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Gynaecology & Obstetrics Clinical Features, Diagnosis, and Pathology 9d1302b4

Which type of Degeneration of fibroid leads to formation of womb stone?

A
Fatty
B
Calcific
C
Red
D
Cystic
High-Yield Explanation
Ans. is 'b' i.e., Calcific Degenerations of fibroidsHyaline degenerationo The most common (65%) type of degeneration affecting all sizes of fibroids except the tiny one.o It is common specially in tumors having more connective tissues. The central part of the tumor which is least vascular is the common site.o The feel becomes soft elastic in contrast to firm feel of the tumor.o Naked eye examination on the cut surface shows irregular homogenous areas with loss of whorl-like appearanceo Microscopic examination reveals hyaline changes of both the muscles and fibrous tissues.Cystic degenerationo Usually occurs following menopause and is common in interstitial fibroidso It is formed by liquefaction of the areas with hyaline changes.Fatty degenerationo Usually found at or after menopause. Fat globules are deposited mainly in the muscle cells.Calcific degeneration (10%)o Usually involves the subserous fibroids with small pedicle or myomas of postmenopausal women. It is usually preceded by fatty degeneration.o There is precipitation of calcium carbonate or phosphate within the tumor. When whole of the tumor is converted into a calcified mass, it is called "womb stone".Red degeneration (carneous degeneration)o Occurs in a large fibroid mainly during second half of pregnancy and puerperium. Partial recovery is possible and as such called necrobiosis. The cause is not known but is probably vascular in origin. Infection does not play any part.o Naked eye - raw-beef appearance often containing cystic spaceso The odor is often fishy due to fatty acids.o Color is due to the presence of hemolysed red cells and hemoglobin.o Microscopically, evidences of necrosis are present. Vessels are thrombosed but extravasation of blood is unlikely.

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