On hysteroscopy, a submucosal fibroid is seen projecting entirely into the endometrial cavity with only a narrow stalk attaching it to the uterine wall. According to the FIGO classification of abnormal uterine bleeding, how should this fibroid be typed?

• A Type 1 (submucosal, less than 50% intramural)
• B Type 0 (pedunculated intracavitary) ✓
• C Type 2 (submucosal, 50% or more intramural)
• D Type 3 (contacts endometrium, entirely intramural)

Explanation

In the FIGO PALM-COEIN leiomyoma subclassification, Type 0 denotes a pedunculated submucosal fibroid lying wholly within the cavity without any intramural extension, exactly as described here. Type 1 has less than 50% intramural component, Type 2 has 50% or more intramural extension, and Type 3 abuts the endometrium while remaining entirely within the myometrium.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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