Goubaa Mohamed MD Djerba Tunisia

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--- Arabic
This is a 32-year-old female (virgin female) who presents with profuse vaginal bleeding and vague abdominal pain. Patient have transabdominal and transrectal examinations. Patiente âgée de 32 ans (vierge) présentant une ménometrorragie abondante avec des douleur abdominale vague. Un examen échographique par voie abdominale et endorectale a été réalisé.

Leiomyoma uterus cervix fibroid

utérus léiomyome fibrome

gynecology cervix uterus

gynécologie échographie utérus col

ultrasound uterus cervix fibroid

Doppler col cervix


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In the cervix, there is a large slightly hyperechoic solid mass. An endometrial canal cannot be found. The color images demonstrate that a mass contains blood flow.
Evolution: fall spontaneous of the mass.
The pathologist finding : submucosal leiomyoma.
Au niveau du col utérin on note la présence d'une masse solide légèrement hyperéchogène. Le canal endométrial n'est pas visible. Le doppler couleur montre que la masse est vascularisée. Evolution : chute spontanée de la masse. A l'histologie : léiomyome sous muqueux.


Submucosal leiomyoma of cervix léiomyome sous muqueux du col utérin


Submucosal leiomyoma of cervix

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The clinical symptoms and the appearance of fibroids depend on their position, size, and number. The symptoms are usually most pronounced when the fibroids are submucosal or prolapse into the endometrial canal. Pain and vaginal bleeding are then common, often occurring irregularly and unrelated to the menstrual cycles.
The role of uterine leiomyomas as causative factor of sterility is controversial. Submucosal myomas, in particular, can interfere with fertility and be associated to obstetric complications as abruption of placenta, post-partum metrorrhagia and puerperal sepsis.
With Doppler ultrasonography : Polyps typically contained a single feeding vessel, whereas fibroids had several vessels, which arose from the inner myometrium.

Differential diagnosis
* polyp
* Haematma
* Adenomyosis
* Endometrial Carcinoma

Références :
* 1: Fleischer AC, Shappell HW. Color Doppler sonohysterography of endometrial polyps and submucosal fibroids. J Ultrasound Med. 2003 Jun;22(6):601-4.
* 2: Yu KJ, Lai CR, Sheu MH. Spontaneous expulsion of a uterine submucosal leiomyoma after administration of a gonadotropin-releasing hormone agonist. Eur J Obstet Gynecol Reprod Biol. 2001 Jun;96(2):223-5.
* 3: Caruso A, Caforio L, Testa AC, Pomini F, Ciampelli M, Mancuso S. Conventional ultrasonography and color Doppler velocimetry of uterine leiomyomas. Rays. 1998 Oct-Dec;23(4):649-54. English,