Snapshot A 45-year-old African American G2P2 woman presents with abnormal uterine bleeding. She reports irregular spotting between periods and pain with intercourse. Physical exam reveals a mobile, asymmetric, nontender uterus with multiple nodular abnormalities. A Transvaginal ultrasound shows hyperchoic masses within the uterine wall. She decides to undergo a hysterectomy because she does not want any more children. summary Otherwise known as fibroids Leiomyomas are smooth muscle growths of the uterine myometrium can be login to view 3 more bullets Often present with multiple discrete tumors Epidemiology benign uterine tumor tumor in females seen in African Americans (5x more common) occurs in women 20-40 years of age Presentation Symptoms login to view 12 more bullets Physical exam login to view 7 more bullets IMAGING transvaginal ultrasound has high sensitivity (95-100%) login to view 1 more bullet STUDIES Labs login to view 1 more bullet Histology login to view 1 more bullet Differential Diagnosis Leiomyosarcoma Adenomyosis Endometrial polyp Pregnancy Diagnosis Confirmed with sonogram Treatment If asymptomatic login to view 2 more bullets If symptomatic login to view 10 more bullets Complications very rarely (if at all) transforms into leiomyosarcoma infertility iron deficiency anemia Prognosis having symptomatic fibroids decreases quality of life