Spontaneous prolapse of pedunculated uterine submucosal leiomyoma: usefulness of broccoli sign on CT and MR imaging Jin Woo Kim, Chang Hee Lee, Kyeong.

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Spontaneous prolapse of pedunculated uterine submucosal leiomyoma: usefulness of broccoli sign on CT and MR imaging Jin Woo Kim, Chang Hee Lee, Kyeong Ah Kim, Cheol Min Park Clinical Imaging Volume 32, Issue 3, Pages 233-235 (May 2008) DOI: 10.1016/j.clinimag.2007.12.002 Copyright © 2008 Elsevier Inc. Terms and Conditions

Fig. 1 Axial CT scan with contrast enhancement showing a heterogeneously enhancing large mass prolapsed to the perineum through the introitus spreading to the vaginal cavity. Clinical Imaging 2008 32, 233-235DOI: (10.1016/j.clinimag.2007.12.002) Copyright © 2008 Elsevier Inc. Terms and Conditions

Fig. 2 Reformatted sagittal image showing the main portion of the lesion constitutes the bulky perineal mass connected to the uterus. The huge mass portion shows diffuse low attenuation with poor enhancement, which suggests extensive necrosis. Clinical Imaging 2008 32, 233-235DOI: (10.1016/j.clinimag.2007.12.002) Copyright © 2008 Elsevier Inc. Terms and Conditions

Fig. 3 Sagittal T2-weighted MR image (TR/TE, 4130/129) showing a lobulated huge perineal mass with heterogeneous signal intensity, connected to the endometrial cavity by a stalk containing multiple fine linear structures. Clinical Imaging 2008 32, 233-235DOI: (10.1016/j.clinimag.2007.12.002) Copyright © 2008 Elsevier Inc. Terms and Conditions

Fig. 4 Sagittal T1-weighted MR image (TR/TE, 1330/11) with contrast enhancement showing the prolapsed main mass portion with diffuse homogeneous low signal intensity without enhancement. Clinical Imaging 2008 32, 233-235DOI: (10.1016/j.clinimag.2007.12.002) Copyright © 2008 Elsevier Inc. Terms and Conditions

Fig. 5 Photograph of the broccoli. Clinical Imaging 2008 32, 233-235DOI: (10.1016/j.clinimag.2007.12.002) Copyright © 2008 Elsevier Inc. Terms and Conditions

Fig. 6 Photograph of the transvaginally resected gross specimen showing extensive necrosis with multiple hemorrhagic foci. The stalk portion is relatively preserved. Clinical Imaging 2008 32, 233-235DOI: (10.1016/j.clinimag.2007.12.002) Copyright © 2008 Elsevier Inc. Terms and Conditions