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3. leiomyoma

3. leiomyoma. The commonest benign tumor in females. Occurs during childbearing period. * Predisposing factors: Prolonged estrogenic stimulation. * Grossly: uterine wall mass ( es ) Single or multiple, rounded, firm in consistency, pale brown in color, surrounded by pseudocapsule .

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3. leiomyoma

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  1. 3. leiomyoma

  2. The commonest benign tumor in females. • Occurs during childbearing period. * Predisposing factors: Prolonged estrogenic stimulation. * Grossly: uterine wall mass (es) • Single or multiple, rounded, firm in consistency, pale brown in color, surrounded by pseudocapsule. • Cut section is whorly. • The mass (es) may be interstitial, subserousor submucous.

  3. Multiple interstitial leiomyomas

  4. Whorly cut surface of leiomyoma

  5. The mass (es) may show secondary changes; • Degenerations: hyaline, myxomatous, fatty, cystic, red degeneration. • N.B: Red degeneration: hemorrhagic infarction occurring in leiomyoma e.g. during pregnancy due to vascular obstruction by thrombosis or uterine contraction.

  6. Leiomyoma with red degeneration

  7. Calcification, ossification. • 2ry bacterial infection: especially with submucous leiomyoma. • Atrophy and fibrosis after menopause.

  8. * Microscopically: • Interlacing bundles of smooth muscle cells. The cells are spindle shaped with rod-shaped nuclei and abundant cytoplasm. The muscle bundles are surrounded by fibrous stroma, which increases in old masses (fibromyoma).

  9. Leiomyoma

  10. Leiomyoma

  11. Leiomyoma

  12. Leiomyoma

  13. * Complications: • Abnormal uterine bleeding → iron deficiency anemia. • Malignant change (rare 0.5-1%): Leiomyosarcoma. • Fertility problems: interfere with implantation, may cause abortion & interfere with child birth.

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