Uterine Fibroid Pseudocapsule: an Update of its Importance in Fibroid Management and Female Reproduction

Uterine fibroids or myomas are the most common benign tumors of the female genital tracts, consisting mainly of smooth muscle cells with different amounts of fibrous tissue and are benign. During its growth, fibroid causes compressive phenomena on the surrounding myometrium, that for ischemic phenomena, produce a sort of pseudocapsule, constituted by a surrounding network of collagen fibers, neurofibers and blood vessels, as a separate fibroneurovascular tissue. Occasionally the pseudocapsule surface is interrupted by collagen fibers and vessels that anchor the fibroid to myometrium, well represented in microscopic sections. At the ultrastructural level, visualized by transmission electron microscopy, the pseudocapsule cells have the features of smooth muscle cells similar to the myometrium. So, the pseudocapsules are part of the myometrium which compresses the leiomyoma. Studies confirmed preliminary evidence that pseudocapsules is rich of neuropeptides together with their related fibers, as a neurovascular bundle, containing a vascular network rich in neurotransmitters, as a neurovascular bundle, with biological very important biological functions and a significant impact on the reproductive uterine functions. In this paper, after a review of all papers in such topic, I summarize the importance of this small structure in the context of the myometrium, for the purpose anatomical, pathophysiological and reproductive systems.