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Ulcerative Colitis

Description
Uterine leiomyomas are well-circumscribed, pseudoencapsulated, benign monoclonal tumors
composed mainly of smooth muscle with varying amounts of fibrous connective tissue (1,2).
3 major subtypes:
o Subserous: Common; external; may become pedunculated
o Intramural: Common; within myometrium; may cause marked uterine enlargement
o Submucous: ~5% of all cases; internal, evoking abnormal uterine bleeding and infection;
occasionally protruding from cervix
Rare locations: Broad, round, and uterosacral ligaments
System affected: Reproductive
Synonym(s): Fibroids; myoma; fibromyoma; myofibroma; fibroleiomyoma
Epidemiology
Incidence
Cumulative incidence is 70%, highest in perimenopausal age group
Incidence increases with each decade during reproductive years
Not seen in premenarchal females
Predominant sex: Females only
3 more frequent; occurs earlier in African Americans
Prevalence
411% of all women
2040% of women in reproductive years (2)
Risk Factors
African American heritage
Early menarche (<10 years)
Nulliparous
Hypertension
Familial predisposition
Obesity
Alcohol
Pathophysiology
Enlargement of benign smooth muscle tumors that may lead to symptoms affecting the reproductive, GI,
or genitourinary system
Etiology
Complex multifactorial process involving transition from normal myocyte to abnormal cells and then to
visibly evident tumor (monoclonal expansion):
Hormones (1): Increases in estrogen and progesterone are correlated with myoma formation (i.e.,
rarely seen before menarche). Estrogen receptors in myomas bind more estradiol than normal
myometrium (2).

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