Cystic uterine tumors

The differential diagnosis of cystic uterine tumors includes fibroids showing cystic degeneration, cystic adenomyomas, congenital cysts, and developmental anomalies.

The incidence, clinical presentation and accuracy in preoperative diagnosis of cystic uterine tumors were studied in a university hospital population over a 6-year period.

29 cases were included. Of these, 8 corresponded to the diagnosis of a non-fibroid uterine cystic enlargement, and 21 to that of a fibroid with cystic degeneration. Age and parity were significantly lower in patients with non-fibroid cysts. Rates of symptomatic women (60 vs. 55.6%) were similar in both groups. The preoperative diagnosis was accurate in 20/21 (95.2%) cases with a degenerated leiomyoma. On the contrary, in 6/8 (75%) cases with a non-fibroid cystic swelling an erroneous diagnosis of an adnexal or an extrauterine mass was made preoperatively. In this group, histology of the tumor showed a cystic adenomyoma in 3, a congenital cyst in 3, and a blind rudimentary uterine horn in 2 cases, respectively.

Uterine cystic tumors are uncommon. Frequently, non-fibroid swellings are erroneously diagnosed as adnexal enlargements and their true origin only becomes evident during surgery.