A 27-year-old patient presented to the Emergency Department of our hospital complaining of heavy vaginal bleeding. The patient’s symptoms started half a month prior and were accompanied by dizziness. The patient was diagnosed with multiple uterine myomas via an ultrasound scan in 2015. Given the age and normal menses amounts, her family chose a follow-up observation at that time. Her usual menstrual cycle was 30-45 d with moderate bleeding lasting 7 d with clots and dysmenorrhea. However, since 2017, her menstrual period has changed to 10-15 d of heavy bleeding. She also sometimes felt dizzy and fatigued. Her lowest hemoglobin concentration was 32 g/L. She was not sexually active. The patient’s mother underwent an abdominal hysterectomy for uterine fibroids at the age of 40. The patient’s aunt (her father’s sister) had a history of uterine fibroids without surgery. The pedigree of this family is shown in Figure. Pelvic examination showed a regularly enlarged uterus, similar to the size at 4 mo of pregnancy, with a hard texture. Blood analysis revealed moderate anemia, with a hemoglobin level of 52 g/L. Serum tumor markers (CA125, CA199, CEA, AFP, SCC) were normal. Ultrasound showed that the volume of the uterus was significantly increased. The size of the uterus was approximately 13 cm × 9.2 cm × 11 cm, and the myometrium and uterine cavity were full of numerous hypoechoic masses of variable sizes. Pelvic magnetic resonance imaging (MRI) was performed one month later and revealed numerous multiple uterine fibroids.