UTERINE LEIOMYOMA AND NEOPLASIA——妇产科学分析.pptVIP

UTERINE LEIOMYOMA AND NEOPLASIA Department of Obstetrics and Gynecology Wu Jie Key Points Introduction Symptoms Diagnosis Treatment INTRODUCTION Leiomyoma is common in clinical practice. It is estimated that up to 30% of American women have these benign tumors, although the majority do not present with significant symptoms and do not require therapy. INTRODUCTION Leiomyomas are present in 20-25% of reproductive-age women. ? Leiomyomas are 3-9 times more frequent in black than white women. About 50% of black women will have leiomyoma. INTRODUCTION Leiomyomas are the most common indication for hysterectomy, accounting for approximately 30% of all such cases. Leiomyomas account for a large number of more conservative operations including myomectomy, uterine curettage, and operative hysteroscopy. INTRODUCTION Histologically, these benign tumors represent localized proliferation of smooth muscle cells surrounded by a pseudocapsule of compressed muscle fibers. INTRODUCTION Most frequent clinical manifestations include: Mass: irregular enlargement of the uterine Pain: torsion or degeneration Bleeding, hypermenorrhea and dysmenorrhea Pressure: symptoms from neighboring organs INTRODUCTION Leiomyomas are considered hormonally responsive tumors because the growth potential of these tumors is related to estrogen production, often with rapid growth occurring in pregnancy or high estrogen states. Menopause generally brings about cessation of tumor growth and even some atrophy. INTRODUCTION In 0.1% of cases, malignancy such as leiomyosarcoma may develop. These are not thought to represent “degeneration” of a fibroid, but rather a new neoplasm. Uterine malignancy is more typical in older patients. INTRODUCTION Be evaluated with considerable more concern for malignancy: Rapidly enlarging uterine masses Postmenopausal bleeding Unusual vaginal discharge Pelvic pain Key Points Introdu