Uterine leiomyomas: a demographical and clinico-pathological exploration in a rustic setup of Tamil Nadu: a comprehensive study
Abstract
Aim: The aim of this study is to evaluate the prevalence of uterine leiomyomas in a rural setup of Tamil Nadu and also to analyse its plethora among the various neoplastic lesions of female genital tract as well as the various demographical and clinico-pathological spectrum of the same.
Material and Methods: A twenty-five years retrospective study was conducted in the Department of Pathology in a rural teaching institute, Rajah Muthiah Medical College and Hospital, in Chidambaram. A total of thousand two hundred hysterectomy specimens clinically diagnosed as uterine leiomyomas were included in the study and all the other female genital tract specimens were excluded from the study.
Result: 1200 cases were studied in the study period among the total two thousand and twenty-two female genital tract neoplastic lesions that were received in the department during the twenty-five-year period. The most common age group affected was 5th decade. The most common clinical presentation was menstrual disturbances among which menorrhagia was the commonest symptom. Taking into account the number of leiomyomas present in a uterus, single leiomyomas outnumbered multiple ones by a vast margin and taking the anatomical location of leiomyoma in a uterus into consideration, intramural leiomyoma stood well ahead of submucosal and subserosal leiomyomas.
Conclusion: Almost 2/3rd of the total female genital tract neoplastic lesions received from the inception of college to December 2012 were Uterine leiomyomas there by making it the most common neoplasm of female genital tract reported in our hospital in a rural setup for a total period of twenty five years starting from the inception of college until December 2012.
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References
2. Kurman RJ, Ellenson LH, Ronnett B, editors. Blaustein’s pathology of the female genital tract. 6th ed. New York: Springer; 2011.
3. Parazzini F, La CV, Negri E, Cecchetti G, Fedele L. Epidemiologic characteristics of women with uterine fibroids: a case-control study. Obstetrics Gynecol. 1988;72(6):853-857.doi:10.1097/00006250-198812000- 00008.
4. Cramer SF, Horiszny J, Patel A, Sigrist S. The relation of fibrous degeneration to menopausal status in small uterine leiomyomas with evidence for postmen-opausal origin of seedling myomas. Mod Pathol. 1996; 9 (7):774-780.
5. Cramer SF, Marchetti C, Freedman J, Padela A. Relationship of myoma cell size and menopausal status in small uterine leiomyomas. Archives of pathology & laboratory medicine. 2000; 124(10):1448-1453. doi: 10.1043 /0003-9985(2000)124<1448: ROMCSA> 2.0. CO;2.
6. Richards PA, Tiltman AJ. Anatomical variation of the oestrogen receptor in the non-neoplastic myometrium of fibromyomatous uteri. Virchows Arch. 1996; 428(6): 347-351. doi: https://doi.org/10. 1007/ BF00202201
7. Witherspoon JT. The hormonal origin of uterine fibroids: an hypothesis. Am J Can. 1935;24(2):402-406. doi: 10.1158/ajc.1935.402
8. Hutchins FL Jr. Abdominal myomectomy as a treatment for symptomatic uterine fibroids. Obstet Gynecol Clin North Am. 1995;22(4):781-789.
9. Gupta G, Kotasthane DS, Kotasthane VD. Hysterectomy: a clinico-pathological correlation of 500 cases. Int J Gynaecol Obstet. 2010;14(1):1-5. doi: 10. 5580/141b.
10. Sutton C. Hysterectomy: a historical perspective. Baillieres Clin Obstet Gynaecol. 1997;11(1):1-22.
11. Nausheen F, Iqbal J, Bhatti FA, Khan AT, Sheikh S. Hysterectomy: The patients perspective. Ann King Edward Med Univ. 2004;10(4). doi: https://doi.org/ 10. 21649/akemu.v10i4.1220
12. Ashraf T. Management of uterine leiomyomas. J Coll Physicians Surg Pak. 1997;7:160-162.
13. Hendrickson MR, Tavassoli FA, Kempson RL, McCluggage WG, Haller U, Kubik- Hutch RA. Mesenchymal tumors and related lesions. In: Tavassoli FA, Deville P, editors. World Health Organization Classification of tumours. Pathology and genetics of Tumors of the Breast and Female Genital Organs. Lyon: IARC Press 2003;239-244.
14. Geethamala K, Murthy VS, Vani BR, Rao S. Uterine Leiomyomas: An ENIGMA. J Midlife Health. 2016; 7 (1): 22-27. doi: 10.4103/ 0976-7800. 179170.
16. Botía CP, Camarasa SC, Baixauli FR, Sanchez AC. Uterine Fibroids: Understanding their Origins to Better Understand their Future Treatments. J Tumor Res. 2017; 3(130):2.
17. Townsend DE, Sparkes R, Baluda MC, McClelland G. Unicellular histogenesis of uterine leiomyomas as determined by electrophoresis of glucose-6-phosphate dehydrogenase. Am J Obstet Gynecol. 1970;107(8): 1168-1173. doi: 10.1016/s0002-9378(15)30365-3.
18. Holdsworth-Carson SJ, Zaitseva M, Vollenhoven BJ, Rogers PA. Clonality of smooth muscle and fibroblast cell populations isolated from human fibroid and myometrial tissues. Mol Hum Reprod. 2014;20 (3): 250-259. doi: 10.1093/ molehr/gat083. Epub 2013 Nov 15.
19. Stewart EA. Uterine fibroids. Lancet. 2001;357 (9252): 293-298. doi: 10. 1016/ S0140-6736 (00) 03622-9
20. Mehine M, Kaasinen E, Mäkinen N, Katainen R, Kämpjärvi K, Pitkänen E, et al. Characterization of uterine leiomyomas by whole-genome sequencing. N Engl J Med. 2013;369(1):43-53. doi: 10.1056/NEJMoa 1302736. Epub 2013 Jun 5.
21. Buttram VC Jr, Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril. 1981;36(4):433-445.doi:10.1016/s0015-0282(16) 45789-4
22. Kim JJ, Kurita T, Bulun SE. Progesterone action in endometrial cancer, endometriosis, uterine fibroids, and breast cancer. Endocr Rev. 2013;34(1):130-162. doi: 10.1210/er.2012-1043. Epub 2013 Jan 9.
23. Peddada SD, Laughlin SK, Miner K, Guyon JP, Haneke K, Vahdat HL, et al. Growth of uterine leiomyomata among premenopausal black and white women. Proc Natl Acad Sci U S A. 2008;105(50): 19887-19892. doi: 10.1073/pnas.0808188105. Epub 2008 Dec 1.
24. Rosati P, Exacoustos C, Mancuso S. Longitudinal evaluation of uterine myoma growth during pregnancy. A sonographic study. J Ultrasound Med. 1992;11 (10): 511-515. doi: 10.7863/jum.1992.11.10.511.
25. Garcia CR, Tureck RW. Submucosal leiomyomas and infertility. Fertil Steril. 1984;42(1):16-19. doi:10. 1016 / s0015-0282(16)47951-3
26. Rosario YP. Uterine fibromyomas: a review of 237 cases. J Obstet Gynaec India 1968;18(1):101-107.
27. Usha, Narang BR, Tiwari PV, Asthhna AK, Gupta RM. Clinicopathological study of benign tumors of the uterus. Indian Medical Gazette 1992:68-71.
28. Ramesh BH. Surgical pathology of uterine corpus [MD dissertation]. Davangere: Kuvempu University; 1999.
29. Gowri M, Mala G, Murthy S, Nayak V. Clinico-pathological study of uterine leiomyomas in hysterectomy specimens. J Evol Med Dent Sci. 2013;46 (2): 9002-9009.
30. Poddar DL. Fibromyoma of the uterus. J Obstet Gynaecol India 1957;4:109-114.
31. Bhaskar Reddy D. Study of 325 cases of fibro-myoma of uterus. J Obstet Gynaecol India. 1963; 13: 340.
32. Chabbra S, Neeru Ohri. Leiomyoma of uterus:A clinical study. J Obstet Gynaecol India. 1993; 33:436-439.
33. Kulkarni MR, Dutta I, Dutta DK. Clinico-patho-logical Study of Uterine Leiomyomas: A Multicentric Study in Rural Population. J Obstet Gynaecol India. 2016;66(Suppl 1):412-416. doi: 10. 1007/s13224-015-0773-y. Epub 2015 Oct 16.
34. Begum S, Khan S. Audit of leiomyoma uterus at Khyber teaching hospital Peshawar. J Ayub Med Coll Abbottabad. 2004;16(2):46-49.
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