Fibroids

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Introduction

Also known as leiomyomata, fibroids are the most common gynecological tumour.

They occur in approximately half of women >35years, though decrease following menopause. They are more common in black women.

Fibroids rarely become malignant (0.1% of cases).

a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.

Fibroids are monoclonal, arising from single smooth muscle cells.

Apoptosis is decreased.

Growth in enhanced via progesterone. Estrogen appears to play minimal role.

Over half of fibroids are asymptomatic and are discovered incidentally on ultrasound.

Fibroid degeneration or torsion can lead to acute pelvic pain

Infertility

Bimanual exam can reveal asymmetrically enlarged, mobile uterus

CBC (anemia)

endometrial biopsy recommended to rule out endometrial cancer

Treat only if symptomatic or if rapidly growing.

Treat anemia if present.

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