Most common site for fibroids in uterus is:
Ans: (b) Intramural Ref: Shaw s Textbook of Gynaecology 15th Edition Pg 352.Explanation:Uterine FibroidsFibroids are the most common benign solid tumours in femalesMost common tumour of uterus.Fibroids are estrogen dependent for growthProgesterone inhibits their growth.GnRH shrinks size of fibroidIncreases in size during pregnancy and OCP intakeDecreases in size after menopauseThe presence of myoma causes hyperplasia of the myometrial wall.The cavity of the uterus is often distorted and enlarged.The endometrium tends to be thicker due to endometrial hyperplasia.The ovaries at times are enlarged, cystic and hyperaemic with evidence of salpingo- oophoritis in about 15% cases.Distribution of fibroid in the body of uterus:Intramural 75%Submucus 15%Subserous 10%Most common site is body of uterusA typical myoma is a w ell-circumscribed tumour with a pseudocapsuleThe vessels which supply blood to the tumour lie in the capsule and send radial branches into the tumour. Because of this arrangement of blood supply, the central portion of the tumour receives the least blood supply, and degeneration is noticeable early and most often in this part of the tumour. On the other hand, calcification begins at the periphery and spreads inwards along the vessels.Microscopically, the tumour consists of bundles of plain muscle cells, separated by varying amount of fibrous strands. Areas of embryonic muscle tissue may be present in a myoma.The endometrium tends to be thicker due to endometrial hyperplasia. The ovaries at times are enlarged, cystic and hyperaemic with evidence of salpingo-oophoritis in about 15% cases.Points to be Remembered in FibroidMost common complication of fibroid during pregnancy- Red degenerationIncidence of sarcomatous change in fibroid - 0.5 %Most common presenting symptom is menorrhagiaMetrorrhagia is caused by - sub mucus fibroidMost common degeneration - Hyaline degeneration.Recurrent pregnancy loss is associated with submucous fibroidPolycythemia in myoma is due to extramedullary erythropoisis within the substance of myomaDanazole. GnRH and RU 486 reduces the size of fibroids
Subserous
Intramural
Submucous
Cervical
Clinical Features, Diagnosis, and Pathology