Leiomyoma of Uterus (Uterine Fibroid) · What Is It, Causes, Types, Diagnosis, Treatment, and More

Better known as uterine fibroids, leiomyomas are benign, fibrous uterine tumors. “Leio” means ‘smooth’, ”myo” means ‘muscle’, and ”oma” means ‘tumor’. 

Leiomyoma is the most common gynecological tumor. They affect 30–50% of the female population in reproductive age, and are predominantly found among individuals of African descent. Leiomyomas are benign tumors that originate in smooth muscle cells of the myometrium, which is the thick middle layer of the uterine wall that contracts during childbirth and menstruation. As a result, leiomyomas can increase the risk of infertility, miscarrige, or other issues during pregnancy. 

Treatment of uterine leiomyomas (also known as uterine fibroids) should be customized to each case. Considerations such as size, location, symptoms, age of the individual, and desire to maintain fertility should all be taken into account when a course of treatment is devised.

Asymptomatic leiomyomas are usually left untreated. Symptomatic leiomyomas, on the other hand, can be removed with non-invasive techniques that cause the tumor to shrink. For instance, uterine artery embolization or MR–guided focused ultrasound surgery. If these options fail, the individual may be treated with surgical removal of the tumor (either through hysteroscopic or abdominal myomectomy) or the whole uterus (hysterectomy). The choice between the two approaches often depends on whether the individual desires to maintain fertility. 

To summarize, leiomyoma of the uterus, also known as uterine fibroids, are the most common gynecological tumors. Leiomyomas are almost always benign, and can range from small, barely visible tumors to larger, palpable ones. Their growth is associated with genetic mutations in smooth muscle cells, and risk factors include hormones like estrogen and progesterone. The different types of leiomyoma are categorized according to their location: subserosal leiomyomas arise under the perimetrium, intramural leiomyomas are found within the walls of the uterus, and submucosal leiomyomas can be found beneath the endometrium. 

Most leiomyomas are asymptomatic, though the presence of pain and other symptoms is often dependent on their number, size, and location. Leiomyomas are usually diagnosed through palpation or ultrasound, and in asymptomatic cases are often discovered incidentally. As they tend to be benign, asymptomatic leiomyomas can be left untreated. Symptomatic leiomyomas can be treated through non-invasive methods, surgery, or medication depending on the tumor’s characteristics and individual’s needs.