Fibroids Research Today is a free monthly online journal that collates and summarizes the latest research about Fibroids, including details on surgery, treatment, causes, prevention, cancer.

Hemoperitoneum due to rupture of a subserosal vein overlying a uterine leiomyoma.

Ihama Y, Miyazaki T, Fuke C

Department of Legal Medicine, School of Medicine, University of the Ryukyus, Okinawa, Japan. makino@med.u-ryukyu.ac.jp

Uterine leiomyoma is the most common tumor in women of reproductive age, but rarely does it lead to fatal hemoperitoneum. We present an autopsy case in which the cause of death was massive hemoperitoneum due to rupture of a subserosal vein overlying a uterine leiomyoma. We report the case of a 28-year-old Japanese woman who had tuberous sclerosis and was gravida 0, para 0. She had a uterine leiomyoma leading to dysmenorrhea. Autopsy revealed a pinhole-sized rupture of a subserosal vein superficial to the leiomyoma that resulted in fatal hemoperitoneum. Rupture of a subserosal vein overlying a uterine leiomyoma may cause sudden and unexpected death.

Published 3 June 2008 in Am J Forensic Med Pathol, 29(2): 177-80.
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Articles on Fibroids published 23 April 2008:

Are fibroids that become endocavitary after uterine artery embolization necessarily a complication?   AJR Am J Roentgenol, 190(5): 1227-30.

OBJECTIVE: This commentary deals with the study by Verma et al. discussing submucosal and endocavitary fibroids after uterine artery embolization (UAE). CONCLUSION: UAE can infarct fibroids. Fibroids spontaneously infarct after childbirth. Because the postpartum cervix is patulous, infarcted fibroids that fall into the uterine cavity easily exit the uterus. Each patient contemplating UAE should anticipate that infarcted fibroids bordering on or inside the uterine cavity may require cervical ... [Abstract] [Full-text]

Submucosal fibroids becoming endocavitary following uterine artery embolization: risk assessment by MRI.   AJR Am J Roentgenol, 190(5): 1220-6.

OBJECTIVE: The purpose of our study was to assess the relationship between the endometrium and submucosal fibroids before and after uterine artery embolization (UAE). MATERIALS AND METHODS: Contrast-enhanced pelvic 1.5-T MRI was performed in 49 women before and after UAE over a 2-year period. Dominant (largest diameter) fibroids in intramural, submucosal, subserosal, pedunculated subserosal, and endocavitary locations were assessed on pre- (baseline) and postembolization MRI. Size, locations of ... [Abstract] [Full-text]

Pathological evaluation of uterine leiomyomas treated with gonadotropin-releasing hormone agonist (GnRH-a) therapy: role of mast cells and a possible mechanism of GnRH-a resistance in leiomyomas.   Pathol Int, 58(5): 268-74.

Gonadotropin-releasing hormone agonist (GnRH-a) therapy is frequently applied to reduce the volume of uterine leiomyomas (UL). In addition, the possible relationship between mast cells (MC) within UL and the development of UL has been suggested, but the role of MC in UL remains to be determined. UL with or without GnRH-a therapy in 121 premenopausal patients were reviewed. The number of MC was evaluated between the two groups, immunohistochemistry was done for insulin-like growth factor-I ... [Abstract] [Full-text]

Articles on Fibroids published 22 April 2008:

Retinoids regulate genes involved in retinoic acid synthesis and transport in human myometrial and fibroid smooth muscle cells.   Hum Reprod, 23(5): 1076-86.

BACKGROUND: Despite the fact that uterine fibroids are the most common benign tumors in women, their etiology is poorly understood. We have previously shown that multiple members of the retinoic acid (RA) pathway have altered expression in fibroids compared with normal myometrium. The aims of the present study were: to investigate regulation of genes involved in the RA pathway in vitro; and to identify genes that can be used as markers to distinguish myometrial and fibroid smooth muscle cells ... [Abstract] [Full-text]

Articles on Fibroids published 18 April 2008:

The FH mutation database: an online database of fumarate hydratase mutations involved in the MCUL (HLRCC) tumor syndrome and congenital fumarase deficiency.   BMC Med Genet, 9: 20.

BACKGROUND: Fumarate hydratase (HGNC approved gene symbol - FH), also known as fumarase, is an enzyme of the tricarboxylic acid (TCA) cycle, involved in fundamental cellular energy production. First described by Zinn et al in 1986, deficiency of FH results in early onset, severe encephalopathy. In 2002, the Multiple Leiomyoma Consortium identified heterozygous germline mutations of FH in patients with multiple cutaneous and uterine leiomyomas, (MCUL: OMIM 150800). In some families renal cell ... [Abstract] [Full-text]

Articles on Fibroids published 15 April 2008:

Non-surgical management of uterine fibroids.   Hum Reprod Update, 14(3): 259-74.

BACKGROUND: Efforts to develop alternatives to surgery for management of symptomatic uterine fibroids have provided new techniques and new medications. This review summarizes the existing literature on uterine artery embolization (UAE) and investigational studies on four newer approaches. METHODS: PubMed, Cochrane and Embase were searched up to December 2007. Studies reporting side-effects and complications and presenting numerical data on at least one outcome measure were included. RESULTS: ... [Abstract] [Full-text]

Articles on Fibroids published 14 April 2008:

Ultrasonographic characteristics of the endometrium among patients with fibroids undergoing ART.   Fertil Steril, 89(4): 1005-7.

A retrospective cohort study examining all completed nondonor first ART cycles was performed to evaluate the ultrasonographic appearance of the endometrial pattern and thickness at time of hCG administration among precycle screened patients with uterine fibroids compared with patients without fibroids. There was no difference in the endometrial thickness (10.3 +/- 2.0 mm vs. 10.0 +/- 2.6 mm) between those with fibroids and controls; however, the rate of nonproliferative endometrial pattern ... [Abstract] [Full-text]

Articles on Fibroids published 4 April 2008:

Urinary bladder leiomyoma associated with pulmonary lymphangioleiomyomatosis.   Urology, 71(4): 755.e3-4.

Leiomyomas account for less than 0.43% of all bladder tumors. To date only about 250 cases have been reported in the literature. Pulmonary lymphangioleiomyomatosis (LAM) is a rare lung disease featuring abnormal proliferation of atypical smooth muscle cells around bronchovascular structures. We describe a woman with LAM who presented with pelvic pain and was found to have a leiomyoma of the bladder wall. Although urologic manifestations of pulmonary LAM are uncommon, they should be considered ... [Abstract] [Full-text]

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