What are the symptoms and manifestations of uterine tumors?

Uterine tumor is the most common benign tumor of female genitalia. The symptoms of uterine tumor are mostly not obvious. A few of them are manifested as vaginal bleeding, abdominal mass and compression symptoms. If the pedicle is twisted or other conditions occur, it may cause pain. Multiple uterine fibroids are common. The symptoms and manifestations of uterine tumors are as follows:

Symptoms of uterine tumors: Uterine sarcoma originates from the mesoderm, which can come from the muscles, connective tissue, blood vessels, endometrial matrix or myoma of the uterus, or from various derivative components of the mesoderm, such as bone, cartilage, fat, striated muscle, etc.

Most patients have no obvious symptoms of uterine tumors, and they are only occasionally discovered during pelvic examinations. If symptoms occur, they are closely related to the location of the tumor, the growth rate, and whether the tumor has degenerated. Common uterine tumors have three symptoms:

One of the symptoms of uterine tumor is menstrual changes: it is the most common symptom, manifested as shortened menstrual cycle, increased menstrual flow, prolonged menstrual period, irregular vaginal bleeding, etc.

The second symptom of uterine tumor is abdominal mass: abdominal distension, a mass can be felt in the lower abdomen, and there is a feeling of falling.

The third symptom of uterine tumor is increased vaginal discharge: increased vaginal discharge, sometimes with a large amount of purulent and bloody discharge and necrotic tissue discharge with a foul odor.

Several major manifestations of various types of uterine tumors

1. Uterine leiomyosarcoma is the most common uterine sarcoma, accounting for 50-60% of all uterine sarcomas. The age of onset is 25-75 years old, with an average age of 50 years old. Younger patients seem to have a better prognosis than postmenopausal patients. When the sarcoma grows within the uterine muscle wall, it may be asymptomatic. After it breaks into the uterine cavity, abnormal uterine bleeding is the most common symptom, which can occur in about 60% of patients.

Half of the patients may have varying degrees of abdominal pain or discomfort. Some patients also complain of gastrointestinal or urinary tract symptoms. About 10% of patients complain of abdominal masses. The masses can be hard or soft, and the surface can be nodular or remain smooth. Occasionally, pedunculated tumors can protrude from the cervix. Some can coexist with fibroids. In the late stage of the tumor, it can metastasize to the pelvic and abdominal organs, often accompanied by bloody ascites. Uterine sarcomas grow rapidly, especially after menopause. If the original uterine fibroids suddenly develop rapidly, the possibility of malignant transformation of the fibroids should be considered.

2. Endometrial stromal sarcoma and intrauterine lymphoid stromal myopathy Endometrial stromal sarcoma is the rarest type of uterine sarcoma. The most common symptom is irregular vaginal bleeding, sometimes accompanied by abdominal pain or back pain. Gynecological examination can reveal an enlarged and soft uterus. If there are polyps protruding from the cervical ostium, the surface may have ulcers, necrosis, bleeding, etc.

The main clinical manifestations are similar to those of uterine leiomyosarcoma, but it is more malignant. In the early stage, it has local infiltration or direct spread; in the late stage, it metastasizes along blood vessels and/or lymphatic vessels.

3. Grape-shaped sarcoma has these characteristics in terms of age of onset, growth site and local morphology.

4. Uterine mixed mesodermal sarcoma accounts for 30-40% of all uterine sarcomas and usually occurs in postmenopausal women. The most common clinical manifestation is irregular vaginal bleeding, especially postmenopausal bleeding; often accompanied by bloody or smelly leucorrhea, lower abdominal discomfort and pain. Late-stage patients may experience abdominal pain, abdominal distension, bloody ascites, cachexia, etc.

Gynecological examinations can reveal an enlarged and soft uterus, an open and retracted uterine opening, and polyp-like masses protruding from the uterine opening into the vagina. This tumor is highly malignant and, in addition to locally invading the uterine body and parauterine tissues, can metastasize to the pelvic, inguinal, and retroperitoneal lymph nodes, as well as to the pleura, lungs, pericardium, liver, kidneys, and bones.

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