PMC7593746_01
Computed tomography (CT) images of the uterus and leiomyoma. Comparison of sagittal (a, c) and axial (b, d) views of the plain abdominal CT images. Compared to the CT scan taken 5 days before the surgery (a, b), the leiomyoma had slightly enlarged in size and anteriorly deviated (white arrowheads) on the day of emergency surgery (c, d). The enhanced CT image (e) showed a twisted cervix at the level of the uterine body and cervical junction (white arrow).
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fig1
CT scan, which revealed a large uterine leiomyoma with calcification measuring 15 x 13 x 9 cm (Figure 1(b)). Compared to the CT scan taken 5 days before, the leiomyoma that was previously 14 x 9 x 7 cm had slightly enlarged and deviated anteriorly, from the pouch of Enhanced CT images showed an elongated cervix, twisted at the uterine body and cervical junction (Figure 1(c)). The final pathologic finding of the specimen was uterine interstitial leiomyoma with diffuse calcification and hemorrhagic necrosis, weighing 1360 g (Figures 1(c) and 1(d)).
Operative findings and gross section of the uterus. The gross material revealed that the uterus was rotated 540 degrees counterclockwise at the level of the junction between the cervix and the uterine body. Both fallopian tubes and uterine body were discolored and necrotic. The cervix was atrophic and unusually elongated (a, b). Pathologic findings were uterine interstitial leiomyoma with diffuse calcification and hemorrhagic necrosis, weighing 1360 g in total (c, d). Both ovaries, fallopian tubes, and uterine body were necrotic, suggesting total tissue infarction due to the axial rotation of the uterus.
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fig2
The uterus with a large leiomyoma was rotated 540 degrees counterclockwise at the level of the junction between the cervix and uterine body (Figures 2(a) and 2(b)).