Uterine Fibroids

Uterine fibroids are the most common neoplasm in females, and may affect about 25 % of white and 50% of black women during the reproductive years.

Fibroids grossly appear as round, well circumscribed, solid nodules that are white, or tan whorled. The size varies, from microscopic to lesions of considerable size. Typically lesions the size of a grapefruit or bigger are felt by the patient herself through the abdominal wall. Microscopically, tumor cells resemble normal cells and form bundles with different directions. These cells are uniform in size and shape, with scarce mitoses. There are three benign variants: bizarre; cellular; and mitotically active.

The symptoms depend on the size, location, number, and the pathological findings. Fibroids, particularly when small, may be entirely asymptomatic. Generally, symptoms relate to the location of the lesion and its size. Important symptoms include abnormal gynecologic hemorrhage, pain, urinary frequency or retention, and in some cases, infertility. During pregnancy they may be the cause of miscarriage, bleeding, premature labor, or interference with the position of the fetus.

The presence of a fibroid does not mean that it needs to be treated; many lesions are followed expectantly depending upon the symptomatology and presence of related conditions, such as anemia. Treatment of uterine fibroids that cause problems can be accomplished by: surgery, uterine artery embolization, hormone therapy, and High Intensity Focused Ultrasound. 

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Related Links:

• US National Library of Medicine
• Mayo Clinic

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