Gynaecology for students and practitioners . f adenomyomata, and these will be consideredin a later section {see p. 489). It will now be necessary to describe in more detail the charactersof the three varieties of fibroid tumour. Subperitoneal (Subserous) Fibroids. These growths are nearlyalways multiple and may attain enormous size. Since they havegreater freedom of growth, subperitoneal fibroids are able to attaina greater size than the other varieties, and apart from degenerativechanges, the largest specimens met with are of this 210 is fairly typical of this class. It will
Gynaecology for students and practitioners . f adenomyomata, and these will be consideredin a later section {see p. 489). It will now be necessary to describe in more detail the charactersof the three varieties of fibroid tumour. Subperitoneal (Subserous) Fibroids. These growths are nearlyalways multiple and may attain enormous size. Since they havegreater freedom of growth, subperitoneal fibroids are able to attaina greater size than the other varieties, and apart from degenerativechanges, the largest specimens met with are of this 210 is fairly typical of this class. It will be noticed that the 4S0 GYNECOLOGY uterus itself is not much enlarged and lies in the centre of the massformed by the tumours ; it is also slightly rotated on its long axis,so that the anterior surface faces to the left. On the right side aretwo subperitoneal growths, sessile, and smooth on their surface ;on the left is a single large pediculated growth showing a well-markednodular surface quite different from those of the other side. Near. Fig. 210. Multiple Fibroid Tumouk, weight 7 lbs. Nullipara, aged 49. The large nodular fibroid had a pedicle 2 inches long. The uterus had rotated, bringing the right cornu forwards. the right cornu are two smaller growths, the anterior sessile andsmooth, the posterior pediculated and nodular. It is obvious thatthe pedicle of the largest growth is long enough to permit of theoccurrence of axial rotation of the tumour or torsion of the pedicle{see p. 452). Unless inflammatory changes have occurred, the peritoneal coveringof a subperitoneal fibroid is connected with the tumour only by a ANATOMY OF FIBROID TUMOURS 431 thin layer of the general subserous connective tissue ; accordinglyit can be readily stripped off when divided. The blood-supply ismainly derived through the uterine attachment and is often scanty,these tumours being as a rule less vascular than either of the othervarieties. Sometimes the main blood-supply is derived from a sourc
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
