Leiomyoma pathophysiology


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Uterine leiomyomata
Uterine fibroids are leiomyomata of the 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.

Uterine leiomyomas originate in the myometrium and are classified by location:
 * Submucosal – lie just beneath the endometrium.
 * Intramural – lie within the uterine wall.
 * Subserous – lies at the serosal surface of the uterus or may bulge out from the myometrium and can become pedunculated.

Estrogen and progesterone usually stimulate their growth, and hormone suppression may hence decrease their size.

Esophageal
They are also the most common benign 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.

Leiomyoma of Jejunum
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.