WOMENS-HEALTH Messages for January, 2001: Rapidly growing fibroids

Rapidly growing fibroids

From: Bill (anonymous@obgyn.net)
Mon, 8 Jan 2001 03:23:21 -0600 (CST)

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Reply: j wang, M.D.: "Re: Rapidly growing fibroids"

My wife, 43 years old, underwent ultrasound examination in June 2000. She was found to have one 34x42mm intramural fibroid located at the front left wall and one 20mm diameter subserosal fibroid at the bottom of the uterus.

7 months later, the ultrasound exam indicated that the first fibroid was enlarged to 60x56mm and the second to a diameter of 24mm. Also this time spots of endometriosis were detected.

Previous history was atypical cells found in a pap test in January 2000 which were operated upon with a cryopexy. The repeat of the pap test in June was normal, but palpitation of a mass led to the ultrasound exam. She has no symptoms. We have two children.

On the basis of the above, the doctor recommended myomectomy to be done without undue delay, within a month or so. My wife is worried she might have cancer and believes the doctor is not telling her the whole story.

Searching the Internet for information, I found only one paper by W.H. Parker et al

http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8127535&dopt=Abstract that finds that rapidly growing leiomyomas are not any more malignant than normal leiomyomas (1 in 1000).

However, most relevant Internet sites recommend surgically removing a fast growing leiomyoma for biopsy without basing their argument on some study. On the other hand, a CME course in the Univ. of Colorado School of Medicine http://www.obgmanagement.com/499/cme499.html#Anchor-Symptomatic-47857 says just the opposite, citing the Parker study.

So the obvious question is which of the above is right. I have a feeling though that the issue is not settled, so my question is, is there any other evidence that can be considered to make a decision based more on fact rather than any individual doctors hunch? Is there a collective "hunch" of doctors in this area?

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