Fibroid pseudocapsule: a modern view of the problem. A literature review

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Abstract

Uterine fibroids are a benign polyetiological, hormone-sensitive, monoclonal tumor originating from the smooth muscle cells of the myometrium. They differ in size, location, growth rate, parenchyma-stroma ratio, morphohistogenesis, and clinical manifestations. Despite the frequent occurrence of this disease, its pathogenesis is poorly understood. In particular, the role of the fibroid pseudocapsule is a topic of interest. The appropriateness of retaining the pseudocapsule during myomectomy and the association of its retention with the risk of disease recurrence also remain controversial. This article is a literature review of data ranging from 2013 to 2023, available in the PubMed and Scopus databases. The main aspects of domestic and international clinical guidelines are also presented. This review covers epidemiological features and clinical aspects of uterine fibroids, as well as intraoperative and morphological characteristics of the fibroid pseudocapsule. Current data on the role of the MED12 gene, PGP 9.5, SP, VIP, VEGFR, IGF-2, endoglin, and oxytocin in the pathogenesis of uterine fibroids are also presented. Literature on the effect of gonadotropin-releasing hormone agonists on the morphology and functions of the pseudocapsule is submitted in the text. Despite the possible regenerative properties of the fibroid pseudocapsule, there is still a lack of systematic studies in the literature regarding the molecular and biochemical characteristics of the pseudocapsule, which makes it necessary to further investigate this morphological structure.

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About the authors

Nikolai I. Polenov

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Author for correspondence.
Email: polenovdoc@mail.ru
ORCID iD: 0000-0001-8575-7026
SPIN-code: 9387-1703

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Maria I. Yarmolinskaya

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: m.yarmolinskaya@gmail.com
ORCID iD: 0000-0002-6551-4147
SPIN-code: 3686-3605

MD, Dr. Sci. (Med.), Professor of the Russian Academy of Sciences

Russian Federation, Saint Petersburg

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2. Figure. Fibroid pseudocapsule (histological section). Hematoxylin and eosin staining, zoom ×480

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