Epithelioid leiomyoma of the uterus is rare, and its prognostic factors have not been well established. Moreover, radiologic findings of this disease have not been previously documented. This is a case of a 49-year-old woman with
epithelioid leiomyoma of the uterus. Magnetic resonance imaging (MRI) revealed a heterogeneous high-intensity mass with multiple ordinary uterine
leiomyomas. The mass showed a slightly diffusion-restricted site. Since benign
tumors could not be confidently diagnosed using these MRI findings, total abdominal
hysterectomy with bilateral
salpingectomy was performed, and a pathological diagnosis of
epithelioid leiomyoma of the uterus was established. Microscopically, this lesion showed edematous changes and
cyst formation, causing a heterogeneous appearance on T2-weighted images. In addition, the diffusion-restricted site is considered to be consistent with areas of solid and dense proliferation of
tumor cells. The patient survived and was well 10 months after the surgery. It is important to recognize this benign variant of
leiomyoma with an unusual appearance, to provide appropriate therapeutic management.