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Uterine Fibroids PowerPoint Presentation

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Description : This presentation is about uterine fibroids. Further classifying them in the different types, their locations and the useful imaging modalities that could be used to diagnose them.

Tags : fibroids,uterine fibroids

Published on : Nov 13, 2022 | Views : 5070 | Downloads : 25

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UTERINE FIBROIDS PRESENTER: PRIYA NATH
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WHAT IS UTERINE FIRBROIDS? Also known as leiomyomas, are the commonest uterine neoplasms. They are benign tumors of smooth muscle origin, with varying amounts of fibrous connective tissue. Usually arise in the myometrium but may occasionally be found in the cervix, broad ligament or ovaries.
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CAUSES: Hormone dependent benign tumors - While it is not clearly known what causes fibroids, it is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of Estrogen.
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WHO ARE AT RISK: Early age at menarche Obese women (due to increase in exposure to estrogen) Black women (reason unknown)
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SIGNS AN SYMPTOMS: Heavy or prolonged menstrual periods Abnormal bleeding between menstrual periods Pelvic pain (caused as the tumor presses on pelvic organs) Frequent urination Low back pain Pain during intercourse A firm mass, often located near the middle of the pelvis, which can be felt by the physician
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TYPES OF UTERINE FIBROIDS: Intramural FibroidsIntramural fibroid tumors are the common type of fibroids and they typically develop within the uterine wall and expand from there. Subserosal FibroidsSubserosal fibroids typically develop on the outer uterine wall. This type of fibroid tumor can continue to grow outward increasing in size. Submucosal FibroidsThe least common of the various types of fibroid tumors are submucosal fibroids. These fibroids develop just under the lining of the uterine cavity.
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TYPES OF UTERINE FIBROIDS: (CONT…) Pedunculated FibroidsPedunculated uterine fibroids occur when a fibroid tumor grows on a stalk, resulting in pedunculated submucosal or subserosal fibroids. These fibroids can grow into the uterus and also can grow on the outside of the uterine wall.
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HOW ARE FIRBROIDS DIAGNOSED? X-ray. Electromagnetic energy used to produce images of bones and internal organs onto film. Transvaginal ultrasound (also called ultrasonography). An ultrasound test using a small instrument, called a transducer, that is placed in the vagina. Magnetic resonance imaging (MRI). A non-invasive procedure that produces a two-dimensional view of an internal organ or structure. Hysterosalpingography. X-ray examination of the uterus and fallopian tubes that uses dye and is often performed to rule out tubal obstruction.
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HOW ARE FIRBROIDS DIAGNOSED? (CONT…) Hysteroscopy. Visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina. Endometrial biopsy. A procedure in which a sample of tissue is obtained through a tube which is inserted into the uterus. Blood test (to check for iron-deficiency anemia if heavy bleeding is caused by the tumor).
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APPEARANCE ON IMAGING Figure 1 A 51-year-old woman with a history of menorrhagia. Sagittal T2W MRI shows a bulky retroverted uterus containing multiple intramural fibroids and a large submucosal fibroid (arrow) projecting into the endometrial cavity.
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CONT… Figure 2 A 43-year-old woman with menorrhagia. Sagittal T2W MRI image shows multiple intramural fibroids (arrows); the largest (arrowhead) lying anteriorly measures 8.5 cm. These show typical low-signal intensity
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CONT… Figure 3 A 59-year-old woman with an abdominal mass and discomfort. Sagittal T2W MRI image shows a 15-cm pedunculated, subserosal fibroid arising from the anterior uterus. There is also a small intramural fibroid lying posteriorly
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CONT… Figure 4 (A, B) A 58-year-old woman with sacral pain. A frontal pelvic radiograph (A) shows calcification overlying the left hip, initially thought to be suggestive of a chondrosarcoma. A subsequent CT scan (B) reveals an incidental calcified fibroid
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CONT… Figure 5 (A, B) A 49-year-old woman with a history of menorrhagia. Transabdominal (TA) USG image (A) shows a bulky uterus showing a 10-cm submucosal fibroid (between cursors). Sagittal T2W MRI image (B) in the same patient shows that the submucosal fibroid (arrowhead) ... Figure 6 A 46-year-old woman with a history of abdominal pain. Transvaginal (TV) USG image shows a 1.1-cm submucous fibroid (arrow) with posterior acoustic shadowing (arrowheads)
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TREATMENT FOR FIBROIDS Hysterectomy. Hysterectomies involve the surgical removal of the entire uterus. Fibroids remain the number one reason for hysterectomies in the United States. Conservative surgical therapy. Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy. Gonadotropin-releasing hormone agonists (GnRH agonists). This approach lowers levels of estrogen and triggers a "medical menopause." Sometimes GnRH agonists are used to shrink the fibroid, making surgical treatment easier.
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CONT… Anti-hormonal agents. Certain drugs oppose estrogen (such as progestin and Danazol), and appear effective in treating fibroids. Anti-progestins, which block the action of progesterone, are also sometimes used. Uterine artery embolization. Also called uterine fibroid embolization, uterine artery embolization (UAE) is a newer minimally-invasive (without a large abdominal incision) technique. The arteries supplying blood to the fibroids are identified, then embolized (blocked off). The embolization cuts off the blood supply to the fibroids, thus shrinking them. Health care providers continue to evaluate the long-term implications of this procedure on fertility and regrowth of the fibroid tissue. Anti-inflammatory painkillers. This type of drug is often effective for women who experience occasional pelvic pain or discomfort.
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REFERENCES https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766886/ http://obgyn.ucla.edu/fibroids https://www.medicinenet.com/script/main/art.asp?articlekey=3452 https://ask4ufe.com/what-are-uterine-fibroids/types-of-fibroids/#fib-type-2