leiomyoma
Summary
Leiomyoma is a benign smooth muscle tumor, most commonly occurring in the uterus (uterine fibroids). These estrogen-sensitive tumors are the most common pelvic tumor in women and can cause menorrhagia, pelvic pain, and bulk symptoms.
Detail
Leiomyomas are benign neoplasms arising from smooth muscle cells, with uterine leiomyomas (fibroids) being by far the most common type. They occur in 70-80% of women by age 50, with higher prevalence in African American women. These tumors are estrogen and progesterone-dependent, explaining their growth during reproductive years and regression after menopause. Pathologically, they consist of whorled bundles of smooth muscle cells with abundant cytoplasm and cigar-shaped nuclei. Uterine fibroids are classified by location: intramural (within myometrium), submucosal (protruding into endometrial cavity), and subserosal (extending toward serosa). Clinical manifestations include abnormal uterine bleeding (menorrhagia being most common), pelvic pressure, urinary frequency, and rarely malignant transformation to leiomyosarcoma (<1% risk). Diagnosis is typically made via pelvic ultrasound or MRI. Treatment options range from observation to medical management (GnRH agonists, tranexamic acid) to surgical intervention (myomectomy, hysterectomy, uterine artery embolization).
Sources
- Robbins and Cotran Pathologic Basis of Disease
- Williams Gynecology
- First Aid for the USMLE Step 1
- Novak's Gynecology
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