A 40-year-old female complains of heavy menstrual bleeding and dysmenorrhoea. On USG-an echogenic area of 20 weeks of pregnancy is seen in the uterus. Tenderness is present. Most likely diagnosis is:

Ans. is a, i.e. Fibroid uterusIn this case: point which favours the fibroid are1. Size of growth = 20 weeks size2. Menorrhagia and dysmenorrhea3. Age of patientThe point which goes against it is tenderness seen in uterus. (This is seen in Adenomyosis, but in adenomyosis size of uterus is never more than 10-12 weeks pregnant uterus size).Remember: In a big fibroid some tenderness can be seen due to necrosis of fibroid.