MARTIN GOLDSTEIN, MD: Valerie presented herself with severe anemia, which had been corrected by transfusion. My feeling was it was imperative to be certain there was not a bowel problem, such as a colon or rectal cancer, or an upper GI bleed from an ulcer, or another cause of blood loss. So, Valerie went through a colonoscopy, an upper GI series and a hematologic evaluation. Based on this, as Valerie had said, we knew that Valerie's blood production was correct, was adequate, and she did not have a cause for bleeding coming from the intestinal tract. Then after that, the most common cause of blood loss in a woman would be menstrual bleeding.
We performed a hysterogram, which is a test where we placed a radiopaque liquid, a liquid that doesn't allow X-rays to penetrate into the uterus.
PAUL MONIZ: We actually have a slide of that. We can show what that is and what that looks like. Walk us through how this tests work. How long is it? What does it show?
MARTIN GOLDSTEIN, MD: A hysterogram is an X-ray test. It is done by placing a small balloon catheter in the bottom of the uterus. The shadow on the bottom of this picture demonstrates the balloon catheter.
Through the balloon catheter, a radiopaque liquid, which shows up white, is injected into the uterus. In Valerie's uterus, which you see here, between the three dark marks there is a footprint shaped irregularity that represents a submucous fibroid. The submucous fibroid, in this case, is fairly large. It's approximately five by seven centimeters, which is about the size of a tennis ball.
PAUL MONIZ: So this is a large growth we're talking about.
