Leiomyoma In Women Research Articles

Leiomioma vascular bucal: relato de dois casos, revisão da literatura e estudo imuno-histoquímico

INTRODUCAO: Os leiomiomas sao neoplasias benignas do musculo liso que ocorrem mais comumente nos tratos geniturinario e gastrintestinal, entretanto sao raros na cavidade bucal, na qual provavelmente a maioria desses tumores tem sua origem a partir de musculo liso vascular. OBJETIVOS: Relatar dois casos com historia clinica semelhante, confrontando seus aspectos com aqueles encontrados na literatura. RELATO DOS CASOS: Dois casos de mulheres na quinta e sexta decadas de vida apresentando nodulo submucoso em ventre lingual. Apos exame microscopico que revelou numerosos vasos sanguineos entremeados a celulas fusiformes, com nucleos ovalados ou alongados, e exame imuno-histoquimico com positividade para actina de musculo liso nos dois casos, o diagnostico final foi leiomioma vascular. CONCLUSAO: O estudo do leiomioma vascular bucal e de extrema importância devido a raridade e semelhanca desse com outras lesoes da cavidade bucal. A analise imuno-histoquimica e importante para o diagnostico final do leiomioma.

Uterine volume and menstrual patterns in users of the levonorgestrel-releasing intrauterine system with idiopathic menorrhagia or menorrhagia due to leiomyomas

Background A prospective cohort study was carried out to evaluate uterine volume and the volume of uterine leiomyomas in women using the levonorgestrel intrauterine system (LNG-IUS) to treat idiopathic menorrhagia ( n=32) and menorrhagia due to leiomyomas ( n=27). A control group used the device as a contraceptive method ( n=28). Methods Clinical and ultrasonographic evaluations were carried out at insertion and at 3, 6, 12, 24 and 36 months later. Total uterine volume and the volume of the leiomyomas were calculated using the ellipsoid formula (anteroposterior diameter)×(transverse diameter)×(longitudinal diameter)×(4/3)×(π). In the case of multiple leiomyomas, the volume of each myoma was added to calculate the total volume of leiomyomas in each patient. Menstrual bleeding episodes were recorded. Results Uterine volume decreased significantly in both groups of menorrhagic patients but not in the control group. In the group of women with idiopathic menorrhagia, a mean reduction of 36.4±15.3 (S.D.) cm 3 (from 127.1 cm 3 to 90.7 cm 3) was observed (p=.041), and a greater and more significant mean reduction of 63.6±19.0 (S.D.) cm 3 (from 156.6 cm 3 to 93 cm 3) occurred in the group of women with leiomyomas (p=.014). In the contraception group, the reduction was of only 2.9±5.4 (S.D.) cm 3 in mean uterine volume (from 70.3 cm 3 to 67.4 cm 3), which was not statistically significant (p=.085). The mean volume of leiomyomas decreased by 5.2±3.1 (S.D.) cm 3 (from 12.8 cm 3 to 7.6 cm 3) after 3 years of use, but this difference was not significant (p=.4099). After 36 months of use, amenorrhea and oligomenorrhea were the most frequent bleeding patterns, occurring in 45–57% and 33–39% of users in the three groups, respectively. Amenorrhea was higher in the contraception group (57.1%) and in women with idiopathic menorrhagia (53.4%) than women in the group with menorrhagia due to leiomyomas (44.5%) (p=.027). Moreover, the prevalence of spotting was almost three times higher (11%) in women with menorrhagia caused by leiomyomas and nearly double (7.7%) in the idiopathic menorrhagia group when compared with 4% in the control contraception group (p=.024). Conclusion The LNG-IUS significantly reduces uterine volume in women with menorrhagia with and without leiomyoma; however, it does not significantly reduce the volume of leiomyomas.

Urethral and paraurethral leiomyomas in the female patient

Urethral leiomyomas in women arise from the smooth muscle of the urethra and are rare, benign urethral tumors seen primarily in women. We present three cases of urethral leiomyomas identified over a 30-year period at our institution. A 45-year old woman presented with a 1 year history of frequency, nocturia, and hesitancy and was found to have both a 2-cm proximal urethral and a 3-cm posterior bladder leiomyoma. She developed stress urinary incontinence postoperatively and was treated with a Burch colposuspension. A 33-year old woman with hematuria was found to have both a 3-cm urethral and a 3-cm paraurethral leiomyoma at the bladder neck. A 21-year old without urinary complaints was found to have a 3-cm leiomyoma at the urethral meatus. Urethral leiomyomas must be differentiated from paraurethral leiomyomas, which are often asymptomatic and may be removed without disrupting the urethral mucosa or smooth muscle. The removal of urethral myomas may be complicated by the development stress urinary incontinence or urethral stricture.

DNA repair gene XRCC1 Arg399Gln polymorphism is associated with increased risk of uterine leiomyoma

DNA repair gene XRCC1 Arg399Gln polymorphism has been associated with the risk of several human tumours. In the present study we investigated whether the XRCC1 polymorphism is related to the risk of uterine leiomyoma, the most common neoplasm of the female genital tract. Three hundred and twenty-seven patients with uterine leiomyoma and 197 normal controls were enrolled, and XRCC1 genotyping was determined by PCR and restriction fragment length polymorphism. The proportions of individuals homozygous for 399Arg allele, heterozygous and homozygous for the 399Gln allele were 85.8%, 13.7% and 0.5% among the control group, and 46.2%, 53.2% and 0.6% in those with leiomyoma (P < 0.001), respectively. Logistic regression analysis (after adjusting for age, parity, menarche age and body mass index) showed a significant increased risk of uterine leiomyoma in women with the Arg/Gln genotype versus the Arg/Arg genotype (odds ratio 6.79; 95% confidence interval 4.20-10.99; P < 0.001). In Korean women, the 399Gln polymorphism of XRCC1 is associated with an increased risk of uterine leiomyoma.

DNA hypomethylation and imbalanced expression of DNA methyltransferases (DNMT1, 3A, and 3B) in human uterine leiomyoma

Objective Despite the high prevalence of uterine leiomyoma in women, little is known about the pathophysiology of this tumor. This study intends to define the epigenetic modulation of this tumor. Methods Twenty-three pairs of leiomyomas and their adjacent myometria were collected. Status of DNA global methylation was determined by using DNA methyl acceptance assay and immunohistochemistry staining with 5-methylcytidine antibody. MRNA level of DNA methyltransferases (DNMT1, 3A, and 3B) was assessed by quantitative real time PCR. Results DNA global hypomethylation was detected in the leiomyoma tissues as compared with the adjacent myometria. DNMT1 expression was increased in 47.5% and was equal in 47.5% in leiomyomas compared to the adjacent myometria. On the other hand, over 74% of cases showed decreased expression of DNMT3A and 3B in leiomyomas compared to the adjacent myometria. Conclusion Global hypomethylation and imbalanced expression of DNMTs in uterine leiomyoma suggested a potential mechanism of epigenetic modulation in the development of this tumor.

Parauterine leiomyomas in women: A clinicopathologic study of 22 cases

During a systematic pathologic study of surgically excised parauterine connective tissues 22 parauterine leiomyomas were found, of which 10 were paracornual, 6 parametrial and 6 perisalpingeal. Their prevalence was 2.4% (22/928) among patients requiring hysterectomy for common gynecologic conditions. There tumors were often concurrent with intrauterine leiomyomas. Their etiology and clinical relevance are discussed.