Stalked Peduncular Subserosal Uterine Fibroid Affecting the Serosa

Description

Centered in the pelvic cavity, the uterus is rendered with its fundus superior and cervix inferior, continuous with the proximal vagina. A pedunculated subserosal uterine fibroid (leiomyoma, myoma) projects outward from the uterine serosa on a narrow stalk, creating an exophytic mass that remains attached to the outer myometrium rather than deforming the endometrial cavity. Laterally, the fallopian tubes course from the uterine cornua toward the ovaries, which sit posterolateral to the uterus near the tubal fimbriae. The mass sits superficial to the uterine wall and displaces the serosal contour. Clear anatomy. Peduncular subserosal fibroids matter because their symptoms and risks differ from intramural or submucosal disease: they more often cause bulk-related pelvic pressure, urinary frequency, or dyspareunia than abnormal uterine bleeding, and their exophytic growth can mimic an adnexal mass on pelvic exam or ultrasound. Stalked lesions carry a torsion risk, presenting with acute focal pain and peritoneal signs, and they can undergo ischemic or red degeneration, a pattern clinicians frequently consider in pregnant patients with sudden pain. For operative planning, the stalk is a key landmark, since laparoscopic myomectomy typically aims for controlled pedicle coagulation and transection while protecting the adjacent fallopian tube, utero-ovarian ligament, and superficial uterine vessels along the serosa. Use this illustration in gynecology and pelvic anatomy teaching to contrast subserosal, intramural, and submucosal fibroid locations, or in patient-facing counseling materials that explain why a pedunculated uterine myoma can feel like an ovarian lump and why torsion is treated urgently. It also fits radiology and surgical publications discussing differential diagnosis of adnexal masses, MRI localization of leiomyomas, and technique notes for minimally invasive myomectomy. Anatomical accuracy verified by SciePro's Medical Advisory Board.