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Having Bulky Uterus With Intramural Fibroid. Serious Problem? Suggest Treatment?

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Posted on Tue, 9 Jul 2013
Question: hi i am XXXXX and i want suggestion with regard to my mother having bulky uterus(vol-138cc) with intramural fibroid(3.6x2.0cms)-uterine fundus-posteriorly with heterogenously thick endometrium (14mm) s/o endometrial hyperplasia (nabothian follicles (7to9mm)-cervix) in her ultra sound and pelvic scan .IS it a serious problem and what would be the next best step for that .here doctor suggested to d&c may we follow her suggestion and proceed for d&c.
doctor
Answered by Dr. Aarti Abraham (20 minutes later)
Hello
thanks for your query.
Please provide me with a few details so I can guide you better -
1. Is your mother menopausal.
2. If not, details of her menstrual cycle, pattern of bleeding etc.
3. Reasons for getting ultrasound.
4. kindly upload exact ultrasound report if possible instead of typing it.
5. Any significant medical or family history for your mother.
Looking forward to hearing from you
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (9 hours later)
actually my mother is getting her menstrual cycle regularly till 3 months baCK from last 3 months she is not having her menstrual cycle and now suddenly from past 10 days there is a continous bleeding in small quantities and i am worried about my mother a lot because my grand mother had cancer and she is no more i love my mother so much doctor please help me doctor these are some photos of my mother scanning report.
doctor
Answered by Dr. Aarti Abraham (1 hour later)
Hi again,
It would help me to know what kind of cancer your grandmother had.
Also, at this age, her uterine lining is quite thick ( 14 mm ).
Such a small fibroid does not require treatment unless she is having heavy bleeding, because after menopause, fibroids shrink in size.
THe next BEST step is to go for a D and C, as that will tell you if there is any abnormality inside the uterus.
It is like a biopsy of the uterine wall.
Also, she should go for Pap smear, as that will rule out cervical cancer also.
Meanwhile, have her thyroid levels and blood glucose levels measured.
Take care.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Aarti Abraham (2 days later)
doctor has done d&c and sent it to the biopsy and the biopsy report says that gross: 1.multiple gray white bits.size 3cms.
2.multiple gray white and dark bit 1cm.all embeded.
microscopic appearence:
specimen I endometrium: shows simple hyperplasia with no atypia.no evidence of malignancy.
specimen II cervix biopsy:chronic nonspecific cervicitis. no dysplasia or malignancy seen.
here the doctor is saying that she will do hystorectomy(operation). is it a good suggetion actually my mother is having 7.7% of hb count and also she is 53 years old does she can withhold the surgery please doctor i want ur suggestion.we will prepare her for the operation if u say it is cumpolsory and best for future.
doctor
Answered by Dr. Aarti Abraham (52 minutes later)
Hi again.

Simple hyperplasia of the endometrium has very less chance of developing into malignancy.
According to me, she can try medical management with hormonal therapy ( mostly progesterone is given for this condition ).

If she does not respond to medication, only then hysterectomy is required.
There is no reason for a hysterectomy straightaway, specially as your mother is having anemia.
Firstly, for at least 2 - 3 months, treatment for anemia can be started, and medication for the heavy bleeding can also be started.
If she fails to respond to the treatment, then hysterectomy is the next option.

There are various newer methods available like endometrial ablation which will also work in her case.

Take care.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Aarti Abraham (18 minutes later)
where can i find this hormonal therapy.
doctor
Answered by Dr. Aarti Abraham (1 minute later)
It has to be prescribed by a gynaecologist.
It is available freely, but by prescription only.

Please discuss with your doctor about medical therapy before planning for surgery.

If you have no more follow ups, please close this discussion.

Regards
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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Having Bulky Uterus With Intramural Fibroid. Serious Problem? Suggest Treatment?

Hello
thanks for your query.
Please provide me with a few details so I can guide you better -
1. Is your mother menopausal.
2. If not, details of her menstrual cycle, pattern of bleeding etc.
3. Reasons for getting ultrasound.
4. kindly upload exact ultrasound report if possible instead of typing it.
5. Any significant medical or family history for your mother.
Looking forward to hearing from you
Take care.