Leiomyoma

Question 1

What are leiomyomas?

Answer 1

They are smooth muscle neoplasm of Müllerian duct origin

Most common type of neoplasm in the body

Question 2

What are the 7 sites that leiomyomas can occur in?

Answer 2

1. Peduculated
2. Sebserous
3. Submucous
4. Pedunculated-submucous
5. Prolapsed
6. Cervical
7. Intramural

Question 3

What is the peak age for fibroids?

Answer 3

35-45

Question 4

What are the 4 types of degeneration?

Answer 4

1. Hyaline and cystic degeneration with calcification
   - 10% of the tumours outgrow their blood supply and start to calcify
2. Red degeneration
   - found in pregnancy and oral progesterone/oestrogen and this causes extravasation of blood into the tissue
3. Sarcomomatous degeneration
   - rapid growth of the leimyomata which causes pain
4. Metastatic leimyomata
   - spreads to the lungs and omentum

Question 5

What is the typical presentation of a woman with fibroids?

Answer 5

1. Infertility_most common complaint with recurrent miscarriages
2. Vaginal bleeding
   - 30-50% of the time
3. Vaginal discharge
   - secondary to infection
4. Pain
5. Pelvic mass (lobulated, indistinguishable from uterus)
6. Uterine inversion
7. Pressure effects the urogenital tract
   - bladder outlet obstruction
   - constipation