Uterine tumours

Two types of tumor are usually occurred in the uterus.

  1. Fibroid or myoma
  2. Adenomyoma

1. Fibroid or myoma

Fibroids are muscle tumors of the uterus that are very common in the general population.  They arise from a single smooth muscle cell that has lost the proper signaling to stop growing.  Over time the muscle tumors get larger and may start to cause problems.  Women may have more than one fibroid.  Most of the fibroids are benign and cause no problems other than the problems caused by their location and size.  Large fibroids have been implicated in pelvic pain, low back pain, increased abdominal size, irregular bleeding, increased menstrual discomfort, and infertility.  Their role in infertility is not clearly understood.  There is speculation that the fibroids compress the lining of the uterus (the endometrium) or interfere with the blood supply to the endometrium.  Some fibroids are in locations that may cause blockage of the cervix or fallopian tubes.  They have also been implicated in preterm labor and early pregnancy loss.  Again, their exact mechanism of infertility is not clear and is likely different depending on the size and location of the tumor(s).

A view of a large fibroid uterus. The ovaries and tubes are seen on both sides.
The simple presence of leiomyomas does not warrant surgery in all cases. Patients with symptoms, a history of infertility, or large fibroids may benefit from surgery.  The surgical removal of fibroids is known as a myomectomy.

It can be diagnosed by patient’s complaints, by doing a pelvic examination and by ultrasonography. Pelvic CT scanning and MRI are also helpful but usually not necessary. Many leiomyomas are discovered as patients begin their fertility evaluation. Leiomyomas may occur in tissues outside of the uterus.  Ligaments and connective tissues in the pelvis also contain muscle fibers that may give rise to leiomyomas.   These tumors  usually will not cause problems with fertility, though they are often removed for diagnostic purposes as they present as a solid mass.   Uterine leiomyomas tend to be more of a problem seen in reproductive age women and will usually regress after menopause.  Women with multiple leiomyomas are likely at higher risk for recurrence after a myomectomy.

2. Adenomyoma
Adenomyoma is another form of uterine tumor which causes severe menstrual pain. It occurs within the musculature of uterus giving a firm consistency and irregular shape. It causes infertility by hindering the implantation of embryos. Though removal of adenomyoma is thechnically very difficult, it needs to be removed. Otherwise pregnancy will not occur.