Uterine fibroids are non-cancerous tumors that grow in and on the uterus. Between 60% and 80% of all women experience uterine fibroids by the time they are 50 but not all of them will be aware of their presence. Fibroids can be asymptomatic, can cause severe and debilitating symptoms, or the symptoms may be somewhere in the middle of these extremes.
There is no known cause for fibroids but experts do understand factors that put certain individuals at higher risk for developing fibroids. We also know that fibroids need a blood supply to thrive and grow and they respond to estrogen and grow faster and larger in estrogen-rich environments.
Most fibroids grow from a location in or on the uterus and are tapped into the uterine artery for their much-needed blood supply.
Where Does A Parasitic Fibroid Come From?
Fibroids can grow directly attached to the uterus or they can grow from a stem or stalk-like structure that allows them to hang down from their attached location. These hanging fibroids are called pedunculated fibroids and in rare cases, their stems can be longer than normal allowing the fibroid to travel around so they are referred to as migrating or wandering fibroids.
Wandering fibroids can cause some unusual problems and can become challenging to address. If the stalk the fibroid is hanging from becomes twisted, it is referred to as a torsion of the fibroid and can escalate into a medical emergency. When torsion occurs, it usually is accompanied by sharp sudden pain in the abdomen and if you experience these symptoms you should seek medical help right away.
The other unusual situation that can arise from a pedunculated fibroid is that this fibroid can turn into a parasitic fibroid. Parasitic leiomyomas can begin as subserosal pedunculated fibroid tumors – tumors that are attached by a stem and growing from the outside of the uterus. The fibroid comes into contact with other tissue or a nearby organ and becomes attached to it.
Eventually, this fibroid can detach from its original blood source (the uterus) but the fibroid continues to be supplied with the blood it needs to thrive and grow from the tissue or organ it is now attached to.
Another rare type of parasitic fibroids is known as extrauterine fibroids and is even more difficult to diagnose. Studies have shown that these benign tumors can be found growing in the urethra, ovaries, vulva, urinary bladder, etc. They can develop on their own, with no apparent cause but research has suggested that most are thought to be caused by a previous myomectomy or hysterectomy where the surgeon used a surgical tool called a power morcellator.
This tool cuts the tumor into many very small pieces so the surgeon can remove them laparoscopically. Tiny pieces can be mistakenly left behind and can attach somewhere, tap into that blood supply and begin to grow as a parasitic fibroid.
Diagnosing Parasitic Fibroids
Parasitic leiomyomas are harder to diagnose, short of removing them, because they are rare, are found in unusual locations, and can present in unusual ways. They are often mistaken for other types of tumors or cysts.
An MRI is the most reliable diagnostic test to determine what type of growth/tumor may be present. The MRI provides high-quality 3D representations of the unusual growths but even then because these are so rare and can be in strange locations, the results still may be unclear.
The expertise of the radiologist and their ability to recognize the characteristic features of these types of tumors may help the patient receive the right kind of treatment in a timely manner.
Treatment For Parasitic Leiomyomas
Generally, uterine fibroids are best treated with a non-surgical procedure called uterine fibroid embolization (UFE). This procedure blocks the blood flow from the uterus to the fibroids causing them to shrink and die.
Extrauterine or parasitic fibroids may be best removed through myomectomy because they are no longer attached to the uterine blood supply and UFE is ineffective in treating these types of fibroids.
If the patient is experiencing multiple fibroids and parasitic leiomyoma then the least invasive form of treatment would be to use a combination of UFE and myomectomy to remove the fibroids and preserve the uterus.
The Benefits Of Uterine Fibroid Embolization (UFE)
Uterine fibroid embolization is the best method to treat most fibroids. Hysterectomy and myomectomy are two surgical methods that are commonly used to treat uterine fibroids and every year in the U.S. over 600,000 hysterectomies are performed with only 10% being medically necessary.
Both hysterectomy and myomectomy have many risks and side effects that we have discussed in other blog posts. One of these noteworthy risks was recently discussed by the FDA in June 2022 and was in regard to the use of power morcellators during these surgical procedures. The text on the FDA website states:
“These devices are commonly used in hysterectomy (surgical procedure to remove a woman’s uterus) and myomectomy (surgical procedure to remove uterine fibroids which are noncancerous growths in a woman’s uterus)”.
It then goes on to detail that uterine sarcoma is more prevalent in women who have fibroids and that the instance of sarcoma is greater than what was once believed.
Historically, it was believed that hidden sarcoma (cancer) was probable in 1 out of every 10,000 women who undergo surgery to remove fibroids. Now it is thought that this figure is actually closer to 1 in 2,000. Using a power morcellator during laparoscopic surgery on a cancerous tumor can cause cancer to spread and diminish the survival rate of this patient.
Uterine fibroid embolization treats fibroids without the use of surgery or tools that can make the patient’s prognosis worse. If you have been diagnosed with uterine fibroids and a myomectomy or hysterectomy has been recommended to you by your OB-Gyn, please contact The Atlanta Fibroid Center for a second opinion.
UFE can effectively treat 90% of all women who are diagnosed with fibroids without surgery, compromising or losing their uterus, or enduring a long recovery. Dr. John Lipman and Dr. Mitchell Ermentrout are two of the nation’s leading experts in the UFE procedure. They have helped thousands of women experience freedom from their fibroids and he would like to help you too. Contact us today to learn more!