Leiomyoma

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Leiomyoma
A histological image of a leiomyoma
Synonyms	Fibroid, myoma, fibromyoma
Pronounce	N/A
Specialty	N/A
Symptoms	Pelvic pain, menorrhagia, urinary frequency, constipation
Complications	Infertility, anemia, urinary tract infections
Onset	Reproductive age
Duration	Variable
Types	Uterine leiomyoma, cutaneous leiomyoma, leiomyosarcoma
Causes	Unknown, possibly genetic and hormonal factors
Risks	Obesity, nulliparity, family history
Diagnosis	Pelvic examination, ultrasound, MRI
Differential diagnosis	Adenomyosis, endometrial polyp, ovarian cyst
Prevention	None specific
Treatment	Medication, surgery, uterine artery embolization
Medication	GnRH agonists, NSAIDs, oral contraceptives
Prognosis	Generally good with treatment
Frequency	Common, affecting up to 70% of women by age 50
Deaths	N/A

Leiomyoma is a benign smooth muscle tumor that can occur in any organ but is most commonly found in the uterus, where it is often referred to as a uterine fibroid. Leiomyomas are the most common benign tumors in women and are typically discovered during the reproductive years.

Pathophysiology

Leiomyomas are composed of smooth muscle cells and fibrous connective tissue. They arise from the smooth muscle layer of the uterus, known as the myometrium, but can also occur in other locations such as the esophagus, small intestine, and skin. The exact cause of leiomyoma development is not fully understood, but it is believed to be related to hormonal factors, particularly estrogen and progesterone.

Clinical Presentation

Many leiomyomas are asymptomatic and are discovered incidentally during pelvic examinations or imaging studies. When symptoms do occur, they may include:

• Abnormal uterine bleeding
• Pelvic pain or pressure
• Frequent urination
• Constipation
• Infertility

Diagnosis

The diagnosis of leiomyoma is typically made through imaging studies such as ultrasound or magnetic resonance imaging (MRI). Histological examination of tissue samples can confirm the diagnosis.

Colonic leiomyoma under low magnification

Beta-catenin immunohistochemistry in leiomyoma

Treatment

Treatment options for leiomyoma depend on the size, location, and symptoms. They include:

• Observation for asymptomatic cases
• Medications such as gonadotropin-releasing hormone (GnRH) agonists to shrink the tumors
• Surgical options like myomectomy or hysterectomy
• Minimally invasive procedures such as uterine artery embolization

Prognosis

Leiomyomas are benign and do not metastasize. However, they can cause significant symptoms and complications, such as anemia from heavy bleeding. Rarely, a leiomyoma may undergo malignant transformation into a leiomyosarcoma.

Also see

• Uterine fibroid
• Leiomyosarcoma
• Myomectomy
• Hysterectomy

This 'Reproductive system diseases' related article is a stub.