. Essentials of gynecology, arranged in the form of questions and answers prepared especially for students of medicine ... t is called a fibrouspolypus. The subperitoneal or subserous fibroids (see Figs. 47 and 48) areoften multiple ; may be sessile or pedunculated ; may grow upwardinto the abdominal cavity and draw uterus up, or grow downwardinto the pelvis, and perhaps become incarcerated. They may formadhesions with other organs, get their nutrition through the adhe-sions, and become detached from the uterus. These are the mostfibrous, least vascular, and slowest-growing fibromyomata. FIBRO
. Essentials of gynecology, arranged in the form of questions and answers prepared especially for students of medicine ... t is called a fibrouspolypus. The subperitoneal or subserous fibroids (see Figs. 47 and 48) areoften multiple ; may be sessile or pedunculated ; may grow upwardinto the abdominal cavity and draw uterus up, or grow downwardinto the pelvis, and perhaps become incarcerated. They may formadhesions with other organs, get their nutrition through the adhe-sions, and become detached from the uterus. These are the mostfibrous, least vascular, and slowest-growing fibromyomata. FIBROID TUMORS OF THE UTERUS. 183 What changes may occur in fibroids ? 1. They may undergo softeniDg due to oedema or myxomatousdegeneration, rarely fatty degeneration. By this softening fibro-cysts may be formed. 2. They may undergo hardening, due to {a) atrophy, especiallyafter the menopause, or removal of ovaries and tubes. Tlie mus-cular tissue degenerates, and the fibrous tissue contracts. (6) Calci-fication, with the deposit of lime salts, beginning usually in the centre,sometimes at the periphery. Fig. 46. Fig. Submucous fibroid. {Schroeder.) Subperitoneal Fibroid. 3. They may suppurate. This occurs most often in submucousfibroids, especially after instrumental traumatism ; rarely in thesubperitoneal variety after torsion of the pedicle. 4. Submucous fibroids may become more and more pedunculated,forming polypi. They are sometimes extruded from the the capsule ruptures, and spontaneous enucleationoccurs. 5. Cysts are formed by the softening of tissue and by the dilationof lymph-spaces. 184 ESSENTIALS OF GYNECOLOGY. 6. Fibromyomatous uteri are occasionally the seat of carcinomaof their mucosa. 7. The fibroid nodules occasionally undergo a sarcomatous trans-formation. 8. The subperitoneal ones alone or with the uterus may undergoaxial rotation. Minor degrees of this are quite common. Whenthe rotation occurs suddenly, and through a considerable arc, therema
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