Treatment.—As the disease is exceedingly malignant and of rapid growth, immediate hysterectomy is indicated.
CHAPTER XX.
FIBROID TUMORS OF THE UTERUS.
Fibroid tumors originate in the muscular wall of the uterus. They are composed of elements resembling, to a greater or less extent, those that compose the middle uterine wall. They consist of connective tissue and of unstriped muscular tissue in varying proportions. Uterine tumors composed exclusively of muscular fibres—true myomata—very rarely occur.
A number of names, based upon the proportion of the component elements, have been used by writers to designate these tumors. They have been called fibroma, myoma, myo-fibroma, and fibro-myoma. The natural history of all the varieties is about the same, and varies but little with the proportion of the elements. I shall therefore consider them under the general name of fibroid tumors of the uterus.
Fibroid tumors of the uterus are benign, in the sense that they do not, like cancer, infiltrate contiguous structures or infect the general system.
Fibroid tumors are loosely attached to the surrounding uterine wall. They are usually invested by loose cellular tissue, forming a capsule from which they may easily be enucleated. Blood-vessels, usually of small size, connect the tumor with its capsule. Dense adhesion between the tumor and its capsule is the result of inflammatory action. The loose connection of the fibroid tumor with the surrounding structures explains the ease with which these tumors travel and are squeezed out of the uterine wall. It will be remembered that in this respect the fibroid differs from the nodule of cancer and of sarcoma.
Fig. 131.—Interstitial fibroid tumor of the uterus. A small submucous fibroid appears in the uterine cavity.