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Differential diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Fibroids must be differentiated from:

  • ovarian tumours:
    • ovarian cysts - cystic, rarely cause menstrual disturbance, and grow more rapidly
    • ovarian fibroma - often with ascites as Meig's syndrome
    • ovarian carcinoma - usually irregular
  • tubo-ovarian inflammatory mass - uterus not enlarged, mass tender, blood tests usually show leucocytosis, raised ESR
  • pregnancy - associated amenorrhoea, uterus soft, foetus detectable by ultrasound from 7th week onwards
  • uterine endometriosis - uterus only slightly enlarged, usually dysmenorrhoea
  • diverticular disease - identifiable by barium enema
  • colonic carcinoma - identifiable by sigmoidoscopy

In women over 35 years, it is not uncommon for uterine fibroids to co-exist with endometrial carcinoma.


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