Friday, November 6, 2009
39 year old lady was referred for ultrasound because of severe period pain and pelvic pain after sexual intercourse. Ultrasound showed a large 11cm subserosal uterine fibroid. No associated necrosis or calcification.
Uterine fibroid is the most common benign tumour of the uterus. It is typically found in the age range of 20-40 years. This is because oestrogen receptors on the fibroids cause them to respond to estrogen stimulation during the reproductive years. Thus, during menopause, they are expected to shrink. Most are asymptomatic but some may present with heavy menses, pelvic pain and urinary urgency. It may be single or multiple. Location may be intramural (within the wall of the uterus), subserosal (just underneath the outer surface of the uterus), submucosal (beneath the endometrium) and cervical (in the wall of the cervix).
The role of ultrasound will be to confirm the diagnosis, measure the size and characterise the lesion. Ultrasound may be repeated after treatment to assess progress.
MRI-guided focused ultrasound surgery (FUS) is the latest in the treatment of fibroid. It is a non-invasive treatment option that preserves the uterus. Focused high-frequency, high-energy sound waves are used to target and destroy the fibroids while being guided by MRI.