Differential diagnosis of uterine fibroids

The main symptoms of uterine fibroids are menorrhagia, pain and compression, which are similar to the symptoms of other pelvic diseases. It is necessary to rule out uterine sarcoma, adenomyosis, endometrial cancer and uterine and ovarian tumors through auxiliary imaging examinations, especially before traditional treatment. The diagnosis of uterine fibroids is as follows:

1. Pregnancy uterus

The material of cystic lesions of uterine fibroids is too soft and should be distinguished from the pregnant uterus. Pregnant women have a history of amenorrhea and early pregnancy reactions. Their uterus becomes larger and looser with the amenorrhea period. The diagnosis can be made by measuring hCG in urine or blood or by B-ultrasound.

2. Ovarian cysts

There is usually no menstrual change, and the lump is cystic and located on one side of the uterus. B-ultrasound can help confirm the diagnosis, and laparoscopy can confirm the diagnosis if necessary.

3. Adenomyosis

There may be an enlarged uterus and increased menstrual periods. Localized adenomyosis is similar to intramural uterine myoma and is hard in texture. However, adenomyosis has significant secondary dysmenorrhea, and the uterus is often evenly enlarged, rarely exceeding the size of a three-month pregnant uterus. B-ultrasound can help to confirm the diagnosis. However, adenomyosis and uterine fibroids may coexist.

4. Uterine malignant tumor

Hypertensive uterine sarcoma: It grows and develops rapidly, and is often accompanied by abdominal pain, abdominal masses and irregular vaginal bleeding. Ultrasound and MRI examinations are helpful in identification.

Hematologic endometrial cancer: postmenopausal vaginal bleeding is the main symptom, the uterus is evenly enlarged or normal, and soft. It should be noted that uterine fibroids in menopausal women may be combined with endometrial cancer. Curettage or hysteroscopy can help identify it.

Supplementary information on cervical cancer: Irregular vaginal bleeding, excessive leucorrhea or abnormal discharge can be diagnosed by B-ultrasound, cervical cytology examination, cervical puncture biopsy, etc.

5. Others

Uterine and ovarian endometriosis, pelvic inflammatory mass, uterine malformation, etc. can be identified based on medical history, clinical symptoms and B-ultrasound examination.