Differential Diagnosis for Pre-menopausal Prominent Uterine Thickening
Single Most Likely Diagnosis
- Leiomyomas (Uterine Fibroids): This is the most common cause of uterine thickening in pre-menopausal women. Fibroids are benign tumors that can cause the uterus to become enlarged and are often associated with heavy menstrual bleeding, pelvic pressure, and pain.
Other Likely Diagnoses
- Adenomyosis: A condition where tissue similar to the lining inside the uterus grows into the muscular walls of the uterus, leading to thickening and enlargement. Symptoms can include heavy bleeding, pain, and discomfort.
- Endometrial Hyperplasia: A condition characterized by the excessive thickening of the endometrium (the lining of the uterus), which can be caused by hormonal imbalance. It can lead to abnormal uterine bleeding and is a risk factor for endometrial cancer.
- Polyps: Endometrial polyps are growths in the lining of the uterus and can cause uterine thickening. They are usually benign but can cause irregular menstrual bleeding.
Do Not Miss Diagnoses
- Endometrial Cancer: Although less common in pre-menopausal women, endometrial cancer is a critical diagnosis not to miss. It can present with postmenopausal or irregular bleeding and uterine thickening. Early detection is crucial for effective treatment.
- Sarcomas: Uterine sarcomas are rare and malignant tumors that arise from the muscle and supporting tissues of the uterus. They can cause rapid uterine enlargement and are often associated with a poor prognosis.
Rare Diagnoses
- Uterine Arteriovenous Malformations (AVMs): Abnormal connections between arteries and veins in the uterus, which can cause uterine enlargement and bleeding.
- Metastatic Disease to the Uterus: Rarely, cancers from other parts of the body can metastasize to the uterus, leading to thickening and enlargement.
- Uterine Lymphoma: A rare type of cancer that starts in the immune cells of the uterus, which can cause uterine thickening among other symptoms.