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Subserous fibroids

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Subserous or subperitoneal myomas develop near the peritoneal surface of the uterus and may attain an enormous size - up to 20 Kg.

They usually originate from intramural tumours which have grown towards the serous surface. Many become sessile or pedunculated as they grow up into the abdomen and extrude through the uterine surface.

Occasionally, subserous fibroids adhere to the omentum or bowel mesentery, develop an omental or mesenteric blood supply, and become detached completely from the uterus. These are described as parasitic tumours.

Most subserous fibroids are covered by peritoneum but exceptionally, extrusion occurs from a part of the uterus not covered with peritoneum, such as from the anterior wall below the peritoneal reflection. Such tumours may cause considerable displacement of pelvic viscera, including the ureter, which then becomes liable to damage at operation.


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