Peduncular Subserosal Uterine Fibroid

Description

Arising from the outer uterine surface, a peduncular subserosal uterine fibroid (leiomyoma, myoma) projects laterally on a narrow stalk from the serosa of the uterine corpus near the fundus. The myometrial wall is rendered in section on the left, with the endometrial cavity implied centrally and the serosal contour continuous with the fibroid’s pedicle. Superior and lateral to the uterus, the fallopian tube courses toward the ovary on the right, placing the adnexa in close proximity to a mass that can sit adjacent to the broad ligament and mimic an ovarian lesion. Orientation is clear. A critical landmark. Pedunculated subserosal fibroids matter because their symptoms and surgical behavior differ from intramural or submucosal disease: they often cause bulk-related pelvic pressure, dyspareunia, or urinary frequency while leaving bleeding patterns relatively unchanged. The stalk introduces specific risks, torsion with acute pain and ischemic degeneration, venous congestion, and occasional autoamputation with parasitic revascularization on the omentum or pelvic sidewall. On ultrasound and MRI, identifying the pedicle and the bridging vessels from the uterine serosa helps distinguish a subserosal myoma from an adnexal neoplasm, and it guides operative planning for laparoscopic myomectomy or hysterectomy where traction on the pedicle can transmit force to the uterine wall and fallopian tube. Use this illustration in gynecology teaching modules on fibroid classification (subserosal versus intramural versus submucosal), radiology primers on adnexal mass differential diagnosis, and patient-facing surgical consent materials explaining why a “womb” fibroid can appear to arise near the ovary. It also suits textbooks and CME content discussing acute pelvic pain from torsed pedunculated fibroids and the typical laparoscopic approach to pedicle coagulation and transection. Anatomical accuracy verified by SciePro's Medical Advisory Board.