Fibrous bodies in the ovaries. Ovarian fibroma - causes, types, treatment. Types of ovarian fibroma

Fibroma is a benign tumor of connective tissue. Fibroids are found in the skin, subcutaneous fatty tissue, internal organs - in particular, and in the ovary. Fibromas are dense, smooth formations of the correct rounded or ovoid shape. This is not the most common ovarian tumor, it occurs in 3-5% of cases of ovarian neoplasms.

Features of ovarian fibroma:

Fibromas are most often found in one of the ovaries, bilateral fibromas are very rare.
Fibroids are very slow growing, but can grow extremely large. There were fibroids weighing about 20 kg! However, more often such ovarian tumors are found in sizes of about 5 cm.
Fibromas, fortunately, rarely undergo malignancy - the transformation into malignant.
Ovarian fibroids usually do not form until puberty. The age peak for a bottom ovarian tumor is 40-50 years.
Fibromas are hormonally inert tumors, that is, they do not secrete any sex hormones, so the patient's appearance does not suffer in any way.
A feature of fibroma is that the connective tissue in its composition does not have its own vessels, therefore, growing in diameter, it suffers from malnutrition. In the structure of the tumor, hemorrhages, necrosis, cavities occur - the tumor acquires a "variegated" character.

The "trademark" sign of ovarian fibroma is one extremely specific symptom - the triad or triple of Meigs' symptoms. These three classic symptoms include: accumulation of fluid in the chest cavity (hydrothorax), in the peritoneal cavity (ascites) and anemia (decreased hemoglobin level). The mechanism of development of this feature is still unclear.

Ovarian fibroma, unlike other tumors, has practically no proven causes of development - hormonal, inflammatory. The only proven cause of development is heredity. In the structure of the ovary there is a certain microscopic rudiment of connective tissue, which, for some unknown reasons, begins to grow uncontrollably and turns into a tumor - a fibroma.

The following factors may contribute to such a sharp increase:

Hormonal disorders - both sex hormones and others - insulin, pituitary hormones. Apparently, these stressful hormonal imbalances trigger the reproduction of future tumor cells.
Sudden changes in the hormonal background - puberty and menopause, loss and termination of pregnancy, treatment with hormonal drugs, and so on.
Already mentioned heredity, often the presence of fibroids can be traced through the female line from generation to generation.

Symptoms

Ovarian fibromas grow extremely slowly, so the symptoms do not appear quickly either. Fibroids of small sizes may not manifest themselves at all. We list the main, most significant symptoms and clinical manifestations:

Pain. Pain occurs with the growth of fibroids, squeezing neighboring tissues with it.
Violations of the menstrual cycle can be both a sign of fibroma and its background condition.
Symptoms of squeezing neighboring organs in the small pelvis - the rectum, bladder, which leads to dysfunction of these organs (constipation, impaired urine outflow).
Ascites - the first component of Meigs syndrome - the accumulation of serous fluid in the abdominal cavity. Fluid sometimes accumulates so much that the patient's stomach resembles a full-term pregnant woman.
Hydrothorax is the second component of the syndrome, the accumulation of fluid in the pleural cavity surrounding the lungs. The liquid can compress the lungs, cause shortness of breath, difficulty breathing, cough.
Anemia is the final component of Meigs syndrome, a drop in hemoglobin levels in red blood cells. This condition may be accompanied by weakness, fatigue, dizziness, dryness and pallor of the skin, mucous membranes, brittle nails and hair.

We emphasize once again that small-sized fibromas may not manifest themselves for a long time. Previously, for a long time it was believed that the onset of manifestations of ascites is a sure sign of malignancy of ovarian tumors. Often, patients were denied radical treatment and prescribed maintenance chemotherapy. Now such actions are unacceptable, a detailed examination of a woman is necessary, since this syndrome with fibromas is not malignant.

Diagnostics

As a rule, for the first time a fibroma is detected during a routine gynecological examination. The doctor, examining the patient on the chair, palpates with his hands a dense foreign structure in the ovary. Next, the patient is assigned a series of clarifying studies:

Ultrasound of the pelvic organs is a mandatory study for suspected ovarian formations. However, it is very important to understand that not a single ultrasound doctor, even the most experienced one, will determine by eye whether he sees a benign tumor. Yes, there are certain criteria and distinguishing features, but they are not all one hundred percent accurate.

Therefore, any ovarian mass should be investigated. Therefore, what is on the monitor screen: ovarian fibroma or some other tumor can be said only after its removal and histological analysis.

An MRI of the pelvis can also give a more accurate and clear picture of the formation, information about its size and source, and the nature of its structure. But MRI will not give an exact answer how dangerous this formation is in terms of oncology.

Histological examination is the next stage of diagnosis. For the first stage of diagnosis, culdocentesis is used - a puncture of the posterior wall of the vagina, after which the needle enters the retrouterine space. From there, cells are taken for analysis. This study is especially necessary in the presence of fluid in the pelvis and ascites. Also, the object of study is the fluid from the pleural cavity with hydrothorax.

Treatment

I want to say right away that it is impossible to cure ovarian fibroma by any conservative method - pills, injections, procedures. Any tumor formations of the ovaries are subject to mandatory surgical treatment and removal, since before their direct examination under a microscope it is impossible to judge their nature and danger, the size of the formation and the presence of any complaints in the patient does not matter.

The operation can be carried out in two ways:

Laparoscopically is a microinvasive intervention in which all manipulations are performed using thin conductors inserted into the abdominal cavity through small incisions. This technique creates an excellent cosmetic effect, fast postoperative recovery. However, it is important to understand that such a successful option is possible with small ovarian tumors, the absence of ascites and other suspicions of an oncological process.

Laparotomy - through an incision in the lower abdomen. Such operations on the ovaries are performed with large tumors, suspicion of cancerous tumors, and a pronounced adhesive process in the small pelvis.

During any operation on the ovaries, an express histological examination of the removed formation is performed to exclude a cancerous process. When the danger is eliminated, the operation ends. Upon confirmation of the oncological process, the scope of the operation is expanded according to the protocols for a specific disease.

Fibroids do not recur after removal and do not require any special postoperative treatment. The postoperative period is carried out as usual - suture care, vitamin therapy, physiotherapy.

In clinical practice, ovarian fibroma occurs in 2-4% of cases of pathology of this organ. It is believed that the disease occurs in women in their 40s and 60s. Sometimes the disease is detected at an earlier age, but after puberty. According to the classification, pathology refers to fibromas-thecomas. This is a benign neoplasm.

Fibroma grows from the stroma of the ovary, and in its essence is a thecoma, but not hormonally active.

It grows extremely slowly and reaches huge sizes (weighing up to 20 kg). Neoplasm can fill the entire abdominal cavity. There is such a huge tumor in women who try not to undergo an annual medical examination, but seek medical help when serious complications arise.

Fibroids differ in:

form;
consistency;
histological structure.

They are similar in that they do not secrete hormones. Usually the tumor develops in one ovary, and only in 5% of cases the disease is bilateral.
Fibroma has a leg:

thin and long;
short and thick, with blood vessels.

It twists in 13-36% of cases (according to various studies).

The neoplasm grows very slowly, sometimes for several years it does not change in size. With dystrophic changes, its growth is significantly accelerated. It is very quickly subject to necrosis.

Types of ovarian fibroma

Histological examination of the fibroma in the section is white with a pearly sheen. Has a fibrous structure. The release of edematous fluid is often observed. If there are necrotic changes in the tissue, then it will be yellowish or brown-red. The edematous areas are translucent. With severe necrosis with hemorrhagic phenomena, variegated fibroma.

Edema and necrosis are most pronounced in the central parts of the tumor. Due to edema, smooth-walled pseudocystic cavities are formed. They can be filled with content:

transparent;
translucent;
hemorrhagic (due to bleeding).

She happens:

diffuse. The entire ovary is affected, the tumor may lack a capsule.
Delimited. Ovarian tissue is partially preserved. The tumor has a capsule.

The most common is a diffuse tumor.

Fibroma happens:

spherical;
ovoid.

The surface of the neoplasm is bumpy or smooth. In 25% of cases, there are adhesions with neighboring organs.
Often in fibromas reveal dystrophic changes:

Puffiness. Fibroma cells are stellate, not in bundles.
lime deposition. The change is solid.
Mucus fibroma. It is extremely rare.

That is why fibromas differ in consistency. They are:

Hard, woody. To the touch, like a stone, fibroma occurs with complete calcification.
Soft. Happen because of the expressed hypostasis.
Dense, elastic. Occur in the presence of pseudocystic cavities.

Fibroma may consist mainly of cellular elements, or fibrous intercellular substance predominates.

Cellular elements of an elongated shape, with elongated nuclei, barely noticeable protoplasm. Connective tissue is made up of smooth muscle fibers. If there are a lot of them, in this case, the diagnosis of "myofibroma" is made.

Causes and development factors

Often, ovarian tumors develop against the background of hormonal pathology, after trauma and inflammatory diseases.

The main cause of all ovarian neoplasms is hormonal pathology. Most often, fibroma occurs in women with a history of violations, reduced reproductive function.

As well as ovarian tumors of various origins occur after suffering inflammatory diseases, trauma. Especially often neoplasms develop in patients who have undergone ovarian surgery.
Key factors in the development of fibroids are:

Hormonal disorders in the hypothalamic-pituitary-ovarian system, especially if the secretion of gonadotropin, follicle-stimulating hormone, is increased. Due to their influence, hyperplasia, cell proliferation occurs in the ovary, leading to the development of neoplasms.
Heredity. It is believed that the tendency to develop ovarian tumors is transmitted by an autosomal dominant sex-linked type of inheritance. It was found that if there were cases of the occurrence of a uterus in the family history, then the likelihood of developing fibroids is 30-50%. In addition, in these patients, the disease begins at an earlier age, sometimes before the onset of postmenopause, and is much more severe.
Reduced immunity contributes to the accelerated growth of neoplasms.

And although there have been no cases of degeneration of ovarian fibroma into a cancerous tumor, it must be removed, otherwise it can cause serious complications. That is why it is very important to diagnose it in a timely manner.

Symptoms

Fibromas of insignificant size do not cause almost any inconvenience to the patient. In addition, due to the fact that this neoplasm is hormonally inactive, there is no change in the menstrual cycle. Only with the growth of the tumor, a special symptom is revealed - the "Meigs triad":

ascites;
hydrothorax.

Ascites and accumulation of fluid in the pleural cavity appear due to severe edema. And pain in the abdomen can occur in various places, depending on the location of the tumor, its size.

Fibroma pain is due to:

tumor pressure on nearby tissues;
torsion of the leg;
hemorrhages;
irritation of the pelvic peritoneum;
inflammation of the serous integument;
smooth muscle contractions;
circulatory disorders.

That is why, regardless of whether a fibroma has arisen in the right or left ovary, pain can radiate to:

the opposite side from the localization of the neoplasm;
down the abdomen;
lower back;
groin area.

It may be dull, aching, or crampy, but not dependent on the menstrual cycle. With twisting of the leg, hemorrhage - the pain is acute.

If the fibroma is large, then patients may complain of:

constipation;
feeling of heaviness in the abdomen;
urination disorder;
an increase in the volume of the abdomen.

With the manifestation of such symptoms, the patient must be referred for a consultation with a gynecologist.

When diagnosing fibroids, the age of the patient also matters. Most often, fibromas occur after 40 years, and only in very rare cases earlier, if there were prerequisites for the development of the disease:

infertility;
ovarian cyst;
trauma;
violation of the menstrual cycle;
stimulation of ovulation.

If the fibroma is not large, then it is detected during a mandatory preventive medical examination by a gynecologist.

Diagnostics

An ovarian tumor can be detected during an ultrasound.

A small fibroma is found by chance. After all, the patient does not make any complaints. The tumor grows extremely slowly, the disease in the initial stages is asymptomatic. A gynecologist can suspect ovarian fibroma with a bimanual examination.

If the patient goes to the clinic, with the appearance of pain and other concomitant symptoms, then on their basis it is impossible to make an accurate diagnosis. According to complaints, it is impossible to determine exactly where the tumor is located. Symptoms arising from non-hormonally active ovarian tumors are characteristic of left- and right-sided lesions, gastrointestinal cancers, etc. Often, patients with stromal tumors (fibroma, tecoma) are treated for, since these diseases clinically manifest almost the same.
The doctor, after conducting a bimanual examination, will determine if there is a neoplasm. If it is not palpable, but the patient is at risk, it is mandatory to prescribe:

blood analysis;
dopplerography.

MRI and CT provide exactly the same information in fibromas as ultrasound, so they are rarely recommended.

With fibromas, if the tumor has grown strongly, anemia is detected. In other cases, all indicators are normal.

With the help of ultrasound, neoplasms with a size of 1.5 mm are detected. If a patient has fibroma, often the study shows:

deposits of calcifications in the ovary;
the presence of cavities filled with contents.

If the fibroma is up to 6 cm, there is a suspicion of an adhesive process, in patients with, it is recommended to perform a transvaginal scan. In the presence of a large tumor, a transabdominal examination is considered more informative.

On ultrasound, the fibroma is visible as a round or oval formation, with clear contours. Echo-negative inclusions indicate that there are degenerative changes.

With fibromas, with the help of CDC (color Doppler mapping), the following are detected:

avascular tumor;
vessels are not visible.

Since fibroma is similar to other tumors, differential diagnosis is mandatory.

Differential Diagnosis

If a fibroma is suspected, it is necessary to conduct a differential diagnosis with other neoplasms of the ovary, uterine appendage, which have similar symptoms:

tekoma;
sarcoma;
Brenner's tumors, etc.

It is impossible to distinguish a tecoma from a fibroma only by touch, since both of these formations develop on the stromal cord, have a stalk, and are dense in consistency. Even ultrasound does not allow to accurately differentiate these neoplasms. That's just tekoma produces hormones, therefore:

May develop before puberty. Girls have early uterine bleeding, growth zones close prematurely.
The menstrual cycle is disturbed. In women of reproductive age, menometrorrhagia, metrorrhagia,.
There are proliferative processes in the endometrium. Often reveal hyperplasia, uterine myoma, tumor of the mammary glands.
Reproductive function is impaired. In women, tecoma is complicated by infertility, miscarriage.

It is difficult to distinguish fibroma from a malignant neoplasm, especially in the initial stages. Ultrasound, bimanual examination and Doppler sonography are not enough for accurate diagnosis, a histological examination is necessary.

Treatment

Treatment of ovarian fibroma is radical. The neoplasm is removed not only if:

large tumor;
complications arose.

When a small tumor is detected, the main treatment is only one - surgery. All other methods, including traditional medicine, are recommended as additional therapy.

It would seem that ovarian fibroma is a benign formation, slowly growing, why remove it? In the initial stages, the disease is asymptomatic, and if the tumor is not large, it does not cause discomfort to the patient. The operation is not carried out only if there are contraindications. Surgery for ovarian fibroids is necessary because:

It is impossible to predict exactly how the tumor will grow. It may remain unchanged for many years, and then suddenly progress.
Without surgery, it is impossible to establish with absolute certainty that the tumor is not malignant. Primary ovarian cancer in terms of symptoms, clinical picture is similar to fibroma. That is why the neoplasm is removed and sent for histological examination.
Fibroma of the ovary does not resolve. There are tumors that, with the help of medications, and sometimes even disappear on their own (for example, hemangioma), but not fibroma.
If the neoplasm is small, delimited, then it is better to remove it immediately, without waiting for it to grow. In this case, laparoscopy is performed.

What kind of operation to perform, the doctor decides, depending on the size of the fibroma, the presence of adhesions, the age of the patient.

Preparing for the operation

Fibroma of the ovary is subject to mandatory surgical removal.

A patient with ovarian tumors should be prepared for surgery in advance.

One day before the operation, the patient washes exclusively in the shower. She definitely needs to shave off her pubic hair.
During the day before the operation, the patient should not eat. Immediately before the surgical intervention, her intestines are cleaned, according to indications, the stomach is washed.
The day before the operation, the patient is transferred to the preoperative ward, and sedatives are prescribed.
Before being sent to the operating room, the patient must urinate with a catheter.

All these measures are necessary so that during the surgical intervention and after it there are no serious complications.

Before the resection, the operating room is prepared. On a special sterile table, the surgical nurse lays out the necessary instrument. Counts large and small gauze pads. Their number must be known exactly so as not to accidentally forget the napkin inside the surgical wound.

Surgical intervention

The method of surgical intervention depends on the size of the tumor, the presence of other indications and the individual characteristics of the patient:

If the fibroma is located on a long stalk, very mobile, it is recommended to perform a Pfannenstiel operation.
A large tumor, an overweight patient, a dense abdominal wall are indications for a median longitudinal incision.
A small, demarcated tumor is removed by laparoscopy.
When possible, women of reproductive age undergo surgery with preservation of part of the ovary.
Patients in the postmenopausal period are advised to remove the entire ovary to prevent the development of malignant neoplasms.

The operation must be performed by an experienced surgeon. During the removal of the fibroma, one must be as careful as possible so as not to crush the tumor. Otherwise, the contents may leak into the abdominal cavity and cause postoperative peritonitis.

Most often, the operation to remove fibroids is carried out in this way:

Open the abdominal cavity. A mid-abdominal incision is recommended, which can be extended upward if necessary.
After opening the peritoneum, the type of tumor is assessed. If there are adhesions, they are carefully separated.
The tumor is removed from the abdominal cavity. To do this, a tupfer is brought on a long tamponator, then the fibroma is pushed into the surgical wound. It will help to remove the neoplasm by pressing with your hands on the anterior abdominal wall near the wound.
The tumor is rotated with the smallest side to the incision and pulled out.
If the fibroma is too large and cannot be removed, even by lengthening the incision as much as possible, then it is punctured and the liquid is sucked off. To prevent the contents from flowing into the abdominal cavity, the foot end of the operating table is lowered and tilted to the side.
When removing a fibroma, you can not capture the capsule, otherwise you can break it. It is better to use polyp or ovarian forceps.
When the tumor is brought out, the edges of the surgical wound are expanded with a special tool, the surgical field is isolated with napkins.
The tumor pedicle is clamped with Kocher forceps. The tumor is cut off. Then the clamps are replaced with a ligature.
Examine the remaining organs of the small pelvis. In some cases, the fibroma is removed along with the uterine appendages.
The stumps are carefully peritonized.
Tools, napkins are removed from the wound. The incision is sutured in layers.

A laparotomy is performed to bring the tumor out.
Fibroma is excised very close to the surface, but within the healthy tissues of the ovary.
With the help of round piercing or intestinal needles, healthy ovarian tissues are connected with interrupted catgut sutures.
Be sure to examine the uterus with appendages and the second ovary.
Tools, swabs are removed and the surgical wound is sutured in layers.

The removed neoplasm is sent for histological examination.

Treatment prognosis. Possible complications. Effects

If the fibroma was detected before the onset of complications, the patient strictly adhered to the doctor's recommendations, then the prognosis will be favorable. With a small tumor, it is possible to preserve the reproductive function of the ovary.

But patients with fibromas need to be examined periodically. Often, ovarian tumors are the first warning signs of the imminent occurrence of cancer of the uterus, mammary glands.
If the disease was detected late, the patient did not comply with all medical prescriptions, fibroma can cause serious complications:

torsion of the leg;
adhesive process;
tumor rupture;
necrotic changes in the ovary;
purulent inflammation;
peritonitis;
hemorrhage.

Important to remember! Ovarian fibroma does not resolve on its own, even with the help of herbs and medicines. It is treated only by a radical method.

Prevention

Since fibromas occur due to hormonal disorders, excessive production of sex hormones that promote ovulation, preventive measures are:

pregnancy;
prolonged breastfeeding;
taking oral contraceptives (if there are no contraindications).

Only early diagnosis will help prevent the occurrence of complications after fibroids. That is why it is necessary to undergo an annual examination by a gynecologist. In addition, if the tumor is detected in time, then it is removed by laparoscopy. And these are just a few small cuts.

Or ovaries.

Ovarian fibroma, like fibrous tumors in other organs, usually develops asymptomatically, however, upon reaching a significant size, characteristic symptoms of the pathological process appear.

Concept and statistics

The share of fibrous formations in gynecology accounts for approximately 10% of the total.

Women of premenopausal and menopausal age (40-60 years old) are most susceptible to such neoplasms. Ovarian fibroma is a tumor formation that does not have hormonal activity.

In appearance, such tumors are rounded seals with a nodular or smooth surface. Such ovarian formations can grow up to 12 centimeters or more and are predominantly unilateral. Such tumors, as a rule, have a stalk, so they are mobile.

On the cut, the fibrous formation has a whitish-gray or white color, the tumor is poor in the vascular network.

If the fibroma was formed quite a long time ago, then in its middle there are dead areas with ischemia, hemorrhages, degenerative lesions. From a morphological point of view, the tumor is formed from connective tissue cells.

Forms

Specialists distinguish several fibrous varieties:

diffuse fibroma - affects the entire ovary;
Limited tumor form - is a capsule with contents that separates it from the rest of the ovarian tissue.

Fibrous formations often swell and have cystic cavities with liquid contents inside, then they are called cystadenofibromas.

Usually, fibrous formations grow slowly, however, under the influence of dystrophic changes, they begin to grow very quickly. Often, such tumors are accompanied by cystic processes in the ovarian tissues, which are formed for similar reasons.

The insignificant size of fibrous formations usually does not affect ovarian functionality, and does not prevent conception, pregnancy and successful delivery.

Reasons for development

As in the case of uterine fibroma, an ovarian tumor has an uncertain etiology, however, the risk of pathology increases in the presence of an unfavorable state of health of the patient, contributing to the development of various diseases (premorbid background).

These include pathologies of the endocrine system, including violations of reproductive and menstrual functions, pathologically low immune status, inflammatory processes in the ovaries or appendages (adnexitis, oophoritis, etc.).

In general, among the probable causes of fibroids in the ovaries are:

Reduced immune status;
Pathological processes in the genitourinary system and genital organs;
Inflammatory lesions of the appendages or ovaries of chronic origin;
The presence of endocrine pathologies;
genetic predisposition;
Age features;
Menstrual irregularities, etc.

Often, ovarian fibroma is accompanied by pathologies such as ovarian cystosis or. Therefore, many experts believe that these diseases have common etiological factors.

Symptoms of ovarian fibroma

Usually, ovarian fibroma develops hidden. With sizes less than 3 cm, ovarian functions are usually not impaired, and therefore there are no symptoms.

When the mass begins to grow, the patient experiences the onset of symptoms such as Meigs syndrome, which includes the presence of pleurisy (an inflammatory lesion of the lung membrane), anemia, and (accumulation of fluid in the peritoneum).

Similar conditions appear:

General weakness of the body;
Tachycardia manifestations;
Bloating in the abdomen;
soreness;
Excessive fatigue;
shortness of breath.

If the tumor releases transudate into the retroperitoneal space, then ascites occurs. In exceptional clinical situations, ovarian fibroma is accompanied (extremely severe exhaustion) or polyserositis (inflammatory lesions of the serous membranes), but this picture is usually observed when the tumor process is malignant.

Usually, menstrual changes and cycle disorders are absent in ovarian fibroma. If the pathology is combined with other genital diseases, then the clinical picture is a complex of their signs.

Diagnostics

Fibrous ovarian masses are usually found during random physical examinations at the gynecologist, since the tumor develops latently for a long time.

After a gynecological examination, the patient is sent for laboratory tests, instrumental procedures such as ultrasound diagnostics, magnetic resonance or pelvic organs, etc.

If necessary, a histological examination of the biomaterial obtained from the tumor through laparoscopic diagnostics is additionally performed.

Treatment

Treatment of fibrous formations in the ovary is carried out using surgical methods. Since such neoplasms are not able to resolve, conservative therapy is meaningless.

In accordance with the size of the fibroma, the presence of complications, the age and organic characteristics of the patient, the type of surgical intervention is selected.

To get rid of small formations, it is usually used when the fibroma is husked, and the ovary is completely preserved, as well as its functionality.

If the fibroma has reached a large size, then it is removed along with the ovary. If at the same time the age of the patient has approached the premenopausal period, then it is recommended to remove the appendages as well.

If the fibroma is bilateral, that is, the tumor process affects both ovaries, then a part of the one that is less affected by the formation is necessarily left.

Forecast and prevention

In general, the prognosis of ovarian fibroids is positive, the probability of a malignant process is minimal - only 1%. Only pregnancy will have to be postponed until complete recovery and the end of postoperative rehabilitation.

There is no specific prevention of ovarian fibromas, so the main measure is an annual visit to the antenatal clinic with an ultrasound examination of the pelvic organs. This is the only way to timely detect the development of a pathological fibrous process in the ovaries.

The video shows the operation to remove ovarian fibroma by laparoscopic method:

Ovarian fibroma is a volumetric neoplasm of a benign nature that develops from the epithelial tissues (stroma) of this paired reproductive organ. Unlike many other formations, the one described does not synthesize hormones and is considered “silent”, with few symptoms. This disease accounts for about 10% of visits to a gynecologist. What are ovarian fibromas and what should you know about them?

a brief description of

Fibroma of the ovary is a neoplasm of an ovoid or round shape with even, clear contours. It is distinguished by non-infiltrative compressive growth (when, as the structure increases, the surrounding tissues are compressed, but there is no germination). It occurs mainly in women of the older age group (50 years and older).

Often, the occurrence and development of such tumors is associated with hormonal peaks: in puberty, at the time of gestation, before or immediately after menopause.

The texture of the fibroma is soft if there are no deposits of calcium salts. In the presence of calcifications (petrificates) it acquires a hard, shell-like texture. Since the tumor is poorly vascularized (few blood vessels), its growth is relatively slow. In cases of an old process, the neoplasm contains areas of necrosis due to malnutrition and a simultaneous increase in proliferative activity. Fibroma is rarely prone to malignancy: the probability of such an outcome does not exceed 1%.

This is a relatively favorable disease in terms of cure. It is important to start therapy on time.

Etiology and developmental factors

Nothing is known for certain about the causes of the development of the disease. In medical science, there are only some guesses about the mechanism of formation of fibrous formations. With accuracy, we can only talk about the factors that become triggers of the pathological process:

Hormonal imbalances before puberty. A decrease in the concentration of female specific hormones is a risk factor. The change in the concentration of these substances occurs at peak times, as already mentioned.
Endocrine diseases. The body is a complex biochemical system. If there is a lack of pituitary and thyroid hormones, there will be no normal synthesis of female specific substances. This is a direct path to the development of problems with the reproductive system.
Violations in the work of immunity. Atypical cells appear in the body every second. The only factor preventing the growth of tumors is immunity. Failures in the work of the protective system lead to neoplastic processes.
Inflammatory diseases of the ovaries and their appendages. They lead to an increase in the rate of cell division due to the need to start the regenerative process.
The presence of tumors of the reproductive system. Including uterine fibroids, ovarian cysts.

Ovarian fibroma is a tumor that consists of connective tissue and does not produce hormones. When examining its cells under a microscope, one can see oblong collagen fibers connected in dense plexuses. Although a fibroma is a benign formation, it must be removed.

general characteristics

Fibroma of the ovary is quite widespread. In the general structure of benign neoplasms of the appendages, it accounts for about 10%.

A woman most often learns about what a fibroma is after entering menopause, that is, over the age of 40. The diagnosis of the disease is carried out by a gynecologist.

The tumor most often develops unilateral, that is, the patient has a lesion of the left ovary or right appendage. The neoplasm has a rounded shape, its surface may be smooth, or it may be nodular. The maximum tumor size is 12 cm in diameter.

Most women, having heard their diagnosis for the first time, ask themselves: fibroma of the right ovary - what is it, and also what is the difference between a limited and diffuse form of a tumor. If the doctor points to a diffuse formation, this means that it has completely grown into the ovary. When the tumor is demarcated, this will mean that it is separated from the tissues of the ovary by a capsule.

The next, quite logical question that a woman faces is whether this pathology is dangerous. Despite the fact that it is prone to slow growth, the tumor can be life-threatening, so it is recommended to remove it. Fibroma has a low malignant potential, however, the risk of its malignancy exists. In addition, there is a possibility of twisting of the leg on which it is located. It is also possible tissue necrosis of the neoplasm and their suppuration. All this poses a threat to the health and life of women. Therefore, the issue of surgical intervention is quite acute.

Why does a tumor appear in the body

Until now, ovarian fibroma remains a neoplasm with an unclear etiology. This means that the exact causes of its occurrence are unknown to science. Despite this, there is evidence to establish the relationship of its growth and development with certain disorders in the body. Causes and factors that can increase the risk of fibroids:

Violations in the functioning of the endocrine system, which has a direct impact on the menstrual cycle and the ability to conceive a child.
Inflammatory processes of the organs of the female reproductive system. In particular, pathologies such as oophritis and adnexitis, in which the appendages and the ovaries themselves suffer, are of importance.
Disturbances in the functioning of the immune system.
There is evidence that taking Tamoxifen (a drug used to treat cancer) may increase the risk of ovarian fibroids.

The relationship between the development of pathology and diseases such as uterine fibroids and ovarian cysts has also been established. Therefore, scientists suggest that these processes have common etiological factors that affect their manifestation.

Symptoms of the disease

Fibroma of the ovary may not manifest itself for a long time. This explains the fact that a tumor, when it is detected, usually exists in the body for a long time. With a fibroma size of up to 3 cm, the symptoms of the disease are completely absent, so small tumors are found by chance, during an examination for a different reason.

As the pathology progresses, the following symptoms join, which may suggest an ovarian fibroma:

Accumulation of exudate in the peritoneal cavity (ascites). This pathological condition occurs when a fibroid secretes fluid that enters the space of the peritoneum, free from organs. Hydrothorax is a companion of ascites, in which fluid leaks from the abdominal cavity into the pleural cavity.
If the tumor is large, then it is able to put pressure on the internal organs and nerves that permeate them, so the woman will experience pain.
Anemia is another common symptom of fibroids. This condition is characterized by pallor of the skin, dizziness, a general disturbance of well-being.

The menstrual cycle is usually not disturbed, since the tumor does not secrete hormones. A woman with fibroma can become pregnant, although less likely than a healthy woman.

How to detect a tumor

Fibroma of the ovary is often detected by chance, during operations on the pelvic organs. If she gives symptoms, then the woman can consult a gynecologist. The doctor, after examining her on the armchair, will prescribe her a comprehensive examination, which includes the following diagnostic methods:

Ultrasound examination (ultrasound) will detect a tumor of medium echogenicity.
Magnetic resonance imaging (MRI) is performed less frequently than ultrasound, since this study is more expensive, and the information content in terms of detecting ovarian fibroids in these two methods is equivalent.
Diagnostic laparoscopy of ovarian fibroma with the collection of its tissues for further study is carried out directly during surgery.

It is necessary to distinguish ovarian fibroma from pathological processes in the uterus, first of all, from the presence of a myomatous node in it, since these pathologies give similar symptoms. Therefore, it is possible to start treating a woman only after a comprehensive examination.

Treatment

Ovarian fibroma, as a tumor, does not recognize treatment with conservative methods. Surgical intervention is required to get rid of the neoplasm.

The operation to remove the fibroma is carried out in a hospital, in the gynecological department. If the patient has a small formation, then it is possible to exfoliate it using a laparoscope. When the patient has already entered menopause, or is in the premenopausal period, she is most often recommended to completely remove the appendages. The tissues of the removed tumor are subject to mandatory histological examination.

Treatment of folk remedies for fibroids is unacceptable, as you can cause serious harm to your body. However, this is not needed if a woman sees a doctor on time, the prognosis is almost always favorable. The risk that the tumor transforms into cancer does not exceed 1%. Prevention of ovarian fibroma comes down to an annual visit to the gynecologist's office and an ultrasound scan.