PMC9905040_01
Chest X-ray obtained at the first visit revealed widespread decreased permeability of the right lung fields suggestive of a massive pleural effusion.
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FIG1
Plain chest radiography showed widespread decreased permeability of the right lung fields suggestive of a massive pleural effusion (Figure 1).
Contrast-enhanced computed tomography scan obtained during the first visit showing: (a) massive pleural effusion and (b) giant uterine fibroids and ascites in Douglas's pouch.
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FIG2
Moreover, giant uterine fibroids and ascites were suspected in Douglas's pouch (Figures 2a, 2b). 
Magnetic resonance imaging of the pelvis revealed multiple uterine fibroids and no findings suggestive of malignancy. (a) T2-weighted sagittal section showing 90 x 100 x 120 mm degenerative uterine fibroids submucosal to intramural in the right anterior wall of the body of the uterus (up arrow), 55 x 30 x 50 mm submucosal uterine fibroids in the fundus of the uterus (left arrow), and other multiple 10-30 mm intramural and subserous uterine fibroids (right arrow). (b) T1-weighted sagittal section showing a signal equivalent to that of the surrounding myometrium
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FIG3
On magnetic resonance imaging of the pelvis, degenerative uterine fibroids were considered (Figure 3a, 3b).
Uterine corpus (x200) showing findings of leiomyoma, that is, the bunching and complicated array of smooth muscle cells without highly atypical cells, nuclear fission, or necrosis.
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FIG4
A pathological examination of the uterine fibroids led to the diagnosis of smooth uterine leiomyoma (Figure 4).