Leiomyoma

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Leiomyoma

File:Leiomyoma Uterus 40x.jpg
Microscopic view of a Leiomyoma

Leiomyoma, commonly known as fibroids, is a noncancerous tumor originating from smooth muscle cells. Most frequently found in the uterus, leiomyomas can also develop in other areas with smooth muscles, such as the small intestine, esophagus, and stomach.

Definition and Characteristics

Leiomyomas are benign growths that arise from smooth muscle tissue. They are composed of smooth muscle cells and fibrous connective tissue, exhibiting a whorled pattern in histological sections.

Pathogenesis

The development of leiomyomas is not fully understood but involves complex genetic, hormonal, and environmental factors. They are estrogen and progesterone-sensitive, often growing during reproductive years and shrinking after menopause.

Genetic Factors

  • Chromosomal abnormalities
  • Gene mutations, especially in the MED12 gene

Hormonal Influence

  • Estrogen and progesterone stimulate growth
  • Growth may accelerate during pregnancy

Clinical Presentation

Leiomyomas can range from asymptomatic to causing significant symptoms, including:

  • Heavy or prolonged menstrual periods
  • Pelvic pain or pressure
  • Frequent urination
  • Difficulty emptying the bladder
  • Constipation

Diagnosis

Diagnosis of leiomyomas typically involves:

  • Pelvic examination
  • Imaging modalities like ultrasound or MRI

Treatment and Management

Treatment depends on the size, location, and symptoms, as well as patient preferences. Options include:

  • Medication for symptom management
  • Hormonal treatments to shrink tumors
  • Surgical interventions such as myomectomy or hysterectomy
  • Minimally invasive procedures like uterine artery embolization

Epidemiology

Leiomyomas are the most common benign tumors in women of reproductive age, particularly prevalent among African American women.

References

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