Uterine fibroids, or leiomyomas, are benign growths that can appear in any of the layers of the uterus (endometrium, myometrium, serosa). They are hormonally influenced and therefore occur in women of reproductive age. They can range in size from less than a centimeter up to 20 cm or more. Often, patients will have multiple fibroids at one time, but they can be solitary.
Incidence can be as high as 70% of women. Ultrasonography studies have shown that incidence is higher in Black than White women, and that they occur at an earlier age in Black women.
Fibroids are often asymptomatic and may be only first noted incidentally on imaging done for other reasons, but patients can also present with abnormal bleeding, infertility, increased pelvic or bladder pressure, urinary frequency, or rectal pressure.
Uterine fibroids
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Synopsis
Codes
ICD10CM:
D25.9 – Leiomyoma of uterus, unspecified
SNOMEDCT:
95315005 – Uterine leiomyoma
D25.9 – Leiomyoma of uterus, unspecified
SNOMEDCT:
95315005 – Uterine leiomyoma
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Uterine sarcoma – Rare type of malignancy with poor prognosis. Clinical features are often similar to benign fibroids. Histology is necessary to confirm diagnosis. Consider if fibroids fail to respond to initial treatments.
- Endometrial polyp – Uterine lining abnormality often associated with abnormal uterine bleeding; seen on ultrasound or saline sonohysterogram.
- Other pelvic structure – Sometimes pedunculated fibroids can be mistakenly identified as other adnexal / abdominal structures and vice versa.
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Reviewed:05/29/2017
Last Updated:12/15/2021
Last Updated:12/15/2021
Uterine fibroids