The subserous fibroma is a benign muscular tumor which has the particularity of developing on the external face of the uterus. What are the symptoms ? The causes ? Can it become cancerous?
Definition: what is a subserous fibroid?
Subserous fibroma is a fibroid, therefore a benign tumor, of the uterus positioned on its outer edge, on the side of the abdominal wall. He can be inserted into the uterine muscle or connected by a pedicle. Very common, this pathology mainly affects women between 30 and 40 years old, and more often original Afro-American.
What are the symptoms of a subserous fibroid?
Subserous fibroma is relatively asymptomatic. When pedunculated, it can twist, which triggers a sharp pain. It can trigger disorders of surrounding organs if it is too large: urinary, kidney or bowel disorders. Moreover, if it is low, it can represent discomfort during childbirth. A subserous fibroid can eventually grow in size due to the effect of hormones. In other words, it’s not supposed to happen in postmenopausal women. If so, this should raise suspicion of a malignant tumor, a sarcoma.
Can a subserous fibroid become cancerous?
A subserous fibroid does not progress to cancer. On the other hand, there are malignant muscle tumors called sarcomas. “Radiologically, it is difficult to tell the difference unless there are signs of rapid worsening such as discomfort or non-response to medical treatment. Sarcomas represent 1 to 2 fibroids per 1000which remains very rare but the risk exists“, says Dr. Patricia Pautier, oncologist.
What causes a subserous fibroid?
The exact causes of subserous fibroids are unknown. We know, for example, that hormonal disorders do not induce them but activate their growth. “Ethnic origin also plays a role since half of African American women have one or more fibroids. Other risk factors could promote their occurrence: heredity, overweight, high estrogen levels or even age sinceover 45 years olda large proportion of women have fibroids“, specifies the medical oncologist.
The diagnosis of subserous fibroma is essentially clinical and palpable on gynecological examination. The gynecologist can control it at ultrasound if it grows between two consultations but most of the time, the gynecological examination is enough to monitor it. In case of rapid growth of the subserous fibroma and/or discomfort felt by the patient, theremoval of the fibroid may be considered. Beforehand, an MRI will need to be done to eliminate a more aggressive tumor.
In the majority of cases, subserous fibroids do not require any treatment. In the presence of a large fibroid or in the event of a complication, especially if the subserous fibroid twists around the pedicle, surgery to remove the fibroid may be indicated. “In premenopausal women, chemical castration through the administration of a drug blocking the rules can be proposed. However, when treatment is stopped, the fibroid may grow again.“, informs the specialist. If the woman has a desire for pregnancy and/or is embarrassed, thethe fibroid can be removed if not suspicious on imaging. In very exceptional cases, certain criteria on the MRI may be suspect, in which case a biopsy may be performed in a specialized centre. Another treatment that may be offered to shrink the fibroid is embolization. “This technique consists of block a small artery located in the fibroid to reduce its size by reducing its vascularization“, explains Dr. Patricia Pautier. On the other hand, a subserous fibroid that grows in a postmenopausal woman must discuss a hysterectomy because it can be a sarcoma and it is necessary to avoid the fragmentation of the tumor which can occur during an isolated excision of the tumour.
Thanks to Dr Patricia Pautier, medical oncologist, head of the gynecology committee of the Gustave Roussy Institute.