A massive intra-abdominal mass - Answers

ABSTRACT

Refer to page 36) Answer Massive uterine fibroid Uterine fibroids (leiomyomas of the uterus) are extremely common, typically measuring 2cm to 5cm in size. Fibroids may be either solitary or multiple, with presenting complaints of subfertility, dysmenorrhoea, menorrhagia or pelvic pain. Uterine fibroids are benign tumours that arise from the overgrowth of smooth muscle and connective tissue. Histologically, a monoclonal proliferation of smooth muscle cells gives rise to these tumours, which can be hugely variable in size. Uterine fibroids occur twice as frequently in black women as in either white or Asian women and can occur at any time between menarche and menopause, but are most common in women 35 to 49 years of age. 1 Fibroids typically resolve after menopause. Rarely, uterine fibroids may undergo malignant degeneration to become sarcomatous, but this is the exception. The incidence of malignant degeneration is low and has been estimated to be as low as 0.2%.