PMC9630625_01
Transabdominal ultrasound demonstrating a 7.7 x 6.5 x 7.2 cm predominantly intramural fundal uterine fibroid (white arrowheads) with a submucosal component in the fundus (white arrows) (a). Contrast-enhanced pelvic magnetic resonance imaging (MRI) demonstrating a submucosal uterine fibroid with mixed signal on the T2-weighted sequences (b) and uniform enhancement following intravenous contrast (arrowheads) (c).
gr1.jpg
PMC9630625_01_gr1.jpg
fig0001
Transvaginal ultrasound showed an enlarged uterus with a 7.7 x 6.5 x 7.2 cm predominantly intramural fundal fibroid with a small submucosal component in the fundus (Fig. 1a). Contrast-enhanced magnetic resonance imaging (MRI) confirmed the diagnosis demonstrating a submucosal fibroid with mixed signal on the T2-weighted sequences (Fig. 1b) and uniform enhancement following intravenous contrast (Fig. 1c).
Pelvic angiography showing a hypervascular uterine fibroid (arrowheads) (a), and subsequent bilateral uterine artery embolization (b and c). The final angiography demonstrates the embolized fibroid with no residual flow to the lesion (white arrowheads) (d).
gr2.jpg
PMC9630625_01_gr2.jpg
fig0002
A hypervascular fibroid was visualized on angiography corresponding to the large uterine fibroid seen on previous imaging studies (Fig. 2a). The bilateral uterine arteries were embolized to stasis using 500-700 mum bland embolic particles followed by a single Nestor microcoil (Cook, Bloomington IN) embolization (Fig. 2b and c). Final arteriography showed no significant residual flow to the fibroid (Fig. 2d).
Peritoneal carcinomatosis-like lesions seen on laparoscopy 7 years after uterine artery embolization.
gr3.jpg
PMC9630625_01_gr3.jpg
fig0003
During laparoscopy, vesicular-appearing peritoneal implants were identified between the uterosacral ligaments in the posterior cul-de-sac and on the right ovary mimicking endometriosis versus carcinomatosis (Fig. 3a and b).
Histological examination with Hematoxylin-Eosin staining demonstrating embolization bead clumps (large blue areas) in Fallopian tube serosa (a) and myometrium (b and c). Micrographs with 4x (a and b) and 10x (c) magnification levels.
gr4.jpg
PMC9630625_01_gr4.jpg
fig0004
Embolization beads were also found within tissue samples from the myometrium, cervix, and both fallopian tubes (Fig. 4a-c).