leiomyoma - incidences

1. LEIOMYOMA
Dr. Sana Javed
Post-Graduate Resident
Gynae Dept. SZH RahimYarKhan

2. • Benign tumor of uterine smooth muscle
• Gross morphology – Whorled pattern of smooth muscles

3. EPIDEMIOLOGY
• Incidence : 20% in women over 30 yrs of age.
• Age Distribution: 4th – 5th decade of life
• Parity : Higher incidence in Nulliparous & low fertility.
Child bearing has a protective effect.
• Race : Less common in Caucasians ,
2-3 times higher incidence in African – Black races
& at younger age.
• Hereditary Factor : Seen more in patients with a family history of fibroid.

4. • Risks
Early menarche, nulliparity, family history, Increased BMI
• Protective Factors :
Childbearing, Prolonged use of OCPs, Depo-provera and LNG-IUS.

5. AEITIOLOGY
• Unicellular in origin
• Ovarian Hormone dependant tumor.
• EGF , Vascular EDF , TGF-β
• Over- expression of Estrogen and Progesterone receptors .

6. CLASSIFICATION
• Uterine Corpus Fibroids
Sub- mucosal
Intra mural
Sub- serosal
• Cervical Fibroids 1-2%
Intra mural
Sub serosal
• Intra-Ligamentary Fibroids
Broad Ligament - Embryonal remanents.

7. SYMPTOMATOLOGY
• Heavy Menstrual Bleeding – submucosal
• Intermenstrual Bleeding , Vaginal discharge
• Pressure Symptoms
• Lower abdominal pain
• Sub fertility - large fibroid obstructing cornual ends

8. COMPLICATIONS
• Heavy Menstrual Bleeding – anemia
• Sub-serosal pedunculated – torsion
• Degeneration - Cystic , Hyaline , Red
• Calcification
• Sarcomatous Change 0.1%