Fibroid tumors are liable to several forms of degeneration—calcareous, fatty, myxomatous, edematous, cystic, telangiectatic, gangrenous or suppurative, necrobiotic, and malignant.
Calcareous change, from the deposit of lime-salts in the fibroid nodules, is an unusual occurrence. It appears most often in women beyond the menopause, and is part of the atrophic changes that take place at this time. (It has occurred in a woman who had been subjected to oöphorectomy for the relief of a fibroid tumor.)
I have seen a fibroid tumor the size of the adult head—a solid calcareous mass which could be divided only by means of a saw.
The calcareous nodules are surrounded by uterine tissue to which they are but loosely attached. They may be forced out of the uterus and escape at the vulva. They have been called “womb-stones.”
Fatty degeneration is a very unusual condition. It has been assumed to take place, as a step preliminary to absorption, in those cases in which a fibroid tumor disappears after labor or from other cause.
Myxomatous degeneration is also rare. In it an effusion of mucous fluid takes place between the bundles of fibrous tissue. Sometimes large cavities are formed in this way.
In the edematous fibroid the whole tumor is permeated by a serous fluid. This condition is not unusual. It resembles edema in any other part of the body. It is often found in young women before the thirtieth year.
Cystic degeneration of fibroid tumors may result from any of the forms of degeneration with softening in which cystic cavities are formed.
In some cases fibro-cystic tumors are caused by dilatation of the lymphatics. They have been called “lymphangiectatic fibroids.” An endothelial lining has occasionally been found in the cystic cavities of these tumors. The fluid removed from the cyst-cavities coagulates spontaneously. Such fibroids have frequently been mistaken for ovarian cysts.
In the telangiectatic or the cavernous form of fibroid tumor there is an enormous dilatation of the vessels in the new growth. The venous spaces are sometimes as large as a walnut, and are filled with clotted or fluid blood. This change usually affects one part, and not all, of the tumor, which presents the gross appearance of a sponge soaked with blood.