deep leiomyoma

Based on the provided context, here are the signs and symptoms of deep leiomyoma (also known as uterine fibroids):

Common Symptoms

• Heavy menstrual bleeding or painful periods [1]
• Longer or more frequent periods [2]
• Pelvic pressure or pain [3]
• Frequent urination or trouble urinating [4]

Other Possible Symptoms

• A swollen or distended abdomen [5]
• Feeling of pressure in the stomach area [6]
• Fertility issues, including difficult pregnancies and increased chances of needing a cesarean delivery [7]
• Pain during sex [8]

Specific Types of Fibroids

• Intramural fibroids: These are the most common type and can grow larger, stretching the uterus [9]
• Subserosal fibroids: These grow outside the uterus and can cause symptoms like heavy bleeding and pelvic pain [10]

Breakdown of Fibroids

• Acute pain: A sharp pain in the abdomen that may be accompanied by swelling [11]
• Chronic pain: Less severe but more longer-lasting pelvic pain [12]
• Fever: A sign of fibroids breaking down [13]

It's worth noting that not all women with uterine fibroids experience symptoms, and some may only have mild symptoms. However, if you're experiencing any of these symptoms, it's essential to consult a healthcare professional for proper diagnosis and treatment.

References:

[1] Context #1 [2] Context #2 [3] Context #3 [4] Context #4 [5] Context #3 [6] Context #6 [7] Context #3 [8] Context #8 [9] Context #4 [10] Context #4 [11] Context #11 [12] Context #12 [13] Context #11

Diagnostic Tests for Deep Leiomyoma

Deep leiomyomas are rare tumors that occur in the somatic soft tissue sites, and their diagnosis can be challenging. However, several diagnostic tests can help confirm the presence of these tumors.

• Histological examination: A stringent histological criteria is used to diagnose deep leiomyomas, which includes extremely low levels of, or even absence of, mitotic activity and the absence of nuclear atypia and coagulative tumor necrosis [1]. This test is considered the gold standard for diagnosing deep leiomyomas.
• Immunohistochemistry: In selected cases, immunohistochemistry may be used to confirm the diagnosis of deep leiomyomas. However, this test should only be performed in conjunction with histological examination [5].
• Ultrasound: Ultrasound is not typically used for diagnosing deep leiomyomas, as these tumors are rare and often occur in deep somatic soft tissue sites that are difficult to visualize using ultrasound [8].

Other Diagnostic Tests

While not specifically designed for diagnosing deep leiomyomas, other diagnostic tests may be useful in ruling out other conditions or confirming the presence of a tumor.

• MRI: Magnetic Resonance Imaging (MRI) can be used to evaluate the extent of disease and rule out other conditions. However, MRI is not typically used for diagnosing deep leiomyomas [6].
• CT scan: Computed Tomography (CT) scans may also be used to evaluate the extent of disease and rule out other conditions. However, CT scans are not typically used for diagnosing deep leiomyomas [8].

References

[1] Context 1 [5] Context 5 [6] Context 6 [8] Context 8

Treatment Options for Deep Leiomyoma

Deep leiomyomas, also known as uterine fibroids, are a common type of pelvic tumor in females. While surgical options like myomectomy and hysterectomy are available, drug treatment can be an effective alternative for some patients.

• Calcium Channel Blockers: Calcium channel blockers, such as nifedipine, have been reported to relieve pain associated with piloleiomyomas [1]. However, their effectiveness in treating deep leiomyomas is less clear.
• Phenoxybenzamine: This medication has been used to control associated pain in some cases of uterine leiomyoma [2].
• Aromatase Inhibitors: Aromatase inhibitors, such as letrozole, anastrozole, and fadrozole, have been studied for their potential use in treating uterine leiomyomas. However, a Cochrane review published in 2013 found insufficient evidence to support the use of aromatase inhibitors in this context [10].
• GnRH Agonists: GnRH agonists can temporarily shrink fibroids substantially and reduce heavy menstrual bleeding [9]. However, their long-term effectiveness is uncertain.
• UPA (Uterine Proliferation Antagonist): UPA has been shown to exhibit antiproliferative effects on leiomyoma cells and the endometrium. A randomized controlled trial found a reduction in myoma volume with 13 weeks of UPA treatment [14].

Important Considerations

• Limited Evidence: The effectiveness of drug treatment for deep leiomyomas is not well established, and more research is needed to fully understand their potential benefits and risks.
• Individualized Treatment: Patients should discuss their individual needs and circumstances with a healthcare provider to determine the best course of treatment.

References:

[1] Calcium channel blockers for piloleiomyomas (Jun 15, 2021)

[2] Phenoxybenzamine for uterine leiomyoma (Jun 15, 2021)

[10] Aromatase inhibitors for uterine leiomyomas (2013)

[14] UPA for symptomatic fibroids (no specific date)