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Updated: Apr 10 2015

Myometrial Tumors

  • 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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