“ Common, benign uterine tum o ur. In total, 50% of women of reproductive age are affected. Most are asymptomatic, others have menorrhagia,...
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Common, benign uterine tumour. In total, 50% of women of reproductive age are affected. Most are asymptomatic, others have menorrhagia, pelvic pain/mass and subfertility. Rarely malignant transformation (leiomyosarcoma). Defined as intramural (most common), submucosal, subserosal and pedunculated (may tort).
US
• Focal uterine masses, hypo-reflective compared to myometrium and cast an acoustic shadow
MRI
• Low signal on T2 compared to adjacent myometrium.
• Variable signal on T1, high if blood products present.
• Varying degrees of enhancement depending on whether they have started to degenerate.
• Rapid growth, ill-defined margins and invasion are red flags for sarcomatous transformation.
INTERVENTION
• Uterine artery embolisation is a popular alternative to surgery in selected patients.
• Overall clinical success rates are about 85% at 6 years.
• Pedunculated/subserosal fibroids are a relative contraindication (greater risk of detachment).
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