar A, Klyde D, et al. (2012) Pyomyoma after uterine artery embolization. J Vasc Interv Radiol 23:423–424.
Fletcher H, Gibson R, Williams N, et al. (2009) A woman with diabetes presenting with pyomyoma and treated with subtotal hysterectomy: a case report. J Med Case Rep 3:7439.
Nguyen QH, Gruenewald SM (2008) Sonographic appearance of a postpartum pyomyoma with gas production. J Clin Ultrasound 36:186–188.
Lee SR, Kim BS, Moon HS (2010) Magnetic resonance imaging and positron emission tomography of a giant multiseptated pyomyoma simulating an ovarian cancer. Fertil Steril 94:1900–1902.
Stroumsa D, Ben-David E, Hiller N, et al. (2011) Severe clostridial pyomyoma following an abortion does not always require surgical intervention. Case Rep Obstet Gynecol 2011:364641.
Murase E, Siegelman ES, Outwater EK, et al. (1999) Uterine leiomyomas: histopathologic features, MR imaging findings, differential diagnosis, and treatment. Radiographics 19:1179–1197.
Grune B, Zikulnig E, Gembruch U (2001) Sepsis in second trimester of pregnancy due to an infected myoma: a case report and a review of the literature. Fetal Diagn Ther 16:245–247.
Haimes AB, Zimmerman RD, Morgello S, et al. (1989) MR imaging of brain abscesses. AJR Am J Roentgenol 152:1073–1085.
Ueda H, Togashi K, Konishi I, et al. (1999) Unusual appearances of uterine leiomyomas: MR imaging findings and their histopathologic backgrounds. Radiographics 19: S131–145.
Kawakami S, Togashi K, Konishi I, et al. (1994) Red degeneration of uterine leiomyoma: MR appearance. J Comput Assist Tomogr 18:925–928.
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Ono, H., Kanematsu, M., Kato, H. et al. MR imaging findings of uterine pyomyoma: radiologic–pathologic correlation. Abdom Imaging 39, 797–801 (2014). https://doi.org/10.1007/s00261-014-0112-2
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DOI: https://doi.org/10.1007/s00261-014-0112-2