Gynecological diagnosis . If, instead of developing under the serosa, the tumor separates thefolds of the broad ligament and distorts the viscera to a greater orless degree, it is called an (a) Intraligamentous Fibroid Tumor. (See Fig. 105.)—Thesetumors have the greater part of their circumference outside theuterus and are not covered by uterine tissue. Noble ( Gynecologyand Abdominal Surgery/ II. A. Kelly and 0. P. Noble, 1907, p. 669) CLASSIFICATION 247 found this form of tumor in per cent of the 2,274 cases of fibroidtumor he studied. The same characteristics belong to (b) Tumors which
Gynecological diagnosis . If, instead of developing under the serosa, the tumor separates thefolds of the broad ligament and distorts the viscera to a greater orless degree, it is called an (a) Intraligamentous Fibroid Tumor. (See Fig. 105.)—Thesetumors have the greater part of their circumference outside theuterus and are not covered by uterine tissue. Noble ( Gynecologyand Abdominal Surgery/ II. A. Kelly and 0. P. Noble, 1907, p. 669) CLASSIFICATION 247 found this form of tumor in per cent of the 2,274 cases of fibroidtumor he studied. The same characteristics belong to (b) Tumors which originate in the lower posterior segment of theuterus and grow into the cervix and then into the posterior pelvis,or those rare tumors which originate in the cervix itself and de-velop away from the uterus. (See Fig. 108.) The cervix, tobe sure, has no covering of peritoneum. As the tumor incnin size and rises in the pelvis it pushes the peritoneum before , this class of tumors may be included among the sub-. Fig. 103.—Large Multinodular Subperitoneal Fibroid with Thin Abdominal Walls. Seen in Profile. (Kelly.) serous. In subserous fibroids the uterine cavity is altered little ifat all in length or shape. 2. Interstitial (intramural, intraparietal) fibroid tumors are thosewhich arc situated in the wall of the uterus and are surroundedby a covering of uterine musculature. (See Figs. L02 and 101. >They may or they may not alter the contour of the uterus. Theuterine cavity is almost always lengthened, and it may be broad-ened and made asymmetrical in shape by this form of tumor. 3. Submucous Fibroid Tumors. These are the tumors whichvelop into the uterine cavity and are covered with mucous mem-brane and with little, if any, of the uterine musculature. Figs. 104 and 100.) Of all the three varieties these cause thegreatest changes in the form of the uterine cavity. Tin- are 248 DIAGNOSIS OF FIBROID TUMORS OF THE UTERUS the bleeding fibroids. The pressure exerted b
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