Massive fibroid.

This ten-year study of the massive fibroid at the Queen of Angels Hospital will reveal an average of 66 cases per year which could be classified as large and massive. Only about ten cases per year qualify as massive (four gestational months or larger). There were none considered giant size (25 lbs or more).The literature is replete with these, one of which (weighing 100.2 lbs) will be reported in detail. The mortality rate continues to be considerable in these (14.8 to 16.7 percent). In the smaller tumors, mortality is rare and morbidity is minimal.Bleeding, pain, and pressure symptoms, due to impingement on neighboring organs, are the principal symptoms. Sarcomatous change, fortunately, still remains quite rare.Treatment usually involves a pre-operative dilatation and curettage when bleeding is a problem, followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy where indicated. Appendectomy is usually incidental. Anesthesia is usually spinal, if not otherwise contraindicated.Ultrasound is a new and refined diagnostic tool.