Figure 1. (a) MRI performed at the initial consultation. The mass exhibited a clearly demarcated low signal intensity on T2W1 and was diagnosed as a uterine fibroid. (b) Transvaginal ultrasound after lower gastrointestinal endoscopy revealed a 90 × 69 mm mass in the uterine body, with a heterogeneous interior and irregular margins. (c) Plain CT. Increased density was observed in the mesenteric fat tissue surrounding the mass. A mass with marginal calcification was found on the anterior wall of the uterine body, protruding cephalad. (d) Comparison of the initial CT (left) with a CT performed 8 days later for preoperative evaluation (right). The uterine mass had shrunk from 10 × 11 cm (left panel) to 10 × 9.5 cm (right panel), and the absorption value of the internal high-density area had decreased, suggesting absorption of the hematoma. (e) MRI for further investigation of suspected uterine sarcoma. The mass showed moderate signal intensity on T2W1 and high signal intensity on DWI, and heterogeneous signals were present within it, suggesting hemorrhage and necrosis. The mass is indicated by the yellow dotted circle. Heterologous components including osteosarcoma and chondrosarcoma are indicated by the white arrowheads. CT: computed tomography; MRI: magnetic resonance imaging.
