Clinical and Histopathological Correlation of Uterine Leiomyomas: A Retrospective Analysis
DOI:
https://doi.org/10.53555/60x4mn39Keywords:
Uterine Leiomyoma, Fibroids, Menorrhagia, Histopathology, Hyaline Degeneration, Hysterectomy.Abstract
Objectives: To evaluate the clinical presentation and histopathological spectrum of uterine leiomyomas in a tertiary care setting.
Design: A retrospective, descriptive study.
Setting: Department of Obstetrics and Gynaecology and Department of Pathology, MR Medical College, Sangareddy, Hyderabad.
Participants: 75 women with a histopathological diagnosis of uterine leiomyoma following hysterectomy or myomectomy.
Study Period: January 2016 to January 2017.
Main Outcome Measures: Primary outcomes included the age distribution, parity, clinical symptoms, anatomical location of fibroids, and histopathological patterns including degenerative changes and associated endometrial findings.
Results: The mean age of participants was 41.2 years (±5.8 SD), with the highest frequency (42.7%, n=32) in the 41-50 year age group. Multiparous women comprised the majority of cases (78.7%, n=59). The most common presenting symptom was menorrhagia (74.7%, n=56), followed by pelvic pain (44.0%, n=33). Intramural leiomyomas were the predominant anatomical type (56.0%, n=42). Histopathological examination revealed hyaline degeneration as the most frequent degenerative change (50.7%, n=38), and proliferative endometrium was the most common associated finding (65.3%, n=49).
Conclusions: This study confirms that uterine leiomyomas most frequently affect perimenopausal, multiparous women, with abnormal uterine bleeding being the cardinal symptom. A strong correlation exists between clinical features and histopathological findings. Comprehensive histopathological evaluation remains indispensable for definitive diagnosis and for understanding the diverse morphology of this common benign tumor, guiding appropriate clinical management.
References
1. Stewart EA, Cookson CL, Gandolfo RA, Schulze-Rath R. Epidemiology of uterine fibroids: a systematic review. BJOG. 2017;124(10):1501-1512.
2. Cardozo ER, Clark AD, Banks NK, Henne MB, Stegmann BJ, Segars JH. The estimated annual cost of uterine leiomyomata in the United States. Am J Obstet Gynecol. 2012;206(3):211.e1-9.
3. 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):250-9.
4. Munro MG, Critchley HOD, Broder MS, Fraser IS; FIGO Working Group on Menstrual Disorders. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113(1):3-13.
5. Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol. 1990;94(4):435-8.
6. Fraser IS, Critchley HO, Broder M, Munro MG. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med. 2011;29(5):383-90.
7. Acknowledgements: The authors would like to thank the staff of the Departments of Obstetrics & Gynaecology and Pathology, MR Medical College, for their support.
8. Contributorship Statement: RK conceived the study, collected clinical data, and drafted the manuscript. SG performed the histopathological analysis, interpreted the data, and critically revised the manuscript. Both authors reviewed and approved the final version.
9. Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
10. Competing Interests: None declared.
11. Patient Consent: Obtained.
12. Ethics Approval: Institutional Ethics Committee of MR Medical College, Sangareddy (IEC No: MRMC/2018/45).
13. Provenance and Peer Review: Not commissioned; externally peer-reviewed.
14. Data Sharing Statement: No additional data are available.
