Mass found in the serosal surface of the uterus

• A. Subserosal leiomyoma
• B. Intramural leiomyoma
• C. Submucosal leiomyoma
• D. Pedunculated fibroid

Answer: (A)

A mass on the serosal surface of the uterus is best explained by a subserosal leiomyoma. Subserosal fibroids grow just beneath the outer covering of the uterus (the serosa) and project outward toward the peritoneal cavity. They can be attached directly (sessile) or by a narrow stalk (pedunculated). This outward location distinguishes them from intramural fibroids, which are embedded within the uterine wall, and from submucosal fibroids, which protrude into the uterine cavity. When a subserosal fibroid is pedunculated, the stalk may be visible or palpable as it connects the mass to the uterus, and the lesion can appear as a separate mass pressing against or extending from the serosal surface.