Analysis Of 43 Cases Special Subtypes Of Leiomyoma Of The Uterus

Uterine smooth muscle tumors (leiomyoma, LM) is the most common gynecological benign tumor of women of childbearing age. A typical diagnosis of uterine smooth muscle tumors is not difficult, but a few are difficult to confirm the diagnosis, even if the pathologist who worked for years to make sometimes difficult to identify these special types of uterine tumors known as uterine fibroids. These fibroids or microscopic histo-logical features or clinical findings with the biological behavior is different from the ordinary leiomyoma leiomyoma, easy to be confused with uterine leiomyosarcoma. Some of these small number of clinical benign leiomyoma, but has some malignant morphology index, or the whole border is not clear, or microscopic increased nuclear fission or nuclear heteromorphism; some clinical malignant, but they have some morphological benign indicators. Because these fibroids difficult to diagnose before surgery, so intraoper-ative frozen and is diagnosed by pathological basis. Based on the special type of uterine smooth muscle tumors of the clinical characteristics and pathological features of analysis to understand the characteristics of specific types of uterine fibroids, help to avoid mistaken for benign uterine fibroids malignant or benign to malignant mistaken for excessive or inadequate given treatment, and followed up to the right.Methods:The First Affiliated Hospital of Dalian Medical University in September 2001-2,008 11-month period after diagnosis of a special type of 43 cases of uterine fibroids and clinical data integrity, and reliability were analyzed retrospectively to investigate the specific types The age distribution of uterine fibroids, clinical symptoms, diagnosis, surgical options and the pathological type. Results:43 patients with special types of uterine fibroid patients, aged mostly between the ages of women of childbearing age 30-50,93.02% of the total sample, of which 14 cases were 30-40 years old,40-50-year-old in 20 cases. In this group, with clinical symptoms of 31 cases, accounting for 72.09%, of which the most common menstrual changes, a total of 18 cases, accounting for 41.86%; no clinical symptoms of 12 cases, accounting for 27.91%. Preoperative pelvic color Doppler ultrasound, suggesting that fibroid degeneration in 20 cases, accounting for 46.51%. Surgical proce-dures, myomectomy based, a total of 22 cases, accounting for 51.16%, surgery in patients of different ages in different ways, the younger myomectomy bigger the scale of<35 age group myomectomy 80% of patients; older hysterectomy resection of the greater proportion,≥50 age group hysterectomy 100%. Specimens similar characteristics and normal uterine fibroids, are benign histopathological examination. All 43 patients in the follow-up, patients were followed up for 6 months-6 years, no postoperative radiotherapy, chemotherapy, and patients asked to retain their uterus menstruation and fertility, and gynecological examination and B-ultrasound, and no recurrence All patients survived, the survival rate of 100%.Conclusion:1. A special type of uterine fibroids with age of onset of central tendency, more in the 30-50 years old.2. Special type of the main symptoms of uterine fibroids menorrhagia, pelvic mass, lower abdominal pain, dysmenorrhea, etc., but many patients have no obvious clinical symptoms, so women of childbearing age should carry out regular physical examination, especially for early menopause, pregnancy and exogenous progesterone-related groups, is a special type of early detection and effective method of uterine fibroids.3. Special type of uterine leiomyoma and normal uterine leiomyoma and leiomyosarcoma of the identification rely mainly on biopsy.4. treatment of special types of uterine fibroids were treated by operation, the surgical treatment of benign uterine fibroids by the principle of treatment is feasible. The choice of surgical procedure depends on patient age, with or without growth requirements and characteristics of fibroid itself, in order to avoid over-treatment. To enhance the postoperative follow-up to detect recurrence, timely manner. Once relapse, do surgery to expand the scope to prevent sarcomatoid.