This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Clinical Features, Diagnosis, and Pathology, Subject name: Gynaecology & Obstetrics
[{'content': 'Sarcomatous change should be suspected in case of uterine fibroid when there occurs \nSelect and explain. \nA. Increase in the size, B. Pain, C. Bleeding, D. All of the above', 'role': 'user'}, {'content': 'Answer: D \nExplanation: 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.', 'role': 'assistant'}]