leiomyoma

Leiomyoma: A Benign Smooth Muscle Tumor

Leiomyoma, also known as uterine fibroids, are benign growths that arise from the smooth muscle cells and fibroblasts of the uterus. They are noncancerous tumors that can cause a range of symptoms, including abnormal uterine bleeding and pelvic pressure.

Characteristics:

• Benign: Leiomyomas are not cancerous and do not spread to other parts of the body.
• Smooth muscle origin: They arise from the smooth muscle cells and fibroblasts of the uterus.
• Common in reproductive age: Leiomyomas are most commonly found in women of reproductive age, typically between 20-40 years old.

Types:

• Submucosal (SM): These leiomyomas grow into the uterine cavity and can cause heavy bleeding and other symptoms.
• Intramural: These leiomyomas grow within the muscular wall of the uterus and may not cause any symptoms.
• Pedunculated intracavitary: These leiomyomas are attached to the uterine wall by a stalk and grow into the uterine cavity.

Symptoms:

• Abnormal uterine bleeding: Leiomyomas can cause heavy or irregular menstrual bleeding.
• Pelvic pressure: The growth of leiomyomas can put pressure on surrounding organs, causing discomfort and pain.

References:

• [1] Uterine fibroids are common growths of the uterus. They often appear during the years you're usually able to get pregnant and give birth. (Source: Search result 2)
• [3] Leiomyomas are benign soft-tissue neoplasms that arise from smooth muscle; they were first described by Virchow in 1854 as "tuberculum dolorosum ...". (Source: Search result 3)
• [5] Better known as uterine fibroids, leiomyomas are benign, fibrous uterine tumors. “Leio” means 'smooth', ”myo” means 'muscle', and ”oma” means 'tumor'. (Source: Search result 5)
• [7] Uterine fibroids (leiomyomas) are benign smooth muscle tumors of the uterus. Fibroids frequently cause abnormal uterine bleeding and pelvic pressure and ... (Source: Search result 7)
• [10] Result: noun | benign tumor of smooth muscle (usually in the uterus or digestive tract) (Source: Search result 10)

Common Signs and Symptoms of Leiomyoma

Leiomyoma, also known as uterine fibroids, are non-cancerous growths that develop in or on the uterus. The symptoms of leiomyoma can vary from woman to woman, but here are some common signs and symptoms:

• Heavy or Prolonged Menstrual Bleeding: One of the most common symptoms of leiomyoma is heavy or prolonged menstrual bleeding, which can be heavy enough to cause anemia [1].
• Pelvic Pressure or Pain: Women with leiomyoma may experience pelvic pressure or pain, which can range from mild discomfort to severe pain [2].
• Frequent Urination: Some women may experience frequent urination due to the growth of fibroids pressing on the bladder [3].
• Painful Sex: Leiomyoma can cause painful sex due to the growths pressing on the cervix or vagina [4].
• Abdominal Discomfort and/or Fullness: Women with leiomyoma may experience abdominal discomfort and/or fullness, which can be similar to a feeling of being pregnant [5].
• Lower Back Pain: Some women may experience lower back pain due to the growths pressing on the spine or surrounding muscles [6].

It's essential to note that not all women with leiomyoma will experience symptoms, and some may only have mild symptoms. If you're experiencing any of these symptoms, it's crucial to consult a healthcare provider for proper diagnosis and treatment.

References:

[1] Context 1: Heavy menstrual bleeding or painful periods. [2] Context 2: Not all fibroids cause symptoms, but when they do, symptoms can include heavy menstrual bleeding, back pain, frequent urination and pain during sex. Small ... [3] Context 8: Fibroid Symptoms · 8. Frequent Urination or Constipation [4] Context 8: Fibroid Symptoms · 5. Painful Sex [5] Context 5: Feeling of fullness in the pelvic area. [6] Context 9: general abdominal pain, cramps, or spasms

Diagnostic Tests for Leiomyoma (Uterine Fibroids)

Leiomyoma, also known as uterine fibroids, are benign tumors that grow in the uterus. Diagnosing leiomyoma can be done through various tests and examinations.

• Ultrasound: This is a common diagnostic test used to confirm the presence of leiomyoma. Ultrasound uses sound waves to create images of the inside of the body, allowing doctors to visualize the fibroids and their size [1].
• Transvaginal Ultrasonography: This type of ultrasound provides more detailed images of the uterus and can detect fibroids with a high degree of accuracy (90-99%) [2].
• Magnetic Resonance Imaging (MRI): MRI is another imaging test that can provide detailed pictures of the inside of the body. It is often used to confirm the diagnosis of leiomyoma, especially in cases where ultrasound results are unclear.
• Hysteroscopy: This procedure involves inserting a small camera through the cervix to visualize the inside of the uterus and detect any abnormalities, including fibroids [4].
• Laparoscopy: Similar to hysteroscopy, laparoscopy involves inserting a camera through the abdomen to visualize the outside of the uterus and detect any external growths or fibroids.
• Blood Tests: While not directly diagnostic for leiomyoma, blood tests can help rule out other conditions that may be causing symptoms similar to those experienced with fibroids [5].
• Endometrial Biopsy: This procedure involves taking a sample of tissue from the lining of the uterus to check for any abnormalities or cancer cells.

It's worth noting that a combination of these diagnostic tests and examinations can provide a comprehensive understanding of the condition, allowing doctors to develop an effective treatment plan.

Treatment Options for Leiomyoma

Leiomyoma, also known as uterine fibroids, can be treated with various medications to alleviate symptoms and shrink the tumors. Here are some of the most effective drug treatments:

• Gonadotropin-releasing hormone agonists (GnRHa): These medications, such as Lupron, Synarel, and Zoladex, are considered the most effective for treating fibroids [5]. They work by shrinking the tumors and can be used before surgery to reduce their size.
• Ulipristal acetate (Esmya): This medication is specifically designed to treat fibroids and has been shown to be effective in reducing symptoms and tumor size [7].
• Aromatase inhibitors: While there is limited evidence to support the use of aromatase inhibitors for treating leiomyoma, they have been studied as a potential treatment option [11][13]. However, more research is needed to confirm their effectiveness.
• Calcium channel blockers and phenoxybenzamine: These medications can help relieve pain associated with fibroids [6].

Other Treatment Options

In addition to these drug treatments, other options are available for managing leiomyoma symptoms. These include:

• Hormone therapy: Hormonal therapies, such as oral contraceptives, can be used to treat mild to moderate fibroids [3].
• Pain medications: Pain medications can help alleviate discomfort and pain associated with fibroids.
• Surgery: In some cases, surgery may be necessary to remove the tumors.

Important Considerations

It's essential to consult a healthcare provider for complete information about treatment options, including any risks or benefits regarding use of medications. They can also provide guidance on the best course of treatment based on individual circumstances [12].

References:

[3] - NYU Langone doctors use oral contraceptives, hormone therapy, and pain medications to treat women who have mild to moderate fibroids. [5] - The most effective medications for the treatment of fibroids are gonadotropin releasing hormone agonists (GnRHa), (including Lupron, Synarel, Zoladex). [6] - Jun 15, 2021 — Drugs are used mainly for the control of associated pain. Calcium channel blockers and phenoxybenzamine are both reported to be effective. [7] - Ulipristal acetate (Esmya) is specifically designed to treat fibroids and has been shown to be effective in reducing symptoms and tumor size. [11] - Hilário SG, Bozzini N, Borsari R, et al. Action of aromatase inhibitor for treatment of uterine leiomyoma in perimenopausal patients. Fertil Steril. 2009;91(1):240-243. [12] - Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. [13] - A Cochrane review published in 2013 on aromatase inhibitors used for the management of uterine leiomyomas focused on one randomized control trial with 70 patients that met inclusion criteria. The authors concluded there was insufficient evidence to support the use of aromatase inhibitors in the treatment of women with uterine fibroids.

Differential Diagnosis of Leiomyoma

Leiomyoma, also known as uterine fibroids or myomas, can be challenging to diagnose due to its similarity in appearance and symptoms with other conditions. The differential diagnosis for leiomyoma includes various benign and malignant diseases that cause uterine enlargement, bleeding, or pelvic pain.

Common Diagnoses to Consider

According to the search results, the most common diagnoses to consider are:

• Adenomyosis [9]
• Endometriosis [9]
• Pregnancy [9]
• Leiomyosarcoma [9]
• Endometrial carcinoma [9]
• Uterine carcinosarcoma [9]

Other Disease Processes

Many other disease processes share the signs and symptoms of leiomyomas, most of which are common etiologies of abnormal uterine bleeding (AUB) and pelvic pain. According to the Federation of Gynecology and Obstetrics (FIGO), the differential can be broken down into the classification system PALM-COEIN [10].

Imaging Differential Considerations

General imaging differential considerations include:

• Uterine leiomyosarcoma [11]
• Malignant transformation into leiomyosarcoma is rare, unfortunately, no imaging modality can reliably differentiate a benign leiomyoma from the rare leiomyosarcoma.
• Uterine smooth muscle tumors of uncertain malignant potential: rare [11]

Complications in Differential Diagnosis

Although uterine leiomyomas and leiomyosarcomas are considered biologically unrelated tumors, they share morphologic and histologic characteristics that complicate their differential diagnosis [12].

References

[9] The differential diagnosis for uterine leiomyomas includes both benign and malignant diseases that cause uterine enlargement, bleeding or pelvic pain.

[10] Many other disease processes share the signs and symptoms of uterine leiomyomas, most of which are common etiologies of abnormal uterine bleeding (AUB) and pelvic pain. According to the Federation of Gynecology and Obstetrics (FIGO), the differential can be broken down into the classification system PALM-COEIN.

[11] General imaging differential considerations include: uterine leiomyosarcoma, malignant transformation into leiomyosarcoma is rare, unfortunately, no imaging modality can reliably differentiate a benign leiomyoma from the rare leiomyosarcoma, uterine smooth muscle tumors of uncertain malignant potential: rare.

[12] Although uterine leiomyomas and leiomyosarcomas are considered biologically unrelated tumors, they share morphologic and histologic characteristics that complicate their differential diagnosis.