Clinicopathological Study of Uterine Leiomyomas: A Multicentric Study in Rural Population

Abstract

Background and Objectives Leiomyoma of uterus forms the most common type of benign tumor of uterus and also the most common pelvic tumor in women. The symptomatology continues to be variable. Surgery has for long been the main mode of therapy for the myomas. For women who wish to retain the uterus for future pregnancies or other reasons, myomectomy is preferred. Recent trend has been toward nonsurgical approaches like GnRH hormone analogs/agonists, RU 486, or selective uterine artery embolization, laparoscopic cryoablation, radiofrequency thermal ablation, and MRGUs. This multicentric study was an attempt to analyze the clinicopathological spectrum in cases of leiomyoma of the uterus at Cheluvamba Hospital, Adichunchanagiri Institute of Medical Sciences, and to know regarding the pattern of presentation, pathological correlation, with type of fibroid, and endometrial and ovarian changes. Results Leiomyoma is the most common benign tumor of the uterus and commonly affects the women of childbearing age, most commonly in the third decade, 55 %. The most common mode of presentation was menstrual disturbances (76 %), among which menorrhagia was seen in 54 % of the cases. Primary infertility was seen in 15 % of the patients. Intramural fibroids were the most common variety occurring in 60 % of the cases. Endometrial pattern was proliferative in 66.3 %. Cystic ovaries were seen in 8 % of the patients, adenomyosis in 16 % indicating hyperestrogenism. Conclusion Fibromyoma (leiomyoma) is the most common benign tumor of the pelvis. It commonly affects the women of child-bearing age, mostly in the third decade and is most commonly seen in multipara. The most common mode of presentation is menstrual disturbances. Intramural fibroid is the most common variety. The proliferative and hyperplastic endometrium was commonly reported. The presence of proliferative endometrium, adenomyosis, and cystic ovaries all are indicative of hyperestrogenic state associated with development of fibroids.

Leiomyomas in Hysterectomy Specimens: A Clinicohistopathological Study

“…In our study subserosal fibroids were 24.34% and submucosal fibroids were 4.27%. Extrauterine occurrence of cervical fibroids was seen in 0.82% cases while it was 2-8% in similar studies by Dayal et al, 14 Kulkarni et al 15 and Geethamala et al 12 Two cases in our study had broad ligament fibroids which can sometimes be confused with ovarian mass.…”

“…Dual pathology of adenomyosis and leiomyomas were noted in 31.07% of patients in present study similar to studies by Geethamala et al (29.1%), 12 Gowri et al (29%) 18 and Kaur et al (27.69%). 13 However studies by Lahori et al (19.23%) 11 and Kulkarni et al (16%) 15 show lower incidence. Coexistence of these lesions may be due to unopposed estrogenic stimulation.…”

Sonographic assessment of uterine leiomyoma among pregnant women.

“…They are seldom found earlier than puberty and quit to develop after menopause. 17 Begum S et al described that multiparous women were found to own fibroids greater often than nulliparous in their perimenopausal years which indicates their characteristics slow development rate. 18 The findings of our study also showed that fibroids are more common in multiparous women as compared to nulliparous/ primiparous.…”

Clinicopathological features of uterine fibroid in a tertiary care teaching hospital

“…Cervical leiomyomas are quite uncommon. 8 The pathophysiology of leiomyomas suggests that they develop as a result of the proliferation of smooth muscle cells and connective tissue. Smooth muscle cells are shown to proliferate monoclonally.…”