Uterine fibroid

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Uterine fibroid

Reproductive system


Uterine fibroid


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Uterine fibroid

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A 31-year-old woman, gravida 1 para 1, presents to the office because of heavy and painful menstrual bleeding for the last 2 months. She reports soaking 12-15 sanitary pads during her last menses. Her menstrual cycle is regular, with 5-6 days of heavy bleeding. Menarche was at age 12. She is sexually active with one male partner and denies any pain during intercourse. Past medical and surgical history is unremarkable. Temperature is 37° C (98.6°F), pulse is 102/min, respirations are 19/min, and blood pressure is 100/60 mmHg. Physical examination shows an enlarged uterus with irregular contour. The remainder of the examination is unremarkable. Urine pregnancy test is negative. Complete blood count is as follows:  
 Laboratory value  Result 
 Complete blood count 
 Hemoglobin (Hb)  9 g/dL 
 Mean corpuscular volume (MCV)  75 fL 
 Hematocrit  32% 
 Leukocyte count  9,100/mm3 
 Platelet count  400,000/mm3 
 Neutrophils, segmented  54% 
 Eosinophils  1% 
 Basophils  0% 
 Lymphocytes  25% 
 Monocytes  4% 

A transvaginal ultrasound is performed.

Reproduced from: radiopedia.org  
Which of the following is the most likely origin of this patient’s ultrasound finding?  

External References

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fibroid tumors p. 665

Fibroid (leiomyoma) p. 665

Iron deficiency anemia p. 425

fibroid tumors p. 665

Leiomyoma (fibroid) p. 665

Menopause p. 652

fibroid tumors in p. 665

Pregnancy p. 657

fibroid tumors in p. 665

Spontaneous abortion

fibroid tumors p. 665

External Links


Uterine fibroids, are also called leiomyomas. Leio- means smooth, myo- means muscle, and -oma means tumor, so these are benign smooth muscle tumors of the uterus.

In fact, fibroids are the most common type of tumor in females.

The uterus is a hollow organ that sits behind the urinary bladder and in front of the rectum.

The top of the uterus above the openings of the fallopian tubes is called the fundus, and the region below the openings is called the uterine body.

The uterus tapers down into the uterine isthmus and finally the cervix, which protrudes into the vagina.

Zooming into the cervix, there are two openings, a superior opening up top, and an inferior opening down below, both of which have mucus plugs to keep the uterus closed off except during menstruation and right before ovulation.

The uterus is anchored to the sacrum by utero- sacral ligaments, to the anterior body wall by round ligaments, and it’s supported laterally by cardinal ligaments as well as the mesometrium, which is part of the broad ligament.


Uterine fibroids, also called leiomyomas, are non-cancerous growths that develop in the uterus, most commonly in women of childbearing age. The exact cause of uterine fibroids is unknown, but they are thought to be related to hormonal imbalances and genetic factors.

Uterine fibroids can cause symptoms such as heavy menstrual bleeding, pelvic pain or pressure, and frequent urination. In some cases, they can also lead to infertility or complications during pregnancy. Treatment options may include medications to regulate hormones or shrink the fibroids, or surgical procedures to remove them. In some cases, no treatment is necessary if the fibroids are small and not causing symptoms.


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  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Role of Medical Management for Uterine Leiomyomas" Best Practice & Research Clinical Obstetrics & Gynaecology (2016)
  6. "The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology" American Journal of Obstetrics and Gynecology (2018)

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