ABSTRACT
Fibroid is the most common benign tumour occurring in the reproductive age groups, the incidence is around 70%, mainly due to oestrogen. Other risk factors are nulliparity, obesity, early menarche, delayed menopause, family history, and ethnicity. Surprisingly smoking seems to reduce the risk. Other factors reducing the risk are OCP, pregnancy and lactation.Trans-vaginal ultrasound is the gold standard investigation. But MRI is helpful in mapping the site, number, size, depth, nature of lesion and associated pelvic pathology. It also helps in differential diagnosis of fibroid mainly adenomyosis and sometimes both conditions exist together. The most common complaint in fibroids are menstrual problems like menorrhagia, metrorrhagia, dysmenorrhea, infertility, pressure symptoms on bladder and rectum. The patient may become anaemic due to blood loss, our patient in spite of her menorrhagia, her Haemoglobin was nearly normal. Our patient with such a huge fibroid of size of 28 weeks, has no history of pain and the mass found to be non-tender, in spite of extensive cystic degeneration.
ABSTRACT
A thirty-nine-year-old lady P2 L2 admitted with lower abdominal mass since 3 months had no history of menstrual problems and pressure symptoms.1 The uterus was palpable which was of 34 weeks size. She had a scar in subumbilical region for puerperal sterilization which was done 17 years ago after her second childbirth. Medical and surgical history was unremarkable. Routine investigations like urine examination including culture, CBC, clotting profile, kidney function test, x-ray chest, ECG were within normal limits. PAP smear and vaginal swab were normal. USG shows 14.1 mm x 10.6 cm fibroid occupying posterior fundal wall. There is another fibroid measuring 7.5 cm x 6.5 cm in the anterior wall in the body of uterus, other three small fibroids 5.5 cm x 4.5 cm, endometrial thickness normal, both ovaries appear normal, no hydroureters, no degeneration or calcification were noted.