Multimodal ultrasound diagnosis of a huge retroperitoneal leiomyoma originating from the levator ani muscle: a case report

To our knowledge, this is the first reported case utilizing a combination of high-frame-rate CEUS and elastography for the preoperative evaluation of a retroperitoneal leiomyoma originating from the levator ani. This multimodal ultrasound approach, encompassing detailed anatomical mapping with specialized probes, dynamic contrast enhancement kinetics, and tissue stiffness assessment, proved crucial in accurately determining the tumor's origin and characterizing its nature. It can significantly improve diagnostic accuracy for complex pelvic masses, potentially reducing misdiagnosis and guiding optimal clinical management, including the decision to forgo biopsy in select cases with compelling benign imaging features planned for definitive surgery.