Short-term change in growth of uterine leiomyoma: tumor growth spurts

Abstract

Objective To describe the short-term changes in growth of uterine leiomyomata (fibroids). Design Prospective observational study Setting University Research Center Patients Premenopausal women with fibroids (n = 18 blacks and 18 whites) recruited through a physician network and community outreach. Intervention(s) Not applicable. Main Outcome Measures The volumes of 101 fibroids were measured at enrollment, 3, 6, and 12 months with magnetic resonance imaging (MRI), resulting in three interval-specific growth rates. Growth spurts were defined by interval growth rates ≥ 30% per 3 months and substantially greater than during other intervals of observation. An overall measure of short-term change in fibroid growth was calculated as the variance of the three interval-specific growth rates. Results Growth spurts were observed in 37 of the 101 fibroids, a prevalence nearly 10 times higher than that attributable to potential measurement error. Fibroids from the same women did not have similar short-term growth (p=0.27), nor were woman-specific factors (age, race/ethnicity, parity, body mass) or the fibroid position in the uterus important. However, large fibroids (>5 cm diameter) had less short-term change than smaller fibroids (p<0.001). Conclusions Short spurts of growth are common for fibroids, suggesting that tumor biology may change rapidly.

Preoperative evaluation in women with uterine leiomyosarcoma. A nationwide cohort study

“…Various TVUS findings such as central necrosis, mixed echogenic areas or rapid tumor growth, appeared to lead to further diagnostic testing. Rapid growth of tumor size after TVUS examinations was the reason for referral in 13.4% of the postmenopausal women with verified LMS in Norway in the same period , but is also a common finding in uterine fibroids . Rapidly growing presumed fibroid has not been found to increase risk of LMS, but data are limited .…”

Power morcellation for women undergoing laparoscopic supracervical hysterectomy — safety of procedure and clinical experience from 426 cases

“…The reported sensitivities of dilatation and curettage within 33-67% are far from ideal [24,25]. Currently available clinical data clearly indicate that rapid enlargement of the uterus, which traditionally was considered as a characteristic of presumed malignancy is not a reliable predictor associated with sarcoma, but on the other hand, a stable size of presumed fibroids during several months of observation make a sarcoma highly unlikely [26,27].…”

Comparison of characteristics of fibroids in African American and white women undergoing premenopausal hysterectomy

“…The lack of a clear association between time since diagnosis and size of uterus or largest fibroid is consistent with findings from a longitudinal study of fibroid growth patterns, which demonstrated that fibroids do not grow in a linear manner over time. (12, 23) Instead, fibroids show a variety of growth patterns, with some growing rapidly, others showing little change, and still others regressing in size over time.…”