Fibroids anatomy, types and Etiology

Fibroids are also called myoma/leiomyoma/fibromyoma

Features of fibroids:

-benign smooth muscle tumour of the uterus
-estrogen dependent
-whorled appearance
-pearly white in colour

Anatomy of fibroids

-well circumscribed
-pseudocapsule (contain blood vessels)
-cut surface: whorled appearance, pinkish white

Types of uterine fibroids

a. Cervical– anterior, posterior, central, lateral

b. Body of uterus
intramural: the tumour which remains in the myometrial wall,

1. Submucous: fibroid which is forced towards the cavity by uterine contractions (sessile and pedunculated) lying underneath the endometrium makes the uterine cavity distorted and irregular.

Pedunculated fibroid may come out through the cervix. It may be infected or ulcerated to cause metrorrhagia. (least common 5%) but produces maximum symptoms.

Fate:

necrosis
polypoid change: following pedicle formation
infection
degenerations including sarcomatous change

2.Subserous: if the tumour grows outwards, towards the peritoneal surface. It shows itself as a bossy growth (pedunculated, parasitic, broad ligament fibroid)

3.Pedunculated :further extrusion with development of a pedicle

4.Parasitic: pedunculated fibroid gets attached to a vascular organ and is cut off from its uterine origin.

Etiology of fibroids

-Estrogen dependent tumour

-Early meanarche, Late menopause

-Grows in size during pregnancy and cessation of growth following menopause

-Nulliparous women ( a uterus that does not have a baby consoles itself by having a fibroid)

-Infertility (it is a causative factor as well as an effect of fibroids)

-Anovulation, PCOS

-Obesity

-deletions in chromosome 7 and t(12,14) are associated with fibroids

-Protective factor: Multiparity, Smoking

Mrunali Gondane

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