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Chapter 9. LEIOMYOMA (UTERINE FIBROIDS)

Leiomyoma are true benign tumors of the uterus, which, in turn, belongs to hormone-dependent organs. Leiomyoma grow from muscle tissue and contain myocytes, connective tissue components, blood vessels, pericytes, plasma and mast cells.

Depending on parenchyma to stroma ratio this tumor previously had different names: myoma, fibroma, fibromyoma. However, taking into account that fibroids often develop from a muscle cell, i.e. have a monoclonal origin, most authors consider the term leiomyoma (myoma) to be more correct.

Uterine fibroids have their own characteristics:

► This is the most common uterine tumor in women of late reproductive (35-45 years) and premenopausal (46-55 years) age.

► Leiomyoma can grow, regress, and even disappear completely during menopause. However, in 10-15% of patients in the first 10 years of the postmenopausal period, uterine fibroids can increase, combined with endometrial hyperplastic processes, and proliferative ovarian diseases.

► Small uterine fibroids (up to 10 weeks of gestation) can remain stable for a long time, but due to provoking factors (inflammatory process of the uterus and adnexa, uterine curettage, long-term venous congestion of the pelvic organs) it increases rapidly and very rapidly (the so-called "growth spurt").

► A variety of clinical variants (paucisymptomatic, symptomatic) is typical, depending on the localization (subserosal, intramural, submucosal and intermediate variants), size (small, medium, large), location (fundus, body, isthmus, cervix) and growth pattern (true, false) (fig. 9.1).

► According to morphological features, uterine fibroids can be simple (predominance of connective tissue component) and proliferating (cellular, characterized by tumor progression) (fig. 9.2-9.4).

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