Updated: 4/10/2015

Myometrial Tumors

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Leiomyoma (fibroid)
  • Introduction
    • benign smooth muscle tumor arising from myometrium
      • malignant transformation is rare
    • most common of all tumors in females
    • multiple tumors with well-demarcated borders
    • more common in blacks
    • estrogen sensitive
      • tumor size ↑ with pregnancy and ↓ with menopause
    • peak occurrence at 20-40 years of age (premenopausal)
  • Presentation
    • symptoms
      • may be asymptomatic
      • abnormal uterine bleeding
      • recurrent miscarriage
    • physical exam
      • anemia
        • result of bleeding
      • pelvic mass on abdominal palpation
  • Evaluation
    • histology
      • whorled pattern of smooth muscle cells
  • Prognosis, Prevention, and Complications
    • does not progress to leiomyosarcoma
Leiomyosarcoma
  • Introduction 
    • malignant smooth muscle tumor arising from myometrium
    • bulky, irregularly shaped tumor with areas of necrosis and hemorrhage
      • typically arising de novo (not a progression of a benign leiomyoma)
    • more common in blacks
    • most commonly seen in postmenopausal women
  • Presentation
    • symptoms
      • abnormal uterine bleeding
    • physical exam
      • may protrude from cervix
  • Prognosis, Prevention, and Complications
    • highly aggressive tumor with tendency to recur

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