Body mass index and vitamin D as risk factors for the development of uterine leiomyomas in Mexican women

Objective: The objective of the present study was to determine if body mass index and vitamin D levels are risk factors for the development of uterine leiomyomas in Mexican women. Methods: A cross-sectional study was designed. Inclusion criteria were women between 20 and 55 years with a suspect of uterine leiomyomas. Transvaginal ultrasonography was made to confirm the diagnosis and clinical variables were collected. Vitamin D levels were measured in serum by chemiluminescence immunoassay. Binary linear regression analysis was conducted to assess the predictors of uterine leiomyomas. Results: A total of 106 patients were evaluated, the mean age was 41.4 ± 8.0 years. The serum levels of vitamin D were insufficient in 94 (88.7%) and 82 (77.3%) has overweight or obesity. However, only 50 (47.2%) of participants have a diagnostic of uterine leiomyomas. BMI not increased the probability of having insufficient levels of vitamin D or uterine leiomyomas. Only, age (> 45 years) and levels of vitamin D (<30 ng/mL) were predictors of uterine leiomyomas (OR 10.345, 95% CI 2.737–39.095; p = 0.001; and OR 2.26, 95% CI 1.011–5.073; p = 0.014), respectively. Conclusions: Insufficient levels of vitamin D are common in Mexican women. Age and hypovitaminosis D are possible risk factors in the development of uterine leiomyomas in Mexican women.

Clinicopathological Study of Uterine Leiomyomas – A Retrospective Study

Leiomyomas are benign tumors of the uterus affecting women of the reproductive age group. They are the most common gynaecologic neoplasms in women. The aim of our study was to analyse and correlate the histopathological findings of leiomyomas in 203 hysterectomy specimens received in the department of Pathology at Saveetha Medical College and to further delineate the associated changes and variants that were observed in the leiomyoma specimens. In this study we found that the dominant age group was 31-50 years of age with multiple leiomyomas being more common than solitary ones. The most commonly observed location was intramural. Majority of the hysterectomy specimens showed a proliferative pattern of endometrium. Degenerative changes were observed in 26 cases with hyaline degeneration being the most common secondary change. There were multiple uterine pathologies associated with the uterine leiomyomas of which ovarian cortical cysts were the most frequently noted. The histopathological study of leiomyomas is important as it helps to further ascertain the diagnosis and ensure optimal patient management.

Relugolix for oral treatment of uterine leiomyomas: a dose-finding, randomized, controlled trial

Background Uterine leiomyomas are the most common neoplasm affecting women and frequently cause heavy menstrual bleeding and pain. Gonadotropin-releasing hormone (GnRH) receptor antagonists provide fast symptom relief and show promise as a medical (non-surgical) treatment option and as a presurgical treatment to reduce leiomyoma size. The aim of this study was to evaluate the efficacy and safety of three dose levels of oral relugolix, a small molecule GnRH receptor antagonist, in Japanese women with uterine leiomyomas and heavy menstrual bleeding. Methods This phase 2, multicenter, double-blind, parallel-group study was conducted at 36 sites in Japan in women with uterine leiomyomas and heavy menstrual bleeding, defined as a pictorial blood loss assessment chart (PBAC) score of ≥ 120 in one menstrual cycle. Patients were randomized 1:1:1:1 to relugolix 10, 20, or 40 mg, or placebo, orally once daily for 12 weeks. The primary endpoint was the proportion of patients with a total PBAC score of < 10 from week 6 to 12. A sample size of 50 patients per group was estimated to provide ≥ 95% power, based on the comparison of relugolix 40 mg with placebo using a chi-square test with a significance level of 5% (two-sided). Results From November 2011 to September 2012, 216 patients were randomized and 214 patients (99.1%) were analyzed. The proportion (difference vs. placebo) of patients that achieved the primary endpoint in the placebo and 10-, 20-, and 40-mg relugolix groups were 0%, 20.8% (95% confidence interval [CI]: 9.3–32.3, P < .001), 42.6% (95% CI: 29.4–55.8, P < .001), and 83.3% (95% CI: 73.4–93.3, P < .001), respectively. Though treatment-emergent adverse events were similar between the 20- and 40-mg groups, the incidence rates were more frequent compared with the placebo group. Most of these adverse events were mild or moderate in intensity. Conclusions Relugolix decreased menstrual blood loss in women with uterine leiomyomas in a dose–response manner, and was generally well tolerated. Clinical trial registration: ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT01452659, NCT01452659 (registered 17/10/2011); JAPIC Clinical Trial Information, https://www.clinicaltrials.jp, JapicCTI-111590 (registered 31/08/2011).

Giant uterine fibroid: a rare differential diagnosis for an abdominopelvic mass

Uterine leiomyomas also called as fibroid uterus are commonest tumors of the female genitourinary tract, however the occurrence of a giant uterine fibroid is rare. The giant uterine leiomyomas pose a great diagnostic as well as surgical challenge due to its size, vague nonspecific symptoms and the inadvertent injury to the adjacent organs during surgery. Here we would like to report a case of a 42 years female, known psychiatric patient with complaints of progressive abdominal distension for 5 years with rapid enlargement in the past 1 year with amenorrhea for 6 months and constipation for 2 months. Pre-operatively patient was diagnosed with ovarian malignancy and was proceeded with staging laparotomy where the mass was found to be arising from the uterus. Patient underwent total abdominal hysterectomy with bilateral salpingo oophorectomy and pathological examination revealed fibroid uterus with cystic degeneration. Post-operatively the patient recovered well and was discharged and on follow up examination was found to have returned to her normal life.