Presentation
Multifibroid uterus. Surgical planning.
Patient Data
Multiple uterine fibroids are present. All are of low T2 signal, without restricted diffusion, evidence of hemorrhage or necrosis. All fibroids demonstrate enhancement slightly less than that of the myometrium. There are no features concerning for malignancy.
Notable fibroids based on potentially clinically relevant mass effect as follows:
Left fundal subserosal (<50% intramural) - reaching to the level of umbilicus; 8.7 x 6.8 x 9.4 cm (295 ml)
Right anterior lower uterine segment subserosal (<50% intramural); 7.2 x 8.1 x 6.6 (204 ml). This has considerable mass effect onto the urinary bladder.
Right posterolateral intramural; 4.4 x 4.3 x 3.8cm (38 ml). It causes leftward displacement and distortion of the endometrial contour.
Case Discussion
A "what does the surgeon want to know" approach to uterine fibroids.
Note potentially clinically relevant mass effect by several of these. There are no features concerning for malignancy.
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