Question:

What imaging finding on CT is used to differentiate leiomyosarcoma from a leiomyoma?
1. Presence of multiple feeding vessels.
2. Size greater than 10cm x 10cm x 10cm
3. Compression of great vessels
4. Lack of fat planes





Answer:

The correct answer for the question "What imaging finding on CT is used to differentiate leiomyosarcoma from a leiomyoma?" is:

4. Lack of fat planes



Explanation

Lack of fat planes on CT shows a lack of a defined border. This is common in malignant processes. (The mass appears inseparable from both the uterus and the transverse colon. It extends into the pelvis. (Fig. 2d) There is no clear fat plane or capsule on axial or sagittal section. (Fig. 2 and Fig. 3) Given the lack of clear tissue separation, and the clinical history, the above radiologic findings appeared to be most consistent with a leiomyosarcoma.)



From the manuscript:
A Leiomyoma in a Cachectic Woman Presenting as a Giant Abdominal Mass
Radiology Case. 2009 Oct; 3(10):23-29


This article belongs to the OB/GYN section.




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From the manuscript

A Leiomyoma in a Cachectic Woman Presenting as a Giant Abdominal Mass

Free full text article: A Leiomyoma in a Cachectic Woman Presenting as a Giant Abdominal Mass

Abstract
Fibroids are the most common gynecologic tumors. Our case discusses the outcome of a 47-year-old woman who presented to our clinic with cachexia, and a giant abdominal mass. An initial diagnostic imaging workup consisted of X-Ray, CT, and ultrasound and indicated a possible diagnosis of leiomyosarcoma. However, after surgical evaluation, she was diagnosed pathologically with an atypical presentation of a uterine leiomyoma. Our case reviews the epidemiology and presentation of both pathologies, along with the imaging workup, and the operative correlation in our patient.






References



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1. Leiomyoma

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