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Abstract
Leiomyoma and adenomyosis are two common pathologic entities encountered in hysterectomy specimens. It is often speculated, but not confirmed, that repeated injury to uterine wall may initiate smooth muscle proliferation resulting in a smooth muscletumor. Similarly injury to the wall may lead to entrapment of endometrium in muscle layer leading to adenomyosis. To evaluate the above questions and assess the long term morphologic appearance of the C-section scar, 55 consecutive hysterectomies with previous history of C-section and 45 control cases were studied to evaluate the frequency of leiomyoma and adenomyosis. Our findings show no significant statistical difference in the frequency of such lesions between study and control groups in this series. Besides the scar formation, only rare instances of cystic change, osseous metaplasia and abnormal vasculature were noted at the site of C-section incision in the uterus.
Highlights
Adenomyosis and leiomyomata are often encountered in many hysterectomy specimens
The hysterectomies were done for non-malignant cause and the indications for hysterectomies were the followings: prolapsed, fibroid uterus, menorrhagia, pelvic pain, stress incontinence, dysfunctional uterine bleeding, prophylactic hysterectomies due to family history of cancer, and adenomyosis
We have examined the frequency of leiomyoma and adenomyosis in the uterus with and without the previous history of cesarean section where hysterectomy was done for benign reasons
Summary
Adenomyosis and leiomyomata are often encountered in many hysterectomy specimens. Leiomyomata are the most common neoplasm of the uterus [1]. Using monoclonal smooth muscle proliferation in human atherosclerotic plaques as a model, Cramer et al [4] suggested that excessive injury to and repair of the endometrial lining may promote monoclonal expansion of smooth muscle cell proliferation leading to leiomyoma formation. If this statement holds true, the uteri with previous history of C-section should have higher frequency of leiomyoma than the control group
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