A 45-year-old woman with known uterine fibroids reports a noticeable increase in size of her abdomen over the past 6 months despite being postmenopausal for 2 years. Transvaginal ultrasound confirms a rapid increase in fibroid size from 6 cm to 12 cm. The most concerning possibility is:

• A Hyaline degeneration
• B Cystic degeneration
• C Calcific degeneration
• D Sarcomatous change (leiomyosarcoma) ✓

Explanation

Rapid enlargement of a fibroid in a postmenopausal woman, particularly after menopause when fibroids are expected to shrink, raises the suspicion of sarcomatous change (leiomyosarcoma). This is the most critical diagnosis to exclude. Hyaline, cystic, and calcific degenerations are benign changes that do not cause rapid postmenopausal growth. Any rapidly enlarging uterus in a postmenopausal woman warrants tissue diagnosis.

Reference: Berek and Novak's Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.