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Uterine fibroids — DRCOG MCQ

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HardGynaecologyUterine fibroidsDRCOG

A 46-year-old woman has irregular heavy bleeding and ultrasound shows multiple well-defined myometrial masses, the largest 5 cm, distorting the uterine cavity. She has iron deficiency anaemia and wants to preserve her uterus. What is the most likely diagnosis?

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Correct answer: C — Symptomatic uterine fibroids

Multiple well-defined myometrial masses distorting the cavity with heavy bleeding are most consistent with symptomatic fibroids. Adenomyosis more typically causes diffuse uterine enlargement rather than discrete myometrial masses. The pearl is that cavity distortion affects both bleeding and suitability for intrauterine treatment.

Reference: NICE NG88