Weekes L R
J Natl Med Assoc. 1977 Jan;69(1):17-22.
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.
这项在天使女王医院针对巨大子宫肌瘤开展的为期十年的研究显示，每年平均有66例可归类为大肌瘤和巨大肌瘤。每年只有约10例符合巨大肌瘤的标准（四个妊娠月或更大）。没有一例被认为是巨大尺寸（25磅或更重）。文献中充斥着这类病例，其中一例（重达100.2磅）将被详细报道。这些病例的死亡率仍然相当高（14.8%至16.7%）。在较小的肿瘤中，死亡率罕见，发病率也很低。由于压迫邻近器官导致的出血、疼痛和压迫症状是主要症状。幸运的是，肉瘤样变仍然相当罕见。当出血成为问题时，治疗通常包括术前刮宫，然后根据情况进行全腹子宫切除术和双侧输卵管卵巢切除术。阑尾切除术通常是附带进行的。如果没有其他禁忌，麻醉通常采用脊髓麻醉。超声是一种新的、精细的诊断工具。
