Uterine Leiomyoma

Uterine leiomyoma is a benign tumour of the uterus, also known as a fibroid. Uterine sarcoma is cancer of the uterine muscle. Leiomyomas are tumours made mostly of smooth muscle. Leiomyosarcomas are more aggressive and harder to treat than leiomyomas. Uterine leiomyomas can be identified by abdominal ultrasound, an MRI, or a D&C (dilatation and curettage). Effective treatment depends on the stage and type of uterine leiomyoma. The treatments can be surgical, radiation therapy, or a combination of the two. 

What is Uterine Leiomyoma?

Uterine Leiomyoma is a type of uterine fibroid that can occur in women. It develops most commonly in the uterus and grows more quickly than other types of uterine issues. Uterine leiomyomatosis is a rare disease that causes uterine leiomyomatosis in women. This condition develops from the cells of the uterus, which grow out of control and cause growths in the wall of the uterus. These growths are usually slow-growing and painless.

Uterine leiomyoma may cause bleeding, which can be very serious and even life-threatening. The bleeding is usually a result of pregnancy complications, trauma, or endometrial hyperplasia. Fibroids that cause excessive bleeding can be treated with medications like gonadotropin-releasing hormone (GnRH) agonists or anti-progestins.

Symptoms

• Pain in the lower abdomen that is worse with walking or exercise
• Pain with urination or other bowel movements
• Swelling of the lower abdomen, thigh, or pelvic area
• An increased amount of gas passes through the rectum
• Severe cramping in the abdominal area and pelvic muscles

Uterine leiomyoma symptoms can worsen if left untreated.

Causes

Lesions may be present at birth or develop later in life. They usually begin as a firm or spongy mass and later become hard and painless.

Types 

1. Submucosal Leiomyomas: grow inside the muscle layer of the uterus.
2. Intramural Leiomyomas: Intramural leiomyoma grows in the muscular wall of the uterus’s outer or inner lining.
3. Subserosal Leiomyomas: Subserosal leiomyomas grow in or on the surface of the uterus but not through its wall.
4. Uncalcified Uterine Leiomyoma: Uncalcified Uterine Leiomyoma has no visible signs or symptoms; only detection by ultrasound or endometrial biopsy is possible. It is noncancerous (benign). 
5. Calcified Uterine Leiomyoma: Calcified Uterine Leiomyoma can be detected by ultrasound or endometrial biopsy. Some symptoms include bleeding, pain and pressure during menstruation, leukorrhea-like discharge, and weight gain. Uterine leiomyomas can develop in any reproductive-age woman.

Diagnosis and Treatment

Diagnosis: Ultrasound or MRI

Treatment: Surgery or Radiation

Generally, noninvasive treatments are recommended before surgical procedures.

• Medications can be used to decrease pain and menstrual cramps, slow the growth of the tumour and reduce tumour size
• The doctor may refer the patient to physical therapy if you have to cramp your muscles
• Hormone therapy or birth control pills are also used to prevent tumours, similar to the symptoms of menopause

Treatment decisions are based largely on the size and appearance of the tumour. Treatment may include surgery or other techniques to remove the uterus if the uterus is large, if the pain is present, or if bleeding occurs.

1. Surgery (hysterectomy) is performed to treat symptomatic tumours that have not responded favourably to other treatment methods. The goal of surgery is to remove them and relieve symptoms.
2. Radiofrequency ablation (RFA) is a minimally invasive method of removing uterine fibroids and may be performed in the outpatient setting. In RFA, a small probe attached to a radiofrequency generator is inserted into the fibroid and directs intense heat to destroy the fibroid. 
3. Cryoablation involves freezing the uterus with liquid nitrogen to destroy it. This method is often used alongside RFA or in cases where RFA is not appropriate because of bleeding or other reasons. Cryoablation can produce significant tissue damage, but patients can heal without scarring when it is used in carefully selected cases.
4. Radiofrequency ablation is performed before cryoablation and involves destroying the fibroid with radiofrequency energy before freezing. The procedure is known as post-ablation cryo deoxycholate (PACT).

What is Uterine Leiomyosarcoma?

1. Uterine Leiomyosarcoma (leiomyosarcoma of the uterus) tumours appear benign but do tend to invade the abdominal cavity with multiple metastases. Because it is a sarcoma, it can spread to other body parts (metastasize).
2. The thin and fragile wall of the uterus can be easily damaged by uterine leiomyosarcoma or other types of uterine cancer. 
3. To diagnose and treat uterine leiomyosarcoma, the uterus needs to be removed or damaged. 
4. Some treatments are safe, and some are not.

Conclusion

Uterine leiomyomas are benign tumours of the smooth muscle of the uterus. Although they are common in women of reproductive age, they can also occur in older women. They may cause significant symptoms that vary from patient to patient. Uterine leiomyoma can be a symptom of a more serious problem, such as uterine sarcoma, which can be fatal if left untreated. Treatment is required to cure uterine leiomyoma, but in some cases, it may have a lasting effect on the rest of patients’ medical condition, such as regulating their period. After all, treatments are completed, it takes 2–3 weeks for the uterus to heal completely.