Uterine fibroids (leiomyoma): what they are and whether they are cancer

An ultrasound report containing the words "fibroid" or "node" in the uterus is frightening: in everyday speech, "tumor" sounds like a verdict. Let's break down what exactly was found, what doctors call it, and why a fibroid is a benign formation, not cancer.

What uterine fibroids and leiomyoma are

Uterine fibroids are a benign tumor that arises in the muscular layer of the uterus, the myometrium. A node is a rounded tangle of chaotically interwoven smooth muscle fibers; there may be one node or several, and their sizes range from millimeters to centimeters. According to various estimates, fibroids occur in every second to fourth woman during the reproductive period and account for 12–25% of all gynecological diseases.

Each node arises from the abnormal division of a single smooth muscle cell, so all the cells in it are identical. Fibroids are considered hormone-dependent: they contain receptors for sex hormones, appear during the reproductive years, and often shrink after menopause. They are more often found in women who have not yet gone through menopause; the exact cause is unknown.

Whether uterine fibroids are cancer or not

No. Fibroids are a benign, that is, non-cancerous, tumor; they are the most common non-cancerous tumors in women of childbearing age. In some cases, to distinguish a fibroid from an ovarian tumor, the doctor uses magnetic resonance imaging.

How fibroid, leiomyoma, and fibromyoma differ

These are three names for one disease: fibromyoma and leiomyoma are other names for the same benign tumor. The nodes consist of muscle cells and other tissues.

Types of nodes: intramural and others, cervical fibroids

Symptoms depend on the location of the node. Submucosal nodes lie closer to the uterine cavity, are rare — no more than 13% — and more often cause heavy periods. Intramural (interstitial) nodes are located within the thickness of the muscular layer: this is the most common variant, 50–61%. Subserosal nodes are located on the outer side of the uterus, 26–35%. There are also intraligamentary nodes and cervical fibroids — a node in the area of the cervix.

Symptoms of fibroids

In about half of cases, fibroids cause no symptoms at all and are found incidentally. Symptoms depend on the location, size, and number of nodes.

• Heavy or painful periods, bleeding between them; with submucosal nodes, periods become heavier and longer, which can lead to anemia.
• A feeling of heaviness, pressure, or pain in the lower abdomen, pain in the lower back.
• Frequent urination, sudden urges, or incontinence; bloating, constipation, or pain during bowel movements.
• Difficulty conceiving, miscarriages, premature birth.

Pain is more often cramping and coincides with menstruation, but it can be constant. Large nodes, by pressing on the bladder, can lead to urinary tract infections.

A fibroid by itself is not a reason to call an ambulance. 103 or 112 — if sudden acute sharp pain in the lower abdomen occurs (this may be how a rare complication manifests — torsion of the stalk of a subserosal node) or the condition is life-threatening.

How fibroids are diagnosed

The doctor asks about symptoms and performs an examination: checks the abdomen and pelvic area, and performs an internal vaginal examination. Then the patient is usually referred for ultrasound — the most informative method: ultrasound shows whether there is a fibroid, how many nodes there are, where they are, and how large they are. Sometimes fibroids are found during other examinations, such as an ultrasound during pregnancy.

Additionally, tests for microflora, cytology, and infections, a blood test for hormones, and a biopsy may be prescribed.

People see a doctor if fibroid symptoms interfere with work and everyday life or painkillers do not help. Further management is discussed taking into account the size, number, and location of nodes, age, and plans for pregnancy.

This material is for reference and does not replace a doctor's consultation: only a specialist knows what exactly was found and what to do about it after an examination and tests.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer