FIBROID TUMORS OF THE UTERUS. 



CHAPTER VII. 



FIBROID TUMOES OF THE UTERUS FIBROMYOMATA, FIBROIDS, 



DERMOIDS. 



[PATHOLOGY AND ANATOMICAL APPEARANCES. These growths 

 are to be regarded as partial hyperplasias of the uterine parenchy- 

 ma, and consist of masses of smooth muscular fibres intermingled 

 in varying proportion with connective tissue. In their original form 

 they always present rounded, sharply-defined tumors. They are 

 non-malignant in their character, and are far more common than 

 any other form of uterine growth. They rarely appear before pu- 

 berty, and their liability to develop increases up to a certain point 

 with the age, so that they are most commonly found in persons from 

 thirty to fifty years old, while beyond this age they are compara- 

 tively rare. They are met with both in the married and unmarried, 

 and are often associated with menstrual disorder and sterility, 

 which, however, must be looked upon as consequences rather than 

 as causes of the disease. Nothing certain is known regarding 

 their cause. Fibromyomata vary greatly in size. They may be no 

 larger than a pea, or may form a tumor as large as the head, and 

 may weigh several pounds ; but this is somewhat rare. They are 

 sometimes solitary and sometimes multiple, and in the latter case 

 they are usually small. 



The constitution of a fibromyoma varies. Sometimes the fibrous 

 element preponderates, giving it more the character of a pure fibro- 

 ma ; sometimes (but rarely) the growth consists almost purely of 

 unstriped muscular fibres, thus approaching the true myoma in na- 

 ture. Upon section, their structure is found to consist of more or 

 less regular concentric layers of wavy connective tissue, between 

 which the finer bundles of muscular fibres are arranged. The more 

 the firm, tendinous, fibrous tissue preponderates, so much the harder 

 is the tumor and the paler its cut surface. When the muscular ele- 

 ment prevails, the section presents more of the grayish-red coloring 

 of the normal uterine tissue. As a rule, fibromyomata are but spar- 

 ingly vascular, and very seldom contain large blood-vessels. There 

 is, however, one form in which these tumors consist, either partially 

 or totally, of enormously dilated blood-vessels. Sinuses filled with 

 blood may even form, giving to the tumor a likeness to the erectile 

 tissue of the corpus cavernosum, and also its capacity to swell and 

 shrink ; so that sudden changes of volume in such a tumor can be 

 observed ( Virchoitfs telangiectatic or cavernous myoma). 



