Uterine Leiomyoma is a common gynaecological pathology and one of the common indications for myomectomy and hysterectomy. What was concerning on her MRI was an atypical looking adenomyosis with intermediate signal on T2 imaging and DWI sequences that had increased diffusion restriction, because very occasionally a low grade endometrial stromal sarcoma can be confused with adenomyosis. IVL forms within the vascular vessels of the uterus (Yano et al. [14]), and is usually confined to the venous system of the uterus. A retrospective analysis of patients with IVL revealed that about 64% had previously undergone hysterectomy and the time before the occurrence of IVL ranged from 6 months to 20 years (Harris and Karakousis [4]). [Extracted from the article]