Uterine leiomyomas (fibroids) most often project from the outer surface of the uterus (subserosal location). This photograph shows a hysterectomy specimen which has already been opened and reveals two small leiomyomas. At the top of the photograph is a small leiomyoma in an intramural position (totally within the muscle, or myometrium, of the uterus). In the middle of the photograph is a polypoid leimyoma in a submucosal location (projecting into the endometrial cavity). Submucosal leiomyomas often will cause irregular uterine bleeding. If small, this type of leiomyoma can sometimes be removed through a hysteroscope inserted through the cervix thereby avoiding a major surgical procedure.