Uterine fibroids, myometrium, adenomyoma and uterine sarcoma all have in common a problem with the wall of the uterus and are all estrogen-related, so they can all be referred to as estrogen-dependent tumors. Several diseases present with varying degrees of increased uterine size. In fibroids and uterine sarcomas, uterine enlargement is usually irregular, whereas in uterine adenosis and adenomyoma, uterine enlargement is usually regular and spherical. In the latter two conditions the uterus is usually enlarged no more than the uterus at >3 months of gestation. There are three types of uterine sarcomas: uterine smooth muscle sarcoma, uterine carcinosarcoma and endometrial mesenchymal sarcoma. Uterine sarcoma differs from fibroids in that the endometrium, which is supposed to be expelled from the body with menstruation, enters the myometrium and takes root, grows and becomes ill under the action of female hormones. It is one of two manifestations of the disease with endometriosis, once called intrinsic endometriosis. The main symptoms of myometriosis are premenstrual abdominal pain (dysmenorrhea) and infertility. Treatment includes medication and surgery. Uterine adenomyoma is a mixture of fibroids and adenomyosis in which fibroids occur in the myometrium while the endometrium is ectopic into the fibroids. The fibroids are most clearly defined from the surrounding tissues and are easier to remove surgically. The boundary between the fibroid and the surrounding tissues is very unclear and cannot be removed intact like digging a potato, but only wedge-shaped excision of the lesion like removing a tooth of watermelon. The clarity of the boundary between adenomyoma and the surrounding tissue is somewhere between fibroids and adenomyosis. For these reasons, fibroids are easily accomplished laparoscopically, adenomyoma is somewhat more difficult to remove, and adenomyosis is somewhat more difficult. Incision of the lesion allows for a preliminary determination of the benignity and type of tumor. Typical sections of uterine fibroids are woven, while sections of myometrium and adenomyoma reveal punctate and flaky blue endometrial lesions. Uterine sarcomas lack a woven structure and have a crumbly, fish-like appearance. Of course, the final diagnosis requires pathology.