46-year-old female with enlarged uterus, bulk symptoms. Evaluate for uterine fibroids, fertility preservation. Operative planning. PELVIS:UTERUS, ADNEXA: The uterus has a lobulated contour and is markedly enlarged measuring up to 19.4 cm in transverse, 11.6 cm in AP, and 23.7 cm in length. The enlarged uterus causes deviation of the urinary bladder and sigmoid colon anteriorly and to the right.Numerous T2 hypointense urine fibroids are noted, and the 2 largest uterine fibroids are listed for reference:The fibroid in the left lateral uterine fundus measures 8.4 cm in AP, 8.2 cm in transverse, and a 10.8 cm in craniocaudal diameter (axial series 5 image 17, coronal series 6 image 25). This fibroid is primarily subserosal in location, and internal degenerating components are noted on postcontrast sequences (series 11 image 259).The fibroid in the posterior lower uterine segment measures 8.1 cm in AP, 9 cm in transverse, and 8.2 cm in craniocaudal diameter (axial series 5 image 34, coronal series 6 image 24). This fibroid is favored to have submucosal and intramural components.The bilateral ovaries are difficult to reliably visualized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Trace free fluid in the dependent pelvis is likely physiologic.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Markedly enlarged uterus containing multiple fibroids as described above.