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Leiomyoma

Etiology: • unknown

Pathogenesis: • unknown • clonal, estrogen sensitive

Epidemiology: • extremely common neoplasm affecting 25% of reproductive age women • vast majority are asymptomatic

General Gross Description: • solitary or multiple well circumscribed neoplasms • may be submucosal, intramural or subserosal with pedunculation • whorled, bulging, rubbery, white cut surface • variety of degenerative changes including hemorrhagic, cystic, mucinous, fatty, myxoid, fibrotic may be found

General Microscopic Description: • composed of spindle cells with blunt ended elongate bland nuclei and thin elongated cytoplasm • cells arranged in interlacing bundles • may see cytological atypia which is acceptable in the absence of mitoses • may see necrosis or hemorrhage

Clinical Correlations: • most patients are completely asymptomatic • symptoms, if present, include heavy, painful menses, pelvic fullness, infertility, spontaneous miscarriage, urinary symptoms due to pressure on bladder • estrogen sensitive with occasional rapid growth during pregnancy; atrophy after menopause

References: • Cotran RS, Kumar V, Robbins SL. Robbins Pathologic Basis of Disease. 5th edition. W.B. Saunders Philadelphia 1994. pp. 1059-60