Sarcomatous change should be suspected in case of uterine fibroid when there occurs

Ans. d (All of the above) (Ref. Shaw gynecology 14th/ 319)Sarcomatous change in fibroid is commonly seen in postmenopausal women when the tumor is noticed to grow suddenly, causing pain and postmenopausal bleeding.SARCOMATOUS CHANGE IN A MYOMA# Sarcomatous change in a myoma is extremely rare and the incidence is not more than 0.5% of all myomas.# Intramural: To start with most fibroids are intramural. There is a false capsule of connective tissue. It has a higher potential for sarcomatous change than subserous fibroid.# Important sign is nonencapsulation.Fibroids can undergo several types of degeneration:# Hyaline degeneration: this is the most common type of degeneration (can occur in -60%).# Cystic degeneration: -4 %.# Myxoid degeneration: generally considered uncommon although reported as high a 50% by some authors# Red - carneous degeneration: due to haemorrhagic infarction, which can occur particularly during pregnancy. Red degeneration of fibroid is common in pregnancy especially the third trimester.# Red degeneration presents almost exclusively in pregnancy with acute pain, fever and localized tenderness. It is due to aseptic inflammation and thrombosis. It is usually managed conservatively.Additional Educational Points:# Most common type of uterine myoma is intramural.