A 48-year-old female presents with heavy, prolonged menstrual bleeding (menorrhagia) and pelvic fullness. Bimanual examination reveals an enlarged, irregularly contoured, non-tender, firm uterus equivalent in size to a 14-week gestation. Pelvic ultrasound demonstrates multiple intramural and subserosal well-circumscribed hypoechoic solid myometrial masses. What is the diagnosis?
Answer and explanation
Correct answer: A. Uterine leiomyomas (fibroids)
- Step 1: Uterine leiomyomas (fibroids) are benign monoclonal smooth muscle neoplasms of the myometrium.
- Step 2: They are the most common pelvic tumor in women of reproductive age, presenting with abnormal uterine bleeding, bulk symptoms, and an enlarged irregularly lobulated uterus.
Answer
Uterine leiomyomas (fibroids).
Why not the others: 'Endometrial polyps' cause intermenstrual spotting without causing massive irregular uterine enlargement; 'Adenomyosis' presents with a uniformly, symmetrically enlarged, soft, tender uterus ('globular uterus'); 'Uterine leiomyosarcoma' is a rare malignant tumor typically seen in postmenopausal women with rapid solitary growth.
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