Uterine fibroids (anatomopathological and clinicostatistical findings)

Abstract

Introduction: Uterine fibroids, also known as leiomyomas, fibromyomas or myomas, are benign tumors that affect the smooth muscle of the uterus. According to their location, uterine fibroids are classified into: submucous, subserous and intramural fibroids. The main cause of apparition is believed to be elevated hormone levels.

Materials and methods: A retrospective study of 734 cases of uterine fibroids from the period 2013-2015 was performed. The study included an analysis of data from registers of the Morphopathology Department at the Municipal Hospital Nr.2 “Sf. Arhanghel Mihail”, Chisinau. Also, case studies were made, including micro (haematoxylin and eosin, picrofuxin staining) and macro morphological evaluation of specimens.

Discussion results: From the total of 734 female patients with uterine fibroids who had myomectomies, hysterectomies and smears performed, 372 (50,7%) had a single nodule and 362 (49,3%) had multiple nodules. By location, the nodules had the next distribution: submucous – 200 (27,3%), subserous – 4 (0,5%), intramural – 511 (69,6%), mixed – 19 (2,6%). Sorting by dimensions, most of the patients had fibroids with the size ranging from 2 to 5 cm – 44,7%. In terms of age, the women’s distribution is as follows: 21-30y.o. – 28 (3,8%), 31-40y.o. – 122 (16,6%), 41-50y.o. – 370 (50,4%), 51-60y.o. – 172 (23,4%), 61-70y.o – 35 (4,8%), 71-80y.o. – 7 (1%). The main objective symptom detected was the metrorrhagia, although most of the uterine fibroids are asymptomatic. Secondary changes of the reproductive system included adenomyosis, fibrosis, hyalinosis, calcification, salpingitis, ovarian cysts and myxomatosis. The most common endometrial alteration was the glandular hyperplasia – 311 cases (42,4%).

Conclusion: From this study, we detected that uterine fibroids most commonly occur in the fertile age – 70,8%, proving the crucial effect of sexual hormones on the fibroids’ development. The incidence of multiple nodules, compared to that of solitary nodules, is almost the same. Most of the nodules had intramural location.

Key-words: uterine fibroid, tumor, women.