Multimodal ultrasound diagnosis of a huge retroperitoneal leiomyoma originating from the levator ani muscle: a case report
Year: 2026
Type: article
Study design: Case Report
Abstract: Background: Primary retroperitoneal leiomyomas are exceptionally rare, accounting for approximately 1.2% of all retroperitoneal tumors. Those originating specifically from the levator ani muscle are even rarer. The contrast-enhanced ultrasound (CEUS) features of such tumors are poorly documented in the literature, often leading to diagnostic challenges and misdiagnosis. This case report aims to describe the comprehensive multimodal ultrasound findings of a large retroperitoneal leiomyoma arising from the levator ani and highlight the diagnostic value of integrating advanced ultrasound techniques. Case Description: surgical resection via a perineal approach without preoperative biopsy. Histopathological examination confirmed the diagnosis of leiomyoma. Conclusions: To our knowledge, this is the first reported case utilizing a combination of high-frame-rate CEUS and elastography for the preoperative evaluation of a retroperitoneal leiomyoma originating from the levator ani. This multimodal ultrasound approach, encompassing detailed anatomical mapping with specialized probes, dynamic contrast enhancement kinetics, and tissue stiffness assessment, proved crucial in accurately determining the tumor's origin and characterizing its nature. It can significantly improve diagnostic accuracy for complex pelvic masses, potentially reducing misdiagnosis and guiding optimal clinical management, including the decision to forgo biopsy in select cases with compelling benign imaging features planned for definitive surgery.
Source: AME Case Reports
Authors: Juandi Xie, Shulan Li, Zubang Zhou, Songtao Zhang, Bang Du, Qi Wang
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7122653451
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