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| MedlinePlus = 000914 | | | MedlinePlus = 000914 | |
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| {{SI}} | | {{Leiomyoma}} |
| {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} | | {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} |
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| ==Overview== | | ==[[Leiomyoma overview|Overview]]== |
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| A '''leiomyoma''' (plural is 'leiomyomata') is a [[benign]] [[smooth muscle]] [[neoplasm]] that is not [[premalignant]]. They can occur in any organ, but the most common forms occur in the [[uterus]], [[small bowel]] and the [[esophagus]].
| | ==[[Leiomyoma historical perspective|Historical Perspective]]== |
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| == Etymology== | | ==[[Leiomyoma pathophysiology|Pathophysiology]]== |
| *Greek:
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| **leios = smooth
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| **muV = (myo) mouse or [[muscle]]
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| **oma = [[tumor]]
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| *Latin:
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| **Fibra = [[fiber]]
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| ==Uterine leiomyomata== | | ==[[Leiomyoma epidemiology and demographics|Epidemiology & Demographics]]== |
| {{main|Uterine fibroids}}
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| Uterine fibroids are leiomyomata of the [[uterus|uterine]] smooth muscle. As other leiomyomata, they are [[benign]], but may lead to excessive menstrual bleeding ([[menorrhagia]]), often cause [[anemia]] and may lead to [[infertility]]. Enucleation is removal of fibroids without removing the uterus ([[hysterectomy]]), which is also commonly performed. [[Laser]] surgery (called myolysis) is increasingly used, and provides a viable alternative to surgery.
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| Uterine leiomyomas originate in the [[myometrium]] and are classified by location:
| | ==[[Leiomyoma risk factors|Risk Factors]]== |
| *Sub[[mucosal]] – lie just beneath the [[endometrium]].
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| *[[wiktionary:Intramural|Intramural]] – lie within the uterine wall.
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| *Sub[[serous]] – lies at the serosal surface of the uterus or may bulge out from the [[myometrium]] and can become pedunculated.
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| Estrogen and progesterone usually stimulate their growth, and hormone suppression may hence decrease their size.
| | ==[[Leiomyoma screening|Screening]]== |
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| *Differential diagnosis at MR imaging includes [[adenomyosis]], solid adnexal mass, focal myometrial contraction, and uterine leiomyosarcoma.
| | ==[[Leiomyoma causes|Causes of Leiomyoma]]== |
| *Nondegenerated uterine leiomyomas have a typical appearance at MR imaging: well-circumscribed masses of homogeneously decreased signal intensity compared with that of the outer myometrium on T2-weighted images.
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| *Degenerated leiomyomas have variable appearances on T2-weighted images and contrast-enhanced images.
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| ===Diagnostic Findings=== | | ==[[Leiomyoma differential diagnosis|Differentiating Leiomyoma from other Diseases]]== |
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| <div align="left">
| | ==[[Leiomyoma natural history|Natural History, Complications & Prognosis]]== |
| <gallery heights="175" widths="175">
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| Image:Submucosal-myoma-001.jpg
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| Image:Submucosal-myoma-002.jpg
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| </gallery>
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| </div>
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| ==Esophageal== | | ==Diagnosis== |
| They are also the most common [[benign]] [[esophagus|esophageal]] [[tumour]], though this accounts for less than 1% of esophageal neoplasms. The remainder consists mainly of carcinomas. Although the vast majority of benign esophageal tumors are clinically silent and go undetected, large or strategically located tumors may become symptomatic. <ref name=AMN>{{cite web | author = James C. Chou, MD & Frank G. Gress, MD | title =Benign Esophageal Tumors | work =Esophageal Cancer Overview (Cancer of the Esophagus) | url=http://www.health.am/cr/benign-esophageal-tumors/ | publsiher=Armenian Health Network, Health.am | accessdate=2007-03-21}}</ref>
| | [[Leiomyoma history and symptoms|History & Symptoms]] | [[Leiomyoma physical examination|Physical Examination]] | [[Leiomyoma laboratory tests|Lab Tests]] | [[Leiomyoma electrocardiogram|Electrocardiogram]] | [[Leiomyoma chest x ray|Chest X Ray]] | [[Leiomyoma CT|CT]] | [[Leiomyoma MRI|MRI]] | [[Leiomyoma echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Leiomyoma other imaging findings|Other Imaging Findings]] | [[Leiomyoma other diagnostic studies|Other Diagnostic Studies]] |
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| ==Leiomyoma of Jejunum==
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| Leiomyoma is the most common benign tumor of small bowel. Approximately 50% of cases are found in the jejunum, followed by the ileum in 31% of cases. Almost one half of all lesions are less than 5 centimeters. <ref name=ARO>{{cite web | author = By Michael P. Buetow, M.D. | title =Leiomyoma of Jejunum | url=http://www.appliedradiology.com/case/case.asp?ID=88&SubCatID=97&CatID=43&ThreadID= | publsiher=Applied Radiology Online | accessdate=2007-03-21}}</ref> | |
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| ==Treatment== | | ==Treatment== |
| Diagnosis depends on position of the myomas. Traditional Transabdominal or Transvaginal ultrasonogram can detect large submucosal and transmural myomas. For submucosal myomas saline infusion sonography is the best.
| | [[Leiomyoma medical therapy|Medical Therapy]] | [[Leiomyoma surgery|Surgery]] | [[Leiomyoma primary prevention|Primary Prevention]] | [[Leiomyoma secondary prevention|Secondary Prevention]] | [[Leiomyoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Leiomyoma future or investigational therapies|Future or Investigational Therapies]] |
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| ===Medical Treatment:===
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| GnRH analogues for 3-6 months are used to reduce the size of the myomas. It usually reduce the size by 60% to 70%. But once the medication is stopped the myomas will grow back.
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| ===Surgical Treatment:===
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| [[Myomectomy]] is a choice to remove myomas. It is usually done when the client wants to preserve their fertility. | |
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| Total Abdominal or Vaginal [[hysterectomy]] with Bilateral Salpingo-oophorectomy is the definitive treatment.
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| ==Pathological Findings==
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| <gallery>
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| Image:leiomyoma.jpg|Leiomyoma enucleated from a uterus. External surface on left; cut surface on right
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| Image:leiomyoma2.jpg|A large, solitary leiomyoma in the uterus, distoring the endometrial cavity into a Y shape by splaying and pressing it downwards. <br> (Image courtesy of Ed Uthman, MD)
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| </gallery>
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| == References == | | == References == |
| {{Reflist|2}} | | {{Reflist|2}} |
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| ==Additional Resources==
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| *[http://www.merck.com/mrkshared/mmanual/home.jsp Merck Manual]: [http://www.merck.com/mmpe/sec18/ch248/ch248a.html Uterine fibroids]
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| *[http://www.emedicine.com/med/topic738.htm Esophageal Leiomyoma]
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| *[http://www.pathologyatlas.ro/Leiomyoma.html Atlas of Pathology] uterine leimyoma
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| == See also == | | == See also == |
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| {{Soft tissue tumors and sarcomas}} | | {{Soft tissue tumors and sarcomas}} |
| {{SIB}}
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| [[fr:Léiomyome]]
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| [[de:Myom]]
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| [[es:Mioma]]
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| [[he:מיומה]]
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| [[ur:ہمعضلومہ]]
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| [[pl:Mięśniak gładkokomórkowy]]
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| [[sv:Myom]]
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