The patient was a 60-year-old woman (G2 P2) who was referred to our hospital due to an abdominal mass, which was incidentally pointed out at a nearby hospital. MRI was performed and demonstrated a huge (20 x 15 x 18 cm) mass in the right side wall of the uterus. It was composed of two different solid components with central hemorrhagic necrosis. One solid component exhibited a slightly low intensity on T,-weighted images (T,WI), and low intensity on T2-weighted images (T2WI) and diffusion-weighted images (DWI) compared to the myometrium, as well as heterogeneous strong contrast enhancement (Fig. 1). This component was suggested to be leiomyoma (LM). The other solid component with approximately 8 x 8 x 13 cm showed slightly low intensity on T,WI, high intensity on both T2WI and DWI, as well as heterogeneous moderate contrast enhancement (Fig. 1). The apparent diffusion coefficient (ADC) value was 0.91 x 10 3 mm2/s. This component was suggested to be leiomyosarcoma (LMS). Therefore, we diagnosed the mass as LMS arising in LM.
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