Presentation
Most present as small capsular/subcapsular tumors, with only rare lesions presenting as a clinically relevant mass. There is an even more uncommon malignant counterpart, renal leiomyosarcoma. [radiopaedia.org]
We do not endorse non-Cleveland Clinic products or services Policy This video presents a rare case of a 14-year-old, gravida-0 female with a 9 cm intramural fibroid. [consultqd.clevelandclinic.org]
This tumor presents as painful or asymptomatic solitary red-brown nodules and the predominant location is on the extremities. It has been more frequently observed in men. [escholarship.org]
A rich vascular component is also present. [ajnr.org]
Renal tumors (mean age of presentation: 44) are less commonly seen in this syndrome (10-16% of cases) and may present with back pain, although some may be asymptomatic. [orpha.net]
Entire Body System
- Asymptomatic
Results: This patient was successfully operated on and was asymptomatic on follow-up. Histology confirmed that the tumor was a leiomyoma of the urinary bladder. [liebertpub.com]
This tumor presents as painful or asymptomatic solitary red-brown nodules and the predominant location is on the extremities. It has been more frequently observed in men. [escholarship.org]
It is widely believed that a much larger proportion of the female population has uterine leiomyomas, but many of them are unaware of the benign tumors because they are asymptomatic. [microscopyu.com]
[…] progestin-only injectables are associated with a reduced risk, particularly with prolonged use of oral contraceptives Meat consumption may be a risk factor and green vegetables a protective factor ( Obstet Gynecol 1999;94:395 ) Clinical features Typically asymptomatic [pathologyoutlines.com]
She had a history of hysterectomy for UL 12 years previously; she was a non-smoker and asymptomatic. Lung function, bronchoscopy, and laboratory test results were normal. [archbronconeumol.org]
- Infertility
Symptoms depend on the location, size, and number of myomas, and include menstrual abnormalities ( menorrhagia ), features of mass effects (e.g., back/abdominal/pelvic pain or bladder and bowel dysfunction), and infertility. [amboss.com]
Intramural fibroids can also increase the likelihood of infertility and pregnancy loss. Submucous leiomyomas —I often say that “fibroids are like real-estate”. The “health value” –or the problems they cause–are all about location! [cmdrc.com]
However, some may cause menorrhagia, infertility and dystocia. Reference: (1) Lumsden MA et al. Fibroids: diagnosis and management. BMJ. 2015;351:h4887 (2) Vilos GA et al.The management of uterine leiomyomas. [gpnotebook.com]
As other leiomyomata, they are benign, but may lead to excessive menstrual bleeding ( menorrhagia ), often cause anemia and may lead to infertility. [bionity.com]
Large & multiple leiomyomas are associated with infertility. May be part of hereditary leiomyomatosis and renal cell cancer (HLRCC). [librepathology.org]
- Anemia
Abnormal menstruation Hypermenorrhea, menorrhagia, metrorrhagia (possibly associated anemia ) Dysmenorrhea Features of mass effect Enlarged, firm and irregular uterus during bimanual pelvic examination Back or pelvic pain /discomfort Urinary tract or [amboss.com]
Uterine fibroids can also cause bleeding and anemia. [house.fandom.com]
Complications Although uterine fibroids usually aren't dangerous, they can cause discomfort and may lead to complications such as a drop in red blood cells (anemia), which causes fatigue, from heavy blood loss. [mayoclinic.org]
As other leiomyomata, they are benign, but may lead to excessive menstrual bleeding ( menorrhagia ), often cause anemia and may lead to infertility. [bionity.com]
If bleeding is the predominant symptom and there is a concern for anemia or other sequelae of recurrent blood loss, a complete blood count (CBC) is indicated. [ncbi.nlm.nih.gov]
- Fever
The woman had normal appetite, and she denied weight loss, fevers, night sweats, shortness of breath, chest pain or prior bleeding episodes. [healio.com]
A 2014 systematic review (nine studies including 808 eligible women) reported that laparoscopic myomectomy was associated with less postoperative pain, less postoperative fever, and shorter hospital stay than abdominal myomectomy ( 46 ). [m.acog.org]
- Falling
Studies indicate that ovarian steroids, estradiol, and progesterone, promote the growth of leiomyomas; and that the size of fibroids often decline after menopause when levels of those hormones fall [7]. [ncbi.nlm.nih.gov]
Gastrointestinal
- Constipation
[…] metrorrhagia (possibly associated anemia ) Dysmenorrhea Features of mass effect Enlarged, firm and irregular uterus during bimanual pelvic examination Back or pelvic pain /discomfort Urinary tract or bowel symptoms (e.g., urinary frequency /retention, constipation [amboss.com]
In women who have symptoms, the most common signs and symptoms of uterine fibroids include: Heavy menstrual bleeding Menstrual periods lasting more than a week Pelvic pressure or pain Frequent urination Difficulty emptying the bladder Constipation Backache [mayoclinic.org]
Subserous fibroids, if they produce symptoms at all, can cause bloatedness and compression of the bladder (leading to urinary frequency) and bowel (leading to new-onset constipation). [cmdrc.com]
Complications Chronic pelvic pain Heavy menstrual bleeding, which can lead to anemia Poor pregnancy outcomes Infertility Constipation Urinary tract infections or urinary incontinence Torsion of a pedunculated fibroid Degeneration with or without infection [ncbi.nlm.nih.gov]
Skin
- Flushing
Symptoms include flushing and diarrhea and less frequently bronchospasm and heart failure. The heart failure is the result of serotonin-induced fibrosis of the cardiac valves, notably the tricuspid and pulmonary valves. [radiologyassistant.nl]
Musculoskeletal
- Back Pain
Renal tumors (mean age of presentation: 44) are less commonly seen in this syndrome (10-16% of cases) and may present with back pain, although some may be asymptomatic. [orpha.net]
The signs and symptoms of renal cell cancer may include lower back pain, blood in the urine, or a mass in the kidney that can be felt upon physical examination. Some people with renal cell cancer have no symptoms until the disease is advanced. [ghr.nlm.nih.gov]
Symptoms that can develop include blood in the urine (hematuria), lower back pain, and the presence of mass that can be felt (palpable). [rarediseases.org]
Common symptoms include discomfort, fatigue, and back pain. The lesions are hormonally responsive and have clinical manifestations similar to those of uterine leiomyomas. [pubs.rsna.org]
- Long Arm
Each chromosome has a short arm designated “p” and a long arm designated “q”. Chromosomes are further sub-divided into many bands that are numbered. For example, “chromosome 1q42.3-q43” refers to bands 42.3-43 on the long arm of chromosome 1. [rarediseases.org]
Subgroups of common cytogenetic rearrangements include a translocation between chromosomes 12 and 14, trisomy 12, deletions of portions of the long arms of chromosomes 3 or 7 and the short arm of chromosome 1, rearrangements of the short arm of chromosome [atlasgeneticsoncology.org]
Defect is in the fumarate hydratase gene in the long arm of chromosome 1. See also [ edit ] Leiomyosarcoma References [ edit ] ^ Pedeutour, F.; Quade, B. J.; Sornberger, K.; Tallini, G.; Ligon, A. H.; Weremowicz, S.; Morton, C. C. (2000). [en.wikipedia.org]
- Short Arm
Subgroups of common cytogenetic rearrangements include a translocation between chromosomes 12 and 14, trisomy 12, deletions of portions of the long arms of chromosomes 3 or 7 and the short arm of chromosome 1, rearrangements of the short arm of chromosome [atlasgeneticsoncology.org]
Each chromosome has a short arm designated “p” and a long arm designated “q”. Chromosomes are further sub-divided into many bands that are numbered. For example, “chromosome 1q42.3-q43” refers to bands 42.3-43 on the long arm of chromosome 1. [rarediseases.org]
However, CCRs in MY47 m1 did result in fusion of the 3′ ends of COL4A5 and COL4A6 with a small region (64751 bp) from the short arm of chromosome X inserted in between. [nejm.org]
- Muscle Cramp
[…] antiprogestogenic, and antiestrogenic actions) 24% fibroid size reduction in 4 months, may improve bleeding symptoms Side effects: weight gain, edema, acne, oily skin, hirsutism, voice changes, headaches, hot flashes, altered libido, decreased breast size, and muscle [arcfertility.com]
Urogenital
- Pelvic Pain
Abnormal menstruation Hypermenorrhea, menorrhagia, metrorrhagia (possibly associated anemia ) Dysmenorrhea Features of mass effect Enlarged, firm and irregular uterus during bimanual pelvic examination Back or pelvic pain /discomfort Urinary tract or [amboss.com]
[…] medical care if you have severe vaginal bleeding or sharp pelvic pain that comes on suddenly. [mayoclinic.org]
Symptoms of pelvic pain and irregular or heavy menstrual bleeding often occur before they are discovered. [orpha.net]
Next Uterine Fibroid As the uterus is reperfused, the crampy pelvic pain subsides. Two months' treatment effects a marked reduction in fibroid volume and blood flow and is associated with good compliance. [vanity1.campuslabs.com]
Differential Diagnosis The differential diagnosis for uterine leiomyomas includes both benign and malignant diseases that cause uterine enlargement, bleeding or pelvic pain. [ncbi.nlm.nih.gov]
- Metrorrhagia
Abnormal menstruation Hypermenorrhea, menorrhagia, metrorrhagia (possibly associated anemia ) Dysmenorrhea Features of mass effect Enlarged, firm and irregular uterus during bimanual pelvic examination Back or pelvic pain /discomfort Urinary tract or [amboss.com]
Symptoms and Diagnosis The most frequent symptom of women with endometrial polyps is metrorrhagia (irregular, acyclic uterine bleeding), which is reported in 50% of symptomatic cases. Post-menstrual spotting is also common. [fibroids.net]
- Dysuria
Common symptoms (occurring in 15%–20% of cases) are related to voiding; they include dysuria, frequency or hesitancy in urination, dribbling, and hematuria. Pedunculated intraluminal masses may lead to outflow obstruction (, 69 ). [pubs.rsna.org]
Workup
Workup for polycythemia vera was negative [serum erythropoietin: 24.6 mIU/mL (normal, 3.7 mIU/L to 31.5 mIU/L); vitamin B12: 654 pg/mL (normal, 211 pg/mL-911 pg/mL); JAK2 mutation analysis negative]. [healio.com]
Uterine Artery Embolization for Uterine Leiomyoma: Role of Uterine Artery Doppler in the Pre-Interventional, Interventional and Post-interventional Patient Workup. Ultrasound Obstet Gynecol. 2011 Dec 16. [Medline]. Virchow R. [emedicine.medscape.com]
Clinical Testing and Workup A skin biopsy, which is the surgical removal and microscopic study of a small sample of skin tissue, is necessary in order to confirm the presence of leiomyomas. [rarediseases.org]
Given the utility of imaging in the workup of uterine masses, particularly fibroids, radiologists should be aware of leiomyoma variants and their associated clinical, imaging, and pathologic issues. [ajronline.org]
Treatment
These medical treatments are summarized in Table 1. [arcfertility.com]
Additional recommended knowledge Contents 1 Etymology 2 Uterine leiomyomata 3 Esophageal 4 Leiomyoma of Jejunum 5 Treatment 5.1 Medical Treatment: 5.2 Surgical Treatment: 6 Outcomes 7 References 8 See also Etymology Greek: leios = smooth muV = (myo) mouse [bionity.com]
The patient’s age and reproductive goals direct the modality and goals of treatment. Treatment options include both medical and surgical intervention [1]. [ncbi.nlm.nih.gov]
Back to Top Non-surgical treatment for fibroids Focused Ultrasound Treatment MRI-guided focused ultrasound surgery (FUS) is a noninvasive treatment option for uterine fibroids that preserves your uterus. [fibroids.net]
Presentation and treatment of uterine leiomyoma in adolescence: a systematic review. [bmcwomenshealth.biomedcentral.com]
Prognosis
Prognosis The prognosis of HLRCC is poor but treatments with new molecular targets may improve survival in the future. The documents contained in this web site are presented for information purposes only. [orpha.net]
Prognosis The prognosis of uterine fibroids varies extensively for individual patients. Many patients have an excellent prognosis and remain asymptomatic for many years or indefinitely. [ncbi.nlm.nih.gov]
The 2017 AHRQ meta-analysis provided additional information regarding prognosis. [m.acog.org]
[…] adenomatoid tumour Gross well-circumscribed, whorled appearance, firm Site skin, uterus, others Syndromes hereditary leiomyomatosis and renal cell cancer (cutaneous & uterine leiomyomas) Symptoms skin: pain, uterus: bulky Prevalence very common - esp. uterine Prognosis [librepathology.org]
Prognosis The prognosis for a solitary lesion is excellent, especially if it is surgically excised. Multiple piloleiomyomas gradually increase in size and number. [emedicine.medscape.com]
Etiology
Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007 Apr;87(4):725 – 36 9 Walker CL. Uterine fibroids: the elephant in the room. Science. 2005 Jun 10;308(5728):1589 – 92 10 Lethaby A, Vollenhoven B, Sowter M. [arcfertility.com]
Etiology Leiomyomas are comprised of monoclonal cells arising from the myometrium [5]. Continued research to determine the etiology of leiomyomas is ongoing. Several studies have identified specific gene mutations associated with fibroids [2]. [ncbi.nlm.nih.gov]
Etiology HLRCC is caused by a mutation in the FH gene (1q42.1),which is thought to act as a tumor suppressor gene, encoding the enzyme fumarate hydratase (FH) that metabolizes the fumarate produced during the purine nucleotide cycle and arginine synthesis [orpha.net]
Etiology Description A benign, hormone -sensitive smooth muscle tumor of the uterus Can be submucosal, intramural, or subserosal Arises from a single myometrial cell (monoclonal growth) and causes: Upregulation of hormone receptors, particularly estrogen [amboss.com]
[…] fibromyoma, leiomyofibroma, fibroma, myoma Epidemiology Present in 25% of women during reproductive years More common in blacks than whites; usually multiple in blacks Clinically apparent lesions are more common in nulliparous, postmenopausal women Etiology [pathologyoutlines.com]
Epidemiology
Journal Journal ID (nlm-ta): Pan Afr Med J Journal ID (iso-abbrev): Pan Afr Med J Journal ID (publisher-id): PAMJ Title: The Pan African Medical Journal Publisher: The African Field Epidemiology Network ISSN (Electronic): 1937-8688 Publication date (Electronic [scienceopen.com]
Summary Epidemiology The prevalence is unknown. Over 200 families with HLRCC have been reported. Clinical description Disease onset can occur at any age, but is more common in young adults and elderly patients. [orpha.net]
Definition / general Extremely common tumor At autopsy, present in uterus in 77% of females; 84% of tumors are multicentric Terminology Also called fibroid, myofibroma, fibromyoma, leiomyofibroma, fibroma, myoma Epidemiology Present in 25% of women during [pathologyoutlines.com]
An estimate may be drawn from an epidemiologic survey involving 21,479 women in 8 countries, which were evaluated through an online questionnaire. [bmcwomenshealth.biomedcentral.com]
Epidemiology. 2013 May. 24(3):447-53. [Medline]. Kerins MJ1, Vashisht AA2, Liang BX1, Duckworth SJ1, Praslicka BJ1, Wohlschlegel JA2, et al. [emedicine.medscape.com]
Pathophysiology
This article presents the general approach to diagnosis, pathophysiology, histology, and treatment of leiomyomas. Etiology Leiomyomas are comprised of monoclonal cells arising from the myometrium [5]. [ncbi.nlm.nih.gov]
[…] modulators in the regulation of uterine leiomyoma growth. 9 38 Yoshida S...Maruo T 20414849 2010 3 Changes related to phosphatidylinositol 3-kinase/Akt signaling in leiomyomas: possible involvement of glycogen synthase kinase 3alpha and cyclin D2 in the pathophysiology [malacards.org]
Biological studies should be performed in order to determine whether are differences among its pathophysiology. [bmcwomenshealth.biomedcentral.com]
Pathophysiology Three fairly distinct types of cutaneous leiomyomas exist: piloleiomyomas, angioleiomyomas, and genital leiomyomas with distinct clinical and histological characteristics. [emedicine.medscape.com]
Pathophysiology Extensive work has been performed to characterize cellular mechanisms of myometrial tissue and neoplasmic growth leiomyoma. [healthcare-communications.imedpub.com]
Prevention
Prevention Although researchers continue to study the causes of fibroid tumors, little scientific evidence is available on how to prevent them. [mayoclinic.org]
Radiation and chemotherapy do not improve survival or prevent recurrence. Record: found Abstract: found Article: not found Clinical characteristics of vascular leiomyoma of the upper extremity: report of 11 cases. [scienceopen.com]
Next Benignes, pulmonal metastasierendes Leiomyom des Uterus Surgical resection and hormonal therapy help prevent progression of this disease and provide an avenue for a cure. [vanity1.campuslabs.com]
To expand our knowledge of leiomyomas, we need further research to identify predisposing genetic factors for potential use to better target preventive care. [ncbi.nlm.nih.gov]
However, it is possible that leiomyomas can cause infertility or pregnancy loss or prevention of implantation and growth of an embryo. [breast-cancer.ca]