Fibroids (leiomyomata) Flashcards
Fibroids develop from which part of the uterus?
Smooth muscle
What are the different types of fibroids?
1) subserosal
2) intramural
3) submucosal
4) pedunculated
Which ethnic group has a higher prevalence of fibroids?
Afro-Carribean
Which gene mutation can cause fibroids?
Gene for fumarate hydratase
Skin and uterine leiomyomata has a rare association with which type of cancer?
Renal cell cancer
Why do fibroids enlarge in pregnancy and on the COCP and atrophy after menopause?
They are Oestrogen dependent
Presentation of fibroids
Menorrhagia +/- anaemia
Fertility problems (submucosal interrupt implantation)
Pain (torsion of pedunculated fibroids)
Abdominal mass - urinary symptoms
What are the treatment options for fibroids?
GnRH analogues Ullipristal acetate Myomectomy Uterine artery embolisation Hysterectomy
How do GnRH analogues treat fibroids?
goserelin SC monthly, 3-6m before surgery to shrink
How does Ullipristal acetate treat fibroids?
progesterone receptor modulator taken daily for 6 months to shrink them and induce amenorrhoea
what are the main complications of fibroids?
torsion of pedunculated fibroid
red degeneration
malignancy - leiomyosarcoma
main investigations for fibroids
USS, hysteroscopy, MRI or laparoscopy if diagnosis unsure
