Uterine leiomyomata

Uterine artery embolization (UAE) is an established technique to treat benign diseases of the uterus such as uterine leiomyomata (fibroids) and adenomyosis. This article reviews the use of UAE in these conditions and summarizes the evidence regarding safety and efficacy of the technique based on the current literature.

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Malignant transformation in leiomyoma is rare, with a few documented cases of sarcomatous transformation in leiomyomas. However, carcinosarcomatous transformation in leiomyomas is extremely infrequent. A 45-year-old female presented with a mass sensation per abdomen for the last five months. An abdominal ultrasound revealed multiple uterine fibroids. Contrast-enhanced magnetic resonance imaging revealed a large multiloculated abdominopelvic mass arising from the fundus of the uterus, along with multiple smaller subserosal fibroids...

A technical video was produced to demonstrate in step-by-step fashion a multiple contained myomectomy of a 20 × 30 cm giant myoma and seven additional fibroids found in the same patient, which required two different types of specimen retrieval bags for the electronic power morcellation. This complete surgical procedure included leiomyomata enucleation, contained in-bag electronic power morcellation, uterine reconstruction and the application of an adhesion prophylactic medical product.

IMPORTANCE: Leiomyomata, or fibroids, are a common gynecological problem affecting many women of reproductive age. Historically, myomectomy is offered to women with symptomatic fibroids who desire to preserve fertility. More recently, uterine artery embolization (UAE) has been explored as another fertility-sparing option. OBJECTIVE: This review aims to provide an in-depth summary of the effects on fertility and reproductive outcomes following myomectomy and UAE for the treatment of symptomatic fibroids...

OBJECTIVE: The aim of this systematic review is to gather and synthesize evidence regarding the use of oral gonadotrophin-releasing hormone (GnRH) antagonist for the treatment of bleeding associated with uterine myomas. DATA SOURCES: Web of Science, and MEDLINE databases were searched electronically on March 5, 2021, using combinations of the relevant Medical Subject Headings terms and keywords. The search was restricted to the English language and to human studies...

Bone formation in the ovary is exceedingly rare, except in the setting of dermoid cysts. Here, the author reports a case of incidental finding of heterotopic bone formation in a mucinous cystadenoma of the ovary in a 45-year-old woman who had underwent a total abdominal hysterectomy and right salpingo-oopherectomy because of hypermenorrhea during last one year with an ultrasonography report of right ovarian cyst and simultaneous multiple uterine leiomyomatas. Microscopic examination of the ovarian cyst revealed a mucinous cystadenoma with the striking finding of several thin plates of lamellar bone identified in fibrous tissue in the cyst wall...

BACKGROUND: Uterine leiomyomata (UL), commonly known as uterine fibroids, are benign smooth muscle tumors of the myometrium. They cause pelvic pain, abnormal uterine bleeding, and infertility in women of reproductive age. The ovarian hormone estrogen is the main stimulator for the fibroid growth. The etiology is not yet clearly understood; however, UL are believed to be monoclonal tumors arising from a common progenitor cell. Chromosomal cytogenetic abnormalities have been demonstrated in 40-50% of the fibroids...

Leiomyoma is the commonest benign mesenchymal tumor of the uterus, which can be developed at any site where smooth muscle cells are found. The broad ligament is the most common and ovary is one of the rarest extrauterine sites, accounting for 0.5-1% of all benign ovarian tumors. Herein, we report a case of ovarian leiomyoma in a perimenopausal female, clinically presented with heavy menstrual bleed, radiologically diagnosed as subserosal uterine fibroid. Intraoperatively, it was considered as ovarian fibroma but finally diagnosed as ovarian leiomyoma on histomorphology, which was confirmed on special stains and immunohistochemistry...

The rupture of a subserosa variceal vein overlying a uterine myoma is a rare complication and a less common cause of gynecologic haemoperitoneum. The literature data are scarce regarding this condition and less than 100 cases have been reported (including those occurring during pregnancy). The present case is of a 48-year-old woman, with a history of asymptomatic uterine myoma, who was hospitalised for severe abdominal pain with sudden onset and signs of hypovolemic shock. The emergency conventional imaging exams confirmed the diagnosis of uterine myoma and haemoperitoneum, but did not reveal the source of bleeding...

FH Tumour Predisposition Syndrome, also known as Hereditary Leiomyomatosis and renal cell cancer (HLRCC), or Reed Syndrome, is an autosomal dominant condition clinically characterized by multiple cutaneous leiomyomas, multiple early-onset uterine leiomyomas and early-onset renal cell cancer. Here we report a young female with FH Tumour Predisposition Syndrome with no clinical features except early-onset uterine leiomyomas. Whilst there is a significant history of uterine leiomyomas in her family, there is no history of cutaneous leiomyomas or renal cell cancer (RCC)...

Background: Uterine leiomyomata (UL) and endometriosis (EM) are common gynecological diseases damaging the reproductive health of fertile women. Among all the potential factors, environmental endocrine-disrupting chemicals are insufficiently addressed considering the multiple pollutants and mixture exposure. Methods: Women aged 20 to 54 years old in the National Health and Nutrition Examination Survey (NHANES) 2001-2006, having a complete measurement of ten commonly exposed endocrine-disrupting chemicals (including urinary phthalate metabolites, equol, and whole blood heavy metals) and answered questions about UL and EM were included (N=1204)...

OBJECTIVE: To explore the relationship between body mass index (BMI) and waist-to-hip ratio (WHR) and clinicopathological characteristics and prognosis of uterine leiomyomata (UL). METHODS: A retrospective analysis of the clinical data of 133 patients with UL admitted to our hospital from September 2018 to August 2019. According to the BMI standard, the patients were divided into the normal group ( n  = 32), the super-recombination group ( n  = 45), and the obesity group ( n  = 56)...

OBJECTIVE: To examine the association of urinary concentrations of phenols, parabens, and triclocarban with incidence and growth of uterine leiomyomata (UL; fibroids). DESIGN: Case-cohort study, nested within the Study of Environment, Lifestyle, and Fibroids, a prospective cohort study. SETTING: Clinic visits at baseline and every 20 months for 60 months. PATIENT(S): 754 Black women aged 23-35 years residing in the Detroit, Michigan area (enrolled during 2010-2012)...

Introduction: Termination of pregnancy in a patient with huge uterine leiomyomata poses significant challenges to clinicians. In this study, we report the successful termination of pregnancy in a patient with large multiple uterine leiomyomata using a combined regimen of drugs for medical abortion. Case: A 42-year-old woman, 6 weeks pregnant, presented to the Family Planning Clinic with an unintended pregnancy. She had a large, irregular abdominal midline mass, equivalent in size to 30-32 weeks of pregnancy...

STUDY QUESTION: To what extent are ambient concentrations of particulate matter <2.5 microns (PM2.5), nitrogen dioxide (NO2) and ozone (O3) associated with risk of self-reported physician-diagnosed uterine leiomyomata (UL)? SUMMARY ANSWER: In this large prospective cohort study of Black women, ambient concentrations of O3, but not PM2.5 or NO2, were associated with increased risk of UL. WHAT IS KNOWN ALREADY: UL are benign tumors of the myometrium that are the leading cause of gynecologic inpatient care among reproductive-aged women...

Exosomes are small bilayer-lipid membrane vesicles secreted by living cells that are able to transfer regulatory molecules and genetic information from one cell to another. These vesicles are enriched with several nucleic acids including mRNAs, microRNAs (miRNAs), other non-coding RNAs, as well as proteins and lipids. Alterations in the exosomal content and functions are observed in numerous reproductive diseases in both animals and human cases. MicroRNAs, a class of small endogenous RNA molecules, can negatively regulate gene expression at the post-transcription level...

Uterine leiomyomata (UL) are hormone-responsive benign neoplasms. Brominated flame retardants and organochlorine pesticides (OCPs) can disrupt hormones involved in UL etiology. METHODS: The Study of Environmental, Lifestyle, and Fibroids is a Detroit-area prospective cohort of 1693 Black women 23-35 years of age. At baseline and approximately every 20 months for 5 years, women completed questionnaires and underwent transvaginal ultrasounds. Using a case-cohort study design, we selected 729 UL-free participants at baseline and analyzed baseline plasma samples for polybrominated diphenyl ethers (PBDEs), a polybrominated biphenyl ether (PBB-153), and OCPs...

Although previous studies have shown a relationship between uterine leiomyoma and pregnancy outcomes, this relationship is not yet completely understood. Many review articles have addressed this effect, but to date, none has classified this relationship according to the characteristics of the leiomyoma (i.e., type, size, number, and location). This review was conducted to evaluate and classify the relationship between leiomyoma characteristics and the effects of a leiomyoma on pregnancy and prenatal outcomes to facilitate decision-making in preconception and prenatal counselling...

Study Objective: To report 36-month follow-up of a pivotal trial that evaluated the safety and effectiveness of the AEGEA Water Vapor System for the treatment of heavy menstrual bleeding (HMB) secondary to Abnormal Uterine Bleeding due to Endometrial disorders or Leiomyomata (AUB-E and AUB-L). Methods: A prospective, multicenter, single-arm clinical trial at 14 sites in the US, Canada, Mexico, and the Netherlands. Inclusion criteria included a Pictorial Blood Loss Assessment (PBLAC, Higham) score ≥150 and allowed treatment of subjects with leiomyomata classified by the International Federation of Gynecology and Obstetrics (FIGO) Types 2-6 up to 4 cm in diameter, a uterine cavity up to 12 cm in length (uterine sound), Essure® contraceptive inserts and/or prior cesarean section...