1425:(MRI), which guides and monitors the treatment. During the procedure, delivery of focused ultrasound energy is guided and controlled using MR thermal imaging. Patients who have symptomatic fibroids, who desire a non-invasive treatment option and who do not have contraindications for MRI are candidates for MRgFUS. About 60% of patients qualify. It is an outpatient procedure and takes one to three hours depending on the size of the fibroids. It is safe and about 75% effective. Symptomatic improvement is sustained for two plus years. Need for additional treatment varies from 16 to 20% and is largely dependent on the amount of fibroid that can be safely ablated; the higher the ablated volume, the lower the re-treatment rate. There are currently no randomized trial between MRgFUS and UAE. A multi-center trial is underway to investigate the efficacy of MRgFUS vs. UAE.
996:
1012:
867:
invasion of adjacent organs and metastases to distant organs (e.g. lung). MRI findings suggestive of a malignancy include nodular/ill-circumscribed tumor margins, intermediate/high T2-weighted signal intensity of the solid tumor components, regions with high signal T1-weighted sequences in keeping with subacute hemorrhage, fine/wispy enhancement of the solid parts of the tumor, and restricted diffusion on diffusion-weighted imaging (DWI). A biopsy is rarely performed and if performed, is rarely diagnostic. Should there be an uncertain diagnosis after ultrasounds and MRI imaging, surgery is generally indicated.
981:
874:
690:
863:
uterine fibroids with atypical imaging features and fibroids with variant growth patterns. MRI can also identify other uterine (e.g. adenomyosis, endometrial polyps, endometrial cancer) and extrauterine (e.g. benign and malignant ovarian tumors, endometriosis) disorders that may mimic the appearance of uterine fibroids and/or contribute to the patient's symptoms. However, a small proportion of uterine fibroids can mimic other malignant uterine tumors (e.g. leiomyosarcoma) on all available imaging modalities (e.g. ultrasound, CT, MRI and PET-CT).
905:
945:
1494:. African American women are two to three times more likely to get fibroids than Caucasian women. In African American women fibroids seem to occur at a younger age, grow more quickly, and are more likely to cause symptoms. This leads to higher rates of surgery for African Americans, both myomectomy, and hysterectomy. Increased risk of fibroids in African Americans causes them to fare worse in in-vitro fertility treatments and raises their risk of premature births and delivery by Caesarean section.
890:
917:
957:
674:
933:
969:
1174:(SPRM) that has tentative evidence to support its use for presurgical treatment of fibroids with low side-effects. Long-term UPA-treated fibroids have shown volume reduction of about 70%. In some cases UPA alone is used to relieve symptoms without surgery, and to allow successful pregnancies without fibroid regrowth. Indeed, in the tumor cells, the molecule blocks the cell proliferation, induces their
1301:
520:
60:
1290:
488:
484:. Fibroids grossly appear as round, well circumscribed (but not encapsulated), solid nodules that are white or tan, and show whorled appearance on histological section. The size varies, from microscopic to lesions of considerable size. Typically lesions the size of a grapefruit or bigger are felt by the patient herself through the abdominal wall.
473:
1254:(UAE) is a noninvasive procedure that blocks blood flow to fibroids, causing them to shrink. Long-term outcomes with respect to how happy people are with the procedure are similar to that of surgery. There is tentative evidence that traditional surgery may result in better fertility. One review found that UAE doubles the future risk of
1279:
682:
1473:
they usually decrease in size. Surgery to remove uterine fibroids occurs more frequently in women in "higher social classes". Adolescents develop uterine fibroids much less frequently than older women. Up to 50% of women with uterine fibroids have no symptoms. The prevalence of uterine fibroids among
1261:
Uterine artery ligation, sometimes also laparoscopic occlusion of uterine arteries are minimally invasive methods to limit blood supply of the uterus by a small surgery that can be performed transvaginally or laparoscopically. The principal mechanism of action may be similar like in UAE but is easier
1199:
cause temporary regression of fibroids by decreasing estrogen levels. Because of the limitations and side effects of this medication, it is rarely recommended other than for preoperative use to shrink the size of the fibroids and uterus before surgery. It is typically used for a maximum of six months
536:
are located within the muscular wall of the uterus and are the most common type. Unless they are large, they may be asymptomatic. Intramural fibroids begin as small nodules in the muscular wall of the uterus. With time, intramural fibroids may expand inwards, causing distortion and elongation of the
394:
While fibroids are common, they are not a typical cause for infertility, accounting for about 3% of reasons why a woman may not be able to have a child. The majority of women with uterine fibroids will have normal pregnancy outcomes. In cases of intercurrent uterine fibroids in infertility, a fibroid
614:
Fibroids may be single or multiple. Most fibroids start in the muscular wall of the uterus. With further growth, some lesions may develop towards the outside of the uterus or towards the internal cavity. Secondary changes that may develop within fibroids are hemorrhage, necrosis, calcification, and
1204:
and other typically postmenopausal complications. The main side effects are transient postmenopausal symptoms. In many cases the fibroids will regrow after cessation of treatment, however, significant benefits may persist for much longer in some cases. Several variations are possible, such as GnRH
638:
They are in most cases still hormone dependent but may cause life-threatening complications when they appear in distant organs. Some sources suggest that a substantial share of the cases may be late complications of surgeries such as myomectomy or hysterectomy. Particularly laparoscopic myomectomy
425:
Fifty percent of uterine fibroids demonstrate a genetic abnormality. Often a translocation is found on some chromosomes. Fibroids are partly genetic. If a mother had fibroids, risk in the daughter is about three times higher than average. Black women have a 3–9 times increased chance of developing
1238:
have been used experimentally to reduce fibroids. The effect is believed to be due partially by lowering systemic estrogen levels and partially by inhibiting locally overexpressed aromatase in fibroids. However, fibroid growth has recurred after treatment was stopped. Experience from experimental
862:
Physical examination and ultrasound are sufficient for diagnosing uterine fibroids in the majority of patients. When ultrasound findings are inconclusive, magnetic resonance imaging (MRI) may be able to confirm the diagnosis of uterine fibroids in most cases. In addition, MRI can identify benign
815:
and other endometrial diseases. Aromatase inhibitors are currently considered for treatment, at certain doses they would completely inhibit estrogen production in the fibroid while not largely affecting ovarian production of estrogen (and thus systemic levels of it). Aromatase overexpression is
1231:
have been tested, there is evidence that it relieves some symptoms and improves quality of life but because of adverse histological changes that have been observed in several trials it can not be currently recommended outside of research setting. Fibroid growth has recurred after antiprogestin
866:
Malignant tumors of the uterine wall (e.g. leiomyosarcoma) are very rare. Findings suggestive of a malignant uterine tumor rather than a benign fibroid include, fast or unexpected growth (particularly after menopause), interruption/effacement of the endometrial stripe, lymph node enlargement,
502:
Microscopically, tumor cells resemble normal cells (elongated, spindle-shaped, with a cigar-shaped nucleus) and form bundles with different directions (whorled). These cells are uniform in size and shape, with scarce mitoses. There are three benign variants: bizarre (atypical); cellular; and
1131:
For decades, a common approach to treating symptomatic fibroids was "either get a hysterectomy or wait until menopause diminishes the symptoms," but minimally invasive and noninvasive options were often not offered. Especially since the 2010s, minimally invasive and noninvasive options are
528:
Growth and location are the main factors that determine if a fibroid leads to symptoms and problems. A small lesion can be symptomatic if located within the uterine cavity while a large lesion on the outside of the uterus may go unnoticed. Different locations are classified as follows:
1192:
is an effective treatment to shrink fibroids and control symptoms. Its use is limited by unpleasant side effects. Mechanism of action is thought to be antiestrogenic effects. Recent experience indicates that safety and side effect profile can be improved by more cautious dosing.
1372:
Laparoscopic myomectomy has less pain and shorter time in hospital than open surgery. An analysis of 15,000 women found that those who had myomectomy required fewer additional procedures to manage fibroids (including hysterectomies) over the next 5 years than those who had UAE.
1269:
in the United
Kingdom) guidelines state UAE/UFE can be offered to women with symptomatic fibroids (fibroids being usually >30mm in size). Women should be informed that UAE and myomectomy (the surgical removal of fibroids) may potentially allow them to retain their fertility.
1530:
surgeries each year, which affect 22% of
African Americans and 7% of Caucasian women. The bill also called for more funding for research and educational purposes. It also states that of the $ 28 billion issued to NIH, $ 5 million was allocated for uterine fibroids in 2004.
850:-dependent growth of fibroids. These stem-progenitor cells are deficient in estrogen receptor α and progesterone receptor and instead rely on substantially higher levels of these receptors in surrounding differentiated cells to mediate estrogen and progesterone actions via
416:
Diets high in fruits and vegetables tend to lower the risk of developing fibroids. Fibers, vitamin A, C and E, phytoestrogens, carotenoids, meat, fish, and dairy products are of unclear effect. Normal dietary levels of vitamin D may reduce the risk of developing fibroids.
1011:
819:
Genetic and hereditary causes are being considered and several epidemiologic findings indicate considerable genetic influence especially for early onset cases. First degree relatives have a 2.5-fold risk, and nearly 6-fold risk when considering early onset cases.
575:
Since 2011 the FIGO published their consensus paper on the classification of fibroids, namely from 0 to 8. This is part of the PALM COEIN classification and is the most frequently used in clinical practise and research Please continue reading here:
407:
Some risk factors associated with the development of uterine fibroids are modifiable. Fibroids are more common in obese women. Fibroids are dependent on estrogen and progesterone to grow and therefore relevant only during the reproductive years.
378:
Some women with uterine fibroids do not have symptoms. Abdominal pain, anemia and increased bleeding can indicate the presence of fibroids. There may also be pain during intercourse (penetration), depending on the location of the fibroid. During
1158:) is released in low concentration locally. While most levongestrel-IUD studies concentrated on treatment of women without fibroids a few reported good results specifically for women with fibroids including a substantial regression of fibroids.
995:
4693:
4678:
630:
Fibroids of uterine origin located in other parts of the body, sometimes also called parasitic myomas have been historically extremely rare, but are now diagnosed with increasing frequency. They may be related or identical to metastasizing
3087:
Awiwi MO, Badawy M, Shaaban AM, Menias CO, Horowitz JM, Soliman M, et al. (July 2022). "Review of uterine fibroids: imaging of typical and atypical features, variants, and mimics with emphasis on workup and FIGO classification".
1787:"Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013"
1406:
is a minimally invasive treatments for fibroids. In this technique the fibroid is shrunk by inserting a needle-like device into the fibroid through the abdomen and heating it with radio-frequency (RF) electrical energy to cause
391:, or interference with the position of the fetus. A uterine fibroid can cause rectal pressure. The abdomen can grow larger mimicking the appearance of pregnancy. Some large fibroids can extend out through the cervix and vagina.
810:
Aromatase and 17beta-hydroxysteroid dehydrogenase are aberrantly expressed in fibroids, indicating that fibroids can convert circulating androstenedione into estradiol. Similar mechanism of action has been elucidated in
357:
About 20% to 80% of women develop fibroids by the age of 50. In 2013, it was estimated that 171 million women were affected worldwide. They are typically found during the middle and later reproductive years. After
1468:
About 20% to 80% of women develop fibroids by the age of 50. Globally in 2013 it was estimated that 171 million women were affected. They are typically found during the middle and later reproductive years. After
1346:
myomectomy is done through a small incision near the navel. The physician uses a laparoscope and surgical instruments to remove the fibroids. Studies have suggested that laparoscopic myomectomy leads to lower
980:
1311:
Myomectomy is a surgery to remove one or more fibroids. It is usually recommended when more conservative treatment options fail for women who want fertility preserving surgery or who want to retain the uterus.
510:
The appearance of prominent nucleoli with peri-nucleolar halos should alert the pathologist to investigate the possibility of the extremely rare hereditary leiomyomatosis and renal cell cancer (Reed) syndrome.
873:
1562:
is being tested with promising results as a possible use as a treatment for fibroids, intended to provide the advantages of progesterone antagonists without their adverse effects. Low dietary intake of
663:
In disseminated intraperitoneal leiomyomatosis, leiomyomata grow diffusely on the peritoneal and omental surfaces, with uterine fibroids as their source. This can simulate a malignant tumor but behaves
523:
Schematic drawing of various types of uterine fibroids: a=subserosal fibroids, b=intramural fibroids, c=submucosal fibroid, d=pedunculated submucosal fibroid, e=cervical fibroid, f=fibroid of the broad
716:
The exact cause of fibroids is not clearly understood, but the current working hypothesis is that genetic predispositions, prenatal hormone exposure and the effects of hormones, growth factors and
889:
1395:
can be used if the fibroids are only within the uterus and not intramural and relatively small. High failure and recurrence rates are expected in the presence of larger or intramural fibroids.
2024:"Proceedings from the Third National Institutes of Health International Congress on Advances in Uterine Leiomyoma Research: comprehensive review, conference summary and future recommendations"
904:
1186:, hence explaining the long-term benefit. Yet, due to some rare but severe hepatic injuries after UPA treatment, the licence was suspended in 2020 in the EU and voluntary removed in Canada.
426:
uterine fibroids than white women. Only a few specific genes or cytogenetic deviations are associated with fibroids. 80–85% of fibroids have a mutation in the mediator complex subunit 12 (
1164:
in a moderate and well-tolerated dose has been shown in two studies to shrink fibroids effectively. The mechanism of action responsible for how cabergoline shrinks fibroids is unclear.
3656:
Courtoy GE, Donnez J, Ambroise J, Arriagada P, Luyckx M, Marbaix E, et al. (August 2018). "Gene expression changes in uterine myomas in response to ulipristal acetate treatment".
916:
1144:
can be used to reduce painful menstrual periods. Oral contraceptive pills may be prescribed to reduce uterine bleeding and cramps. Anemia may be treated with iron supplementation.
342:
class may decrease the size of the fibroids but are expensive and associated with side effects. If greater symptoms are present, surgery to remove the fibroid or uterus may help.
3176:
1670:
543:
are located on the surface of the uterus. They can also grow outward from the surface and remain attached by a small piece of tissue and then are called pedunculated fibroids.
3292:"Fibroids are serious. Surgery isn't the only way to stop them. Many women are not told about noninvasive treatments that don't affect fertility. Experts want to change that"
1491:
4822:
2428:
Garg K, Tickoo SK, Soslow RA, Reuter VE (2011). "Morphologic
Features of Uterine Leiomyomas Associated with Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome".
2158:
755:
and apoptotic factors as well as other hormones. Furthermore, the actions of estrogen and progesterone are modulated by the cross-talk between estrogen, progesterone and
1368:
myomectomy) is the most invasive surgical procedure to remove fibroids. The physician makes an incision in the abdominal wall and removes the fibroids from the uterus.
3224:
2482:
4602:
1384:
was the classical method of treating fibroids. Although it is now recommended only as last option, fibroids are still the leading cause of hysterectomies in the US.
3315:
Zapata LB, Whiteman MK, Tepper NK, Jamieson DJ, Marchbanks PA, Curtis KM (2010). "Intrauterine device use among women with uterine fibroids: a systematic review☆".
1077:
439:
4213:"Uterine-preserving treatments or hysterectomy reintervention after myomectomy or uterine artery embolisation: A retrospective cohort study of long-term outcomes"
1501:
are more likely to have fibroids. Other suggested causes include the tendency of
African American women to consume food with less than the daily requirements for
944:
395:
is typically located in a submucosal position and it is thought that this location may interfere with the function of the lining and the ability of the embryo to
3873:
1414:
1258:. UAE also appears to require more repeat procedures than if surgery was done initially. A person will usually recover from the procedure within a few days.
549:
are located in the muscle beneath the endometrium of the uterus and distort the uterine cavity; even small lesions in this location may lead to bleeding and
4268:
1453:
There are a number of rare conditions in which fibroids metastasize. They still grow in a benign fashion, but can be dangerous depending on their location.
1265:
The 2016 NICE (National
Institute of Clinical Excellence – the non governmental public body that publishes guidelines in the use of health technologies and
642:
There are a number of rare conditions in which fibroids metastasize. They still grow in a benign fashion, but can be dangerous depending on their location.
5186:
1088:
Most fibroids do not require treatment unless they are causing symptoms. After menopause, fibroids shrink, and it is unusual for them to cause problems.
4547:
2403:
2140:
1551:
1171:
1037:
in cell nuclei is a consistent finding in uterine leiomyomas, and helps in distinguishing such tumors from β-catenin positive spindle cell tumors.
5262:
5171:
660:, leiomyomata grow in more distant sites such as the lungs and lymph nodes. The source is not entirely clear. Pulmonary involvement can be fatal.
2666:
4815:
2006:
1523:
800:
339:
216:
1132:
increasingly being offered as they have advanced on their technological journey from being new and unusual to being common clinical practice.
5252:
5143:
4578:
2564:
1951:
1701:
1196:
4980:
4495:
3447:
Talaulikar VS, Manyonda IT (August 2012). "Ulipristal acetate: a novel option for the medical management of symptomatic uterine fibroids".
1141:
759:
signaling which controls the expression of the respective nuclear receptors. It is believed that estrogen promotes growth by up-regulating
4942:
1411:
of cells. The treatment is a potential option for women who have fibroids, have completed child-bearing and want to avoid a hysterectomy.
956:
5181:
4898:
4708:
1662:
1205:
agonists with add-back regimens intended to decrease the adverse effects of estrogen deficiency. Several add-back regimes are possible,
4325:
1497:
It is unclear why fibroids are more common in
African American women. Some studies suggest that black women who are obese and who have
5166:
5336:
5267:
5209:
4808:
4525:
3781:
3131:
1337:
instrument inserted through the vagina and cervix that can use high-frequency electrical energy to cut tissue, or a similar device.
5310:
4866:
4620:"Histology of uterine leiomyoma and occurrence in relation to reproductive activity in the Baltic gray seal (Halichoerus grypus)"
2090:
Parazzini F, Di
Martino M, Candiani M, Viganò P (2015). "Dietary components and uterine leiomyomas: a review of published data".
764:
2154:
1694:
Ferri's differential diagnosis : a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders
5305:
3490:
Pérez-López FR (April 2015). "Ulipristal acetate in the management of symptomatic uterine fibroids: facts and pending issues".
932:
4960:
2356:"Mutations in the fumarate hydratase gene cause hereditary leiomyomatosis and renal cell cancer in families in North America"
831:
Expansion of uterine fibroids occurs by a slow rate of cell proliferation combined with the production of copious amounts of
657:
2582:"Parasitic myomas after laparoscopic surgery: An emerging complication in the use of morcellator? Description of four cases"
968:
646:
In leiomyoma with vascular invasion, an ordinary-appearing fibroid invades into a vessel but there is no risk of recurrence.
2474:
1737:
Kashani BN, Centini G, Morelli SS, Weiss G, Petraglia F (July 2016). "Role of
Medical Management for Uterine Leiomyomas".
1243:
indicates that aromatase inhibitors might be particularly useful in combination with a progestogenic ovulation inhibitor.
292:. Someone can have one uterine fibroid or many. It is uncommon but possible that fibroids may make it difficult to become
5148:
4923:
2674:
2498:"FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age"
1518:
The 2005 S.1289 bill was read twice and referred to the committee on Health, Labor, and
Pensions but never passed for a
1490:
Eighty percent of
African American women will develop benign uterine fibroid tumors by their late 40s, according to the
299:
The exact cause of uterine fibroids is unclear. However, fibroids run in families and appear to be partly determined by
4861:
4599:
4795:
1837:
Wallach EE, Vlahos NF (August 2004). "Uterine myomas: an overview of development, clinical features, and management".
1526:
vote; the proposed Uterine Fibroid Research and Education Act of 2005 mentioned that $ 5 billion is spent annually on
1251:
1125:
1118:
1076:, of the myometrium can develop. In extremely rare cases uterine fibroids may present as part or early symptom of the
689:
396:
343:
192:
3701:"Matrix Metalloproteinase Activity Correlates With Uterine Myoma Volume Reduction After Ulipristal Acetate Treatment"
559:
are located in the wall of the cervix (neck of the uterus). Rarely, fibroids are found in the supporting structures (
4019:
Akinola OI, Fabamwo AO, Ottun AT, Akinniyi OA (2005). "Uterine artery ligation for management of uterine fibroids".
3796:
4883:
4303:
1422:
1150:
are effective in limiting menstrual blood flow and improving other symptoms. Side effects are typically few as the
1050:
880:
650:
265:
3797:"Allergan Inc. voluntarily withdraws its drug Fibristal, used to treat uterine fibroids, from the Canadian market"
553:. A pedunculated lesion within the cavity is termed an intracavitary fibroid and can be passed through the cervix.
5341:
5315:
725:
3291:
5138:
4719:
3869:
2944:, Yang S, Fang Z, Gurates B, Tamura M, Zhou J, et al. (2001). "Role of aromatase in endometrial disease".
1183:
709:. When multiple fibroids are present they frequently have unrelated genetic defects. Specific mutations of the
706:
560:
5230:
3398:"Review of the safety, efficacy and patient acceptability of the levonorgestrel-releasing intrauterine system"
4551:
5346:
5290:
5176:
1403:
1108:
788:
103:
2407:
577:
5013:
1266:
164:
3177:"Wnt/β-catenin signaling pathway in uterine leiomyoma: role in tumor biology and targeting opportunities"
653:, leiomyomata grow in veins with uterine fibroids as their source. Involvement of the heart can be fatal.
5300:
5066:
4970:
3218:
1539:
Uterine fibroids are rare in other mammals, although they have been observed in certain dogs and Baltic
1967:
1002:
2496:
Munro MG, Critchley HO, Broder MS, Fraser IS, FIGO Working Group on Menstrual Disorders (April 2011).
1024:
in uterine leiomyoma, which is negative as there is only staining of cytoplasm but not of cell nuclei.
895:
A very large (9 cm) fibroid of the uterus which is causing pelvic congestion syndrome as seen on
4888:
3980:"Laparoscopic bipolar coagulation of uterine vessels: a new method for treating symptomatic fibroids"
2726:
2267:
2256:"Multiple clinical characteristics separate MED12-mutation-positive and -negative uterine leiomyomas"
1519:
1392:
1305:
1294:
1147:
1030:
1017:
847:
832:
568:
461:
68:
3533:
Donnez J, Tomaszewski J, Vázquez F, Bouchard P, Lemieszczuk B, Baró F, et al. (February 2012).
1999:
5008:
4955:
4697:
1498:
1235:
851:
4570:
747:
effect on leiomyoma cells and also act by influencing (directly and indirectly) a large number of
5257:
5133:
5125:
4950:
4918:
4893:
4487:
4284:
4250:
4044:
3681:
3515:
3472:
3113:
2969:
2923:
2752:
2715:"MED12, the Mediator Complex Subunit 12 Gene, is Mutated at High Frequency in Uterine Leiomyomas"
2535:
2453:
2236:
2115:
1862:
1482:
The incidence of uterine fibroids in Europe is thought to be lower than the incidence in the US.
1167:
453:
312:
153:
87:
5052:
4062:
2667:"FDA Updated Assessment of The Use of Laparoscopic Power Morcellators to Treat Uterine Fibroids"
2315:"Strong family history of uterine leiomyomatosis warrants fumarate hydratase mutation screening"
445:
4395:
Stewart EA, Rabinovici J, Tempany CM, Inbar Y, Regan L, Gostout B, et al. (January 2006).
910:
A relatively large submucosal leiomyoma; it fills out the major part of the endometrial cavity.
5074:
4835:
4759:
4730:
4641:
4469:
4418:
4377:
4242:
4234:
4193:
4142:
4107:
4036:
4001:
3960:
3939:"Uterine artery embolization for fibroids is associated with an increased risk of miscarriage"
3919:
3851:
3763:
3722:
3673:
3638:
3597:
3556:
3507:
3464:
3429:
3378:
3332:
3269:
3206:
3156:
3105:
3064:
3027:
2961:
2915:
2880:
2828:
2787:
2744:
2648:
2613:
2560:
2527:
2519:
2445:
2385:
2336:
2295:
2228:
2107:
2053:
1947:
1941:
1922:
1854:
1816:
1764:
1697:
821:
449:
281:
148:
75:
2554:
2254:
Heinonen HR, Pasanen A, Heikinheimo O, Tanskanen T, Palin K, Tolvanen J, et al. (2017).
4905:
4843:
4631:
4459:
4449:
4408:
4367:
4359:
4321:
4276:
4224:
4183:
4173:
4134:
4097:
4089:
4028:
3991:
3950:
3909:
3901:
3841:
3833:
3753:
3712:
3665:
3628:
3587:
3546:
3499:
3456:
3419:
3409:
3370:
3324:
3259:
3251:
3196:
3188:
3097:
3054:
3017:
3009:
2953:
2907:
2870:
2862:
2818:
2779:
2734:
2640:
2603:
2593:
2509:
2437:
2375:
2367:
2326:
2285:
2275:
2218:
2185:
2099:
2043:
2035:
1912:
1902:
1846:
1806:
1798:
1754:
1746:
803:(TGIF) is increased in leiomyoma compared with myometrium. TGIF is a potential repressor of
787:
signaling. Progesterone is thought to promote the growth of leiomyoma through up-regulating
673:
611:
There are also hybrid leimyomas, like the type 2-5 which are both subserosal as submucosal.
212:
3699:
Courtoy GE, Henriet P, Marbaix E, de Codt M, Luyckx M, Donnez J, et al. (April 2018).
452:
has been reported. This is associated with a mutation in the gene that produces the enzyme
5225:
5204:
5158:
5044:
5032:
5003:
4990:
4606:
3740:
Donnez J, Donnez O, Matule D, Ahrendt HJ, Hudecek R, Zatik J, et al. (January 2016).
2010:
1417:, is a non-invasive intervention (requiring no incision) that uses high intensity focused
843:
825:
388:
316:
289:
157:
4800:
4517:
2851:"Transforming growth interacting factor expression in leiomyoma compared with myometrium"
4269:"Surgical removal of fibroids has better long-term outcomes than blocking blood vessels"
4188:
4161:
3914:
3893:
3617:"In vivo mechanisms of uterine myoma volume reduction with ulipristal acetate treatment"
3576:"First series of 18 pregnancies after ulipristal acetate treatment for uterine fibroids"
3328:
3264:
3239:
2730:
2271:
5244:
5110:
5088:
5018:
4928:
4852:
4464:
4437:
4397:"Clinical outcomes of focused ultrasound surgery for the treatment of uterine fibroids"
4372:
4347:
4102:
4077:
3846:
3821:
3424:
3397:
3201:
3022:
2997:
2875:
2850:
2380:
2355:
2290:
2255:
2048:
2023:
1917:
1890:
1850:
1811:
1786:
1434:
1151:
1073:
1058:
986:
799:. Progesterone is believed to counteract growth by downregulating IGF-1. Expression of
564:
351:
181:
169:
33:
3996:
3979:
3592:
3575:
3047:"Genetic heterogeneity among uterine leiomyomata: insights into malignant progression"
2957:
1802:
5330:
5282:
5272:
5027:
4413:
4396:
4288:
4254:
3955:
3938:
3758:
3741:
3633:
3616:
3117:
2927:
2866:
2598:
2581:
2539:
1891:"Presentation and treatment of uterine leiomyoma in adolescence: a systematic review"
1240:
1062:
812:
748:
717:
639:
using a morcellator has been associated with an increased risk of this complication.
363:
4770:
4702:
4162:"Minimally invasive surgical techniques versus open myomectomy for uterine fibroids"
3685:
3519:
3476:
2756:
2713:
Mäkinen N, Mehine M, Tolvanen J, Kaasinen E, Li Y, Lehtonen HJ, et al. (2011).
2240:
2205:
Kämpjärvi K, Park MJ, Mehine M, Kim NH, Clark AD, Bützow R, et al. (Sep 2014).
2135:
2119:
1866:
4998:
4178:
4093:
4048:
3905:
3837:
3255:
2973:
2941:
2457:
2354:
Toro JR, Nickerson ML, Wei MH, Warren MB, Glenn GM, Turner ML, et al. (2003).
1558:, have been under investigation. Another selective progesterone receptor modulator
1527:
1381:
1321:
1283:
1228:
1224:
1214:
1201:
1113:
1054:
989:
of uterine fibroids typically show smooth muscle in a whorled (fascicular) pattern.
733:
457:
367:
273:
269:
177:
96:
92:
4138:
3574:
Luyckx M, Squifflet JL, Jadoul P, Votino R, Dolmans MM, Donnez J (November 2014).
3374:
2783:
2103:
1889:
Moroni RM, Vieira CS, Ferriani RA, Reis RM, Nogueira AA, Brito LG (January 2015).
1750:
1034:
1021:
495:
4724:
3503:
2441:
2022:
Segars JH, Parrott EC, Nagel JD, Guo XC, Gao X, Birnbaum LS, et al. (2014).
1457:
4754:
1342:
1255:
1161:
1066:
737:
550:
476:
An enucleated uterine leiomyoma – external surface on left, cut surface on right
384:
331:
285:
208:
131:
108:
4363:
4280:
4032:
3669:
3192:
3101:
2644:
2514:
2497:
2280:
1717:
1300:
519:
59:
5115:
5097:
4776:
4735:
4454:
4125:
Agdi M, Tulandi T (August 2008). "Endoscopic management of uterine fibroids".
3460:
2998:"Ovarian steroids, stem cells and uterine leiomyoma: therapeutic implications"
2898:
Shozu M, Murakami K, Inoue M (2004). "Aromatase and Leiomyoma of the Uterus".
1907:
1559:
1418:
1356:
1289:
1210:
1104:
923:
896:
784:
698:
491:
347:
199:
80:
4238:
2770:
Okolo S (2008). "Incidence, aetiology and epidemiology of uterine fibroids".
2523:
17:
4765:
4687:
4229:
4212:
3013:
2996:
Moravek MB, Yin P, Ono M, Coon JS, Dyson MT, Navarro A, et al. (2015).
2823:
2806:
2739:
2714:
2331:
2314:
2039:
1564:
1540:
1502:
1470:
1442:
1438:
1348:
1334:
1175:
1155:
839:
796:
756:
744:
702:
632:
487:
481:
380:
359:
327:
257:
229:
223:
204:
173:
4781:
4645:
4473:
4422:
4381:
4246:
4197:
4146:
4111:
4040:
4005:
3964:
3923:
3855:
3767:
3726:
3677:
3642:
3601:
3560:
3511:
3468:
3433:
3382:
3336:
3273:
3210:
3109:
3068:
3031:
2965:
2919:
2884:
2849:
Yen-Ping Ho J, Man WC, Wen Y, Polan ML, Shih-Chu Ho E, Chen B (June 2009).
2832:
2791:
2748:
2652:
2617:
2531:
2449:
2389:
2340:
2299:
2232:
2111:
2057:
1926:
1858:
1820:
1768:
1441:. There is no consensus among pathologists regarding the transformation of
3742:"Long-term medical management of uterine fibroids with ulipristal acetate"
3717:
3700:
3551:
3534:
2911:
583:
Type 0: pedunculated submucosal, intracavitary (i.e. inside of the uterus)
338:
supplements may be needed in those with heavy periods. Medications of the
5295:
5196:
5023:
3361:
Sankaran S, Manyonda IT (August 2008). "Medical management of fibroids".
3059:
3046:
1759:
1555:
1408:
1218:
1206:
1179:
1128:
and surgical options have similar outcomes with respect to satisfaction.
804:
768:
752:
729:
308:
293:
141:
4636:
4619:
3820:
Tristan M, Orozco LJ, Steed A, Ramírez-Morera A, Stone P (August 2012).
838:
A small population of the cells in a uterine fibroid have properties of
4975:
4965:
4438:"Abstracts of the 2nd European symposium on focused ultrasound therapy"
2608:
2223:
2207:"Mutations in Exon 1 highlight the role of MED12 in uterine leiomyomas"
2206:
1189:
791:, TGF-beta1 and TGF-beta3, and promotes survival through up-regulating
775:, and promotes aberrant survival of leiomyoma cells by down-regulating
721:
504:
448:) that causes uterine leiomyomata along with cutaneous leiomyomata and
304:
300:
277:
137:
4670:
3414:
2190:
2173:
1333:), the fibroid can be removed by either the use of a resectoscope, an
472:
4682:
1696:(2nd ed.). Philadelphia, PA: Elsevier/Mosby. p. Chapter U.
1433:
About 1 out of 1,000 lesions are or become malignant, typically as a
1328:
1046:
323:
261:
4346:
Shen SH, Fennessy F, McDannold N, Jolesz F, Tempany C (April 2009).
2807:"Sex steroidal regulation of uterine leiomyoma growth and apoptosis"
2313:
Tolvanen J, Uimari O, Ryynänen M, Aaltonen LA, Vahteristo P (2012).
1437:
on histology. A sign that a lesion may be malignant is growth after
1057:
and bloatedness are possible. Compression of the ureter may lead to
268:. Some people with fibroids have no symptoms while others may have
4160:
Bhave Chittawar P, Franik S, Pouwer AW, Farquhar C (Oct 21, 2014).
3535:"Ulipristal acetate versus leuprolide acetate for uterine fibroids"
2772:
Best Practice & Research. Clinical Obstetrics & Gynaecology
2631:
Nezhat C, Kho K (2010). "Iatrogenic Myomas: New Class of Myomas?".
2371:
53:
Uterine leiomyoma, uterine myoma, myoma, fibromyoma, fibroleiomyoma
4831:
2580:
Cucinella G, Granese R, Calagna G, Somigliana E, Perino A (2011).
1968:"Uterine Fibroids: Symptoms, Causes, Risk Factors & Treatment"
1299:
1288:
1277:
792:
760:
710:
688:
680:
672:
595:
Type 4: intramural (i.e. completely inside the wall of the uterus)
518:
486:
471:
427:
4713:
1278:
879:
A very large (9 cm) fibroid of the uterus which is causing
780:
772:
335:
4804:
681:
618:
If the uterus contains too many to count, it is referred to as
4436:
Kurashvili J, Stepanov A, Kulabuchova E, Batarshina O (2014).
4217:
BJOG: An International Journal of Obstetrics & Gynaecology
3894:"Uterine artery embolization for symptomatic uterine fibroids"
3872:. FEmISA: Fibroid Embolisation: Information, Support, Advice.
3285:
3283:
3240:"Uterine artery embolization for symptomatic uterine fibroids"
776:
720:
cause fibroid growth. Known risk factors are African descent,
1095:
medication to control symptoms (i.e., symptomatic management)
950:
A subserosal uterine fibroid with a diameter of 5 centimeters
4076:
Metwally M, Raybould G, Cheong YC, Horne AW (January 2020).
3238:
Gupta JK, Sinha A, Lumsden MA, Hickey M (26 December 2014).
2469:
2467:
1053:. Due to pressure effects gastrointestinal problems such as
626:
Extrauterine fibroids of uterine origin, metastatic fibroids
322:
Treatment is typically not needed if there are no symptoms.
3615:
Courtoy GE, Donnez J, Marbaix E, Dolmans MM (August 2015).
3175:
El Sabeh M, Saha SK, Afrin S, Islam MS, Borahay MA (2021).
2174:"A review of evidence-based management of uterine fibroids"
2172:
Younas K, Hadoura E, Majoko F, Bunkheila A (January 2016).
2000:
American Society of Reproductive Medicine Patient Booklet:
1351:
rates and faster recovery than does laparotomic myomectomy.
1005:
distinguishes muscle (yellow) from connective tissue (red).
3132:"Uterine fibroids - Diagnosis and treatment - Mayo Clinic"
824:
have double concordance rate for hysterectomy compared to
4796:
NIH Fibroid Treatment Study: Information and NIH research
3892:
Gupta JK, Sinha A, Lumsden MA, Hickey M (December 2014).
3165:
Topic Completed: 1 August 2011. Revised: 15 December 2019
2946:
The Journal of Steroid Biochemistry and Molecular Biology
1140:
A number of medications may be used to control symptoms.
1567:
is associated with the development of uterine fibroids.
571:) of the uterus that also contain smooth muscle tissue.
615:
cystic changes. They tend to calcify after menopause.
354:. They do not appear to develop from benign fibroids.
1045:
Fibroids that lead to heavy vaginal bleeding lead to
779:, increasing expression of the anti-apoptotic factor
743:
It is believed that estrogen and progesterone have a
4660:
922:
A small uterine fibroid seen within the wall of the
350:
versions of fibroids are very rare and are known as
5281:
5243:
5218:
5195:
5157:
5124:
5096:
5087:
5065:
5043:
4989:
4941:
4876:
4860:
4851:
4842:
4745:
4664:
4322:"FDA Approves New Device to Treat Uterine Fibroids"
4021:
International Journal of Gynaecology and Obstetrics
2502:
International Journal of Gynaecology and Obstetrics
1785:Global Burden of Disease Study 2013 (5 June 2015).
1492:
National Institute of Environmental Health Sciences
1072:In very rare cases, malignant (cancerous) growths,
816:particularly pronounced in African-American women.
713:protein have been noted in 70 percent of fibroids.
235:
222:
198:
187:
163:
147:
130:
122:
114:
102:
86:
74:
49:
44:
4348:"Image-guided thermal therapy of uterine fibroids"
4304:"A New Treatment to Help Women Avoid Hysterectomy"
3795:Government of Canada, Health Canada (2020-09-16).
1200:or less because after longer use they could cause
4618:Bäcklin BM, Eriksson L, Olovsson M (March 2003).
4078:"Surgical treatment of fibroids for subfertility"
2991:
2989:
2987:
2985:
2983:
592:Type 3: contacts the endometrium, 100% intramural
3356:
3354:
3352:
3350:
3348:
3346:
1262:to perform and fewer side effects are expected.
1221:alone, and combined estrogens and progestogens.
1091:Symptomatic uterine fibroids can be treated by:
4488:"Helping Black Women Recognize, Treat Fibroids"
1178:and stimulates the remodeling of the extensive
1078:hereditary leiomyomatosis and renal cell cancer
440:Hereditary leiomyomatosis and renal cell cancer
3978:Liu WM, Ng HT, Wu YC, Yen YK, Yuan CC (2001).
2700:Fletcher's Diagnostic Histopathology of Tumors
1069:may be mistaken for or coexist with fibroids.
4816:
4571:"Black Women and High Prevalence of Fibroids"
2694:
2692:
693:Multiple uterine leiomyoma with calcification
8:
3887:
3885:
3883:
3223:: CS1 maint: multiple names: authors list (
2481:. U.K. National Health Service. 2017-10-19.
1657:
1655:
1653:
1651:
1649:
1647:
1645:
1643:
1641:
1639:
1637:
1635:
1633:
1631:
1629:
1627:
1625:
1623:
1621:
1619:
1617:
1615:
1613:
1611:
1609:
1607:
1605:
1421:waves to destroy tissue in combination with
1415:Magnetic resonance guided focused ultrasound
1304:After treatment of an intramural fibroid by
4166:The Cochrane Database of Systematic Reviews
3244:The Cochrane Database of Systematic Reviews
2844:
2842:
2805:Maruo T, Ohara N, Wang J, Matsuo H (2004).
1943:Reproductive Surgery in Assisted Conception
1718:"Uterine Fibroids | Fibroids | MedlinePlus"
1603:
1601:
1599:
1597:
1595:
1593:
1591:
1589:
1587:
1585:
974:Giant leiomyomas almost filling the abdomen
366:, uterine fibroids are a common reason for
5093:
4873:
4857:
4848:
4823:
4809:
4801:
4661:
2430:The American Journal of Surgical Pathology
2085:
2083:
2081:
2079:
2077:
2075:
2073:
2071:
2069:
2067:
1832:
1830:
1552:Selective progesterone receptor modulators
962:MRI image with multiple uterine leiomyomas
58:
41:
4635:
4565:
4563:
4561:
4522:Philadelphia Black Women's Health Project
4463:
4453:
4412:
4371:
4228:
4187:
4177:
4101:
3995:
3954:
3913:
3845:
3757:
3716:
3632:
3591:
3550:
3423:
3413:
3263:
3200:
3058:
3021:
2874:
2822:
2738:
2607:
2597:
2513:
2379:
2330:
2289:
2279:
2222:
2189:
2141:The Merck Manual of Diagnosis and Therapy
2047:
1916:
1906:
1884:
1882:
1880:
1878:
1876:
1810:
1780:
1778:
1758:
1172:selective progesterone receptor modulator
494:of a lipoleiomyoma, a type of leiomyoma.
27:Benign smooth-muscle tumors of the uterus
2633:Journal of Minimally Invasive Gynecology
607:Type 8: other (e.g. cervcial, parasitic)
362:, they usually decrease in size. In the
330:, may help with pain and bleeding while
276:. If large enough, they may push on the
5263:Clear-cell adenocarcinoma of the vagina
2131:
2129:
1995:
1993:
1991:
1989:
1987:
1581:
869:
3216:
3082:
3080:
3078:
1293:Treatment of an intramural fibroid by
1197:Gonadotropin-releasing hormone analogs
1065:, which itself may cause infertility.
1061:. Fibroids may also present alongside
938:Two calcified fibroids (in the uterus)
801:transforming growth interacting factor
601:Type 6: subserosal, <50% intramural
586:Type 1: submucosal, <50% intramural
340:gonadotropin-releasing hormone agonist
217:gonadotropin releasing hormone agonist
5253:Squamous-cell carcinoma of the vagina
5144:Endometrial intraepithelial neoplasia
4581:from the original on 25 December 2010
4518:"African American Women and Fibroids"
4063:"Uterine Fibroid Embolisation Africa"
3157:"Uterus - Stromal tumors - Leiomyoma"
1315:There are three types of myomectomy:
701:tumors and approximately 40–50% show
7:
4981:Sex cord tumour with annular tubules
4550:. Women's Health.gov. Archived from
4498:from the original on 22 January 2012
2178:The Obstetrician & Gynaecologist
1098:medication aimed at shrinking tumors
926:on a cross-sectional ultrasound view
334:(acetaminophen) may help with pain.
4899:Papillary serous cystadenocarcinoma
4127:Best Pract Res Clin Obstet Gynaecol
3822:"Mifepristone for uterine fibroids"
3363:Best Pract Res Clin Obstet Gynaecol
3329:10.1016/j.contraception.2010.02.011
1739:Best Pract Res Clin Obstet Gynaecol
1148:Levonorgestrel intrauterine devices
598:Type 5: subserosal, ≥50% intramural
589:Type 2: submucosal, ≥50% intramural
118:Middle and later reproductive years
5167:Cervical intraepithelial neoplasia
5139:Uterine papillary serous carcinoma
4324:(Press release). FDA. 2004-10-22.
3937:Homer H, Saridogan E (June 2010).
1851:10.1097/01.AOG.0000136079.62513.39
846:, and contribute significantly to
25:
5268:Vaginal intraepithelial neoplasia
5210:Gestational trophoblastic disease
4528:from the original on 1 April 2011
4211:Amoah A, Quinn SD (1 June 2023).
3593:10.1016/j.fertnstert.2014.07.1253
2900:Seminars in Reproductive Medicine
1239:aromatase inhibitor treatment of
5311:Vulvar intraepithelial neoplasia
4414:10.1016/j.fertnstert.2005.04.072
3956:10.1016/j.fertnstert.2009.02.069
3876:from the original on 2014-05-31.
3759:10.1016/j.fertnstert.2015.09.032
3634:10.1016/j.fertnstert.2015.04.025
3402:Patient Preference and Adherence
2867:10.1016/j.fertnstert.2009.05.001
2599:10.1016/j.fertnstert.2011.05.095
2485:from the original on 2008-05-05.
2161:from the original on 2016-02-09.
2157:. womenshealth.gov. 2016-12-15.
1673:from the original on 7 July 2015
1010:
994:
979:
967:
955:
943:
931:
915:
903:
888:
872:
383:, they may also be the cause of
311:. Diagnosis can be performed by
67:Uterine fibroids as seen during
4328:from the original on 2008-05-09
2702:(3rd ed.). pp. 692–4.
795:expression and down-regulating
604:Type 7: pedunculated subserosal
480:Fibroids are a type of uterine
4179:10.1002/14651858.CD004638.pub3
4094:10.1002/14651858.CD003857.pub4
3906:10.1002/14651858.CD005073.pub4
3838:10.1002/14651858.CD007687.pub2
3256:10.1002/14651858.CD005073.pub4
1101:ultrasound fibroid destruction
807:pathways in myometrial cells.
658:benign metastasizing leiomyoma
620:diffuse uterine leiomyomatosis
368:surgical removal of the uterus
1:
5187:Villoglandular adenocarcinoma
4139:10.1016/j.bpobgyn.2008.01.011
3997:10.1016/S0015-0282(00)01724-6
3396:Kailasam C, Cahill D (2008).
3375:10.1016/j.bpobgyn.2008.03.001
2958:10.1016/S0960-0760(01)00134-0
2784:10.1016/j.bpobgyn.2008.04.002
2155:"Uterine fibroids fact sheet"
2104:10.1080/01635581.2015.1015746
1803:10.1016/S0140-6736(15)60692-4
1751:10.1016/j.bpobgyn.2015.11.016
1663:"Uterine fibroids fact sheet"
1360:myomectomy (also known as an
456:, located on the long arm of
303:levels. Risk factors include
5306:Extramammary Paget's disease
5149:Uterine clear-cell carcinoma
4924:Ovarian clear-cell carcinoma
4575:Fibroid Treatment Collective
3782:"European Medicament Agency"
3504:10.3109/13697137.2014.981133
3045:Hodge JC, Morton CC (2007).
2675:Food and Drug Administration
2442:10.1097/PAS.0b013e318223ca01
1124:In those who have symptoms,
460:(1q42.3-43). Inheritance is
1252:Uterine artery embolization
1126:uterine artery embolization
1119:uterine artery embolization
515:Location and classification
344:Uterine artery embolization
286:pain during penetrative sex
258:benign smooth muscle tumors
193:uterine artery embolization
5363:
5106:Uterine fibroids/leiomyoma
4961:Sertoli–Leydig cell tumour
4884:Ovarian serous cystadenoma
4364:10.1053/j.sult.2008.12.002
4281:10.3310/nihrevidence_59961
4082:Cochrane Database Syst Rev
4033:10.1016/j.ijgo.2005.07.012
3898:Cochrane Database Syst Rev
3870:"The Embolisation Process"
3826:Cochrane Database Syst Rev
3670:10.1016/j.rbmo.2018.04.050
3193:10.1007/s11010-021-04174-6
3102:10.1007/s00261-022-03545-x
2645:10.1016/j.jmig.2010.04.004
2556:Obstetrics and Gynaecology
2515:10.1016/j.ijgo.2010.11.011
2281:10.1038/s41598-017-01199-0
1940:Metwally M, Li TC (2015).
1423:magnetic resonance imaging
881:pelvic congestion syndrome
677:Multiple uterine leiomyoma
651:intravenous leiomyomatosis
437:
266:female reproductive system
31:
5316:Bartholin gland carcinoma
5258:Botryoid rhabdomyosarcoma
4914:
4548:"Minority Women's Health"
4455:10.1186/2050-5736-2-s1-a1
3461:10.1007/s12325-012-0042-8
3155:Mohamed Mokhtar Desouki.
2811:Human Reproduction Update
2559:. John Wiley & Sons.
2553:Impey L, Child T (2016).
1946:. Springer. p. 107.
1908:10.1186/s12905-015-0162-9
1184:matrix metalloproteinases
726:polycystic ovary syndrome
707:chromosomal abnormalities
66:
57:
5337:Gynaecological neoplasia
4943:Sex cord–gonadal stromal
4862:Glandular and epithelial
3051:Human Molecular Genetics
1667:Office on Women's Health
1325:myomectomy (also called
738:never having given birth
685:Large subserosal fibroid
282:frequent need to urinate
32:Not to be confused with
4308:The Wall Street Journal
4230:10.1111/1471-0528.17412
3984:Fertility and Sterility
3705:J Clin Endocrinol Metab
3290:Cimons M (2022-12-11).
3053:. 16 Spec No 1: R7–13.
2740:10.1126/science.1208930
2586:Fertility and Sterility
1404:Radiofrequency ablation
1232:treatment was stopped.
1109:radiofrequency ablation
239:~50% of women by age 50
5014:Endodermal sinus tumor
4600:Office of Budget (PDF)
4352:Semin Ultrasound CT MR
3801:healthycanadians.gc.ca
1308:
1297:
1286:
1282:Submucosal fibroid in
1267:good clinical practice
694:
686:
678:
525:
499:
477:
284:. They may also cause
191:Medications, surgery,
165:Differential diagnosis
5301:Papillary hidradenoma
5231:Mixed Müllerian tumor
5182:Glassy-cell carcinoma
4971:Granulosa cell tumour
4577:. November 29, 2010.
4302:Beck M (2010-01-20).
4275:. 22 September 2023.
3718:10.1210/jc.2017-02295
3552:10.1056/NEJMoa1103180
3014:10.1093/humupd/dmu048
2912:10.1055/s-2004-823027
2824:10.1093/humupd/dmh019
2332:10.1093/humrep/des105
2040:10.1093/humupd/dmt058
1458:extrauterine fibroids
1303:
1292:
1281:
692:
684:
676:
522:
490:
475:
438:Further information:
5172:Clear-cell carcinoma
4889:Mucinous cystadenoma
3658:Reprod Biomed Online
2144:Professional Edition
1669:. January 15, 2015.
1393:Endometrial ablation
1388:Endometrial ablation
1306:laparoscopic surgery
1295:laparoscopic surgery
1236:Aromatase inhibitors
1227:antagonists such as
1041:Coexisting disorders
1031:immunohistochemistry
1018:Immunohistochemistry
833:extracellular matrix
578:FIGO classification.
569:uterosacral ligament
434:Familial leiomyomata
69:laparoscopic surgery
5009:Embryonal carcinoma
4956:Sertoli cell tumour
4867:surface epithelial-
4637:10.1354/vp.40-2-175
4448:(Suppl 1): A1–A25.
2731:2011Sci...334..252M
2272:2017NatSR...7.1015H
2028:Hum. Reprod. Update
1509:Related legislation
1499:high blood pressure
1474:teenagers is 0.4%.
852:paracrine signaling
547:Submucosal fibroids
541:Subserosal fibroids
534:Intramural fibroids
5134:Endometrioid tumor
4951:Leydig cell tumour
4919:Endometrioid tumor
4894:Cystadenocarcinoma
4746:External resources
4605:2011-09-30 at the
3161:pathology Outlines
3136:www.mayoclinic.org
3060:10.1093/hmg/ddm043
2319:Human Reproduction
2224:10.1002/humu.22612
2009:2008-07-03 at the
1895:BMC Women's Health
1309:
1298:
1287:
1168:Ulipristal acetate
1003:Van Gieson's stain
695:
687:
679:
526:
500:
478:
462:autosomal dominant
454:fumarate hydratase
374:Signs and symptoms
313:pelvic examination
250:uterine leiomyomas
154:Pelvic examination
5324:
5323:
5239:
5238:
5083:
5082:
5075:Adenomatoid tumor
5061:
5060:
4937:
4936:
4836:urogenital system
4791:
4790:
4442:J Ther Ultrasound
3752:(1): 165–173.e4.
3415:10.2147/ppa.s3464
3090:Abdom Radiol (NY)
3002:Hum Reprod Update
2725:(6053): 252–255.
2566:978-1-119-01080-7
2191:10.1111/tog.12223
1953:978-1-4471-4953-8
1797:(9995): 743–800.
1703:978-0-323-07699-9
1692:Ferri FF (2010).
822:Monozygotic twins
783:and antagonizing
557:Cervical fibroids
450:renal cell cancer
243:
242:
211:(acetaminophen),
149:Diagnostic method
39:Medical condition
16:(Redirected from
5354:
5342:Benign neoplasms
5094:
5004:Nongerminomatous
4906:Krukenberg tumor
4874:
4858:
4849:
4825:
4818:
4811:
4802:
4662:
4650:
4649:
4639:
4615:
4609:
4597:
4591:
4590:
4588:
4586:
4567:
4556:
4555:
4544:
4538:
4537:
4535:
4533:
4514:
4508:
4507:
4505:
4503:
4484:
4478:
4477:
4467:
4457:
4433:
4427:
4426:
4416:
4392:
4386:
4385:
4375:
4343:
4337:
4336:
4334:
4333:
4318:
4312:
4311:
4299:
4293:
4292:
4265:
4259:
4258:
4232:
4208:
4202:
4201:
4191:
4181:
4172:(10): CD004638.
4157:
4151:
4150:
4122:
4116:
4115:
4105:
4073:
4067:
4066:
4059:
4053:
4052:
4016:
4010:
4009:
3999:
3975:
3969:
3968:
3958:
3934:
3928:
3927:
3917:
3900:(12): CD005073.
3889:
3878:
3877:
3866:
3860:
3859:
3849:
3817:
3811:
3810:
3808:
3807:
3792:
3786:
3785:
3778:
3772:
3771:
3761:
3737:
3731:
3730:
3720:
3711:(4): 1566–1573.
3696:
3690:
3689:
3653:
3647:
3646:
3636:
3627:(2): 426–34.e1.
3612:
3606:
3605:
3595:
3571:
3565:
3564:
3554:
3530:
3524:
3523:
3487:
3481:
3480:
3444:
3438:
3437:
3427:
3417:
3393:
3387:
3386:
3358:
3341:
3340:
3312:
3306:
3305:
3303:
3302:
3287:
3278:
3277:
3267:
3250:(12): CD005073.
3235:
3229:
3228:
3222:
3214:
3204:
3187:(9): 3513–3536.
3181:Mol Cell Biochem
3172:
3166:
3164:
3152:
3146:
3145:
3143:
3142:
3128:
3122:
3121:
3096:(7): 2468–2485.
3084:
3073:
3072:
3062:
3042:
3036:
3035:
3025:
2993:
2978:
2977:
2938:
2932:
2931:
2895:
2889:
2888:
2878:
2846:
2837:
2836:
2826:
2802:
2796:
2795:
2767:
2761:
2760:
2742:
2710:
2704:
2703:
2696:
2687:
2686:
2684:
2682:
2671:
2663:
2657:
2656:
2628:
2622:
2621:
2611:
2601:
2577:
2571:
2570:
2550:
2544:
2543:
2517:
2493:
2487:
2486:
2471:
2462:
2461:
2436:(8): 1235–1237.
2425:
2419:
2418:
2416:
2415:
2406:. Archived from
2400:
2394:
2393:
2383:
2351:
2345:
2344:
2334:
2310:
2304:
2303:
2293:
2283:
2251:
2245:
2244:
2226:
2202:
2196:
2195:
2193:
2169:
2163:
2162:
2151:
2145:
2136:Uterine Fibroids
2133:
2124:
2123:
2087:
2062:
2061:
2051:
2019:
2013:
2002:Uterine Fibroids
1997:
1982:
1981:
1979:
1978:
1972:Cleveland Clinic
1964:
1958:
1957:
1937:
1931:
1930:
1920:
1910:
1886:
1871:
1870:
1834:
1825:
1824:
1814:
1782:
1773:
1772:
1762:
1734:
1728:
1727:
1725:
1724:
1714:
1708:
1707:
1689:
1683:
1682:
1680:
1678:
1659:
1445:into a sarcoma.
1399:Other procedures
1014:
1001:This variant of
998:
983:
971:
959:
947:
935:
919:
907:
892:
876:
844:progenitor cells
771:, TGF-beta3 and
248:, also known as
246:Uterine fibroids
213:iron supplements
136:Family history,
62:
45:Uterine fibroids
42:
21:
5362:
5361:
5357:
5356:
5355:
5353:
5352:
5351:
5327:
5326:
5325:
5320:
5277:
5235:
5226:Uterine sarcoma
5214:
5205:Choriocarcinoma
5191:
5153:
5120:
5079:
5057:
5053:Meigs' syndrome
5039:
5033:Choriocarcinoma
4985:
4933:
4910:
4868:
4865:
4838:
4829:
4792:
4787:
4786:
4782:Uterine fibroid
4741:
4740:
4673:
4659:
4654:
4653:
4617:
4616:
4612:
4607:Wayback Machine
4598:
4594:
4584:
4582:
4569:
4568:
4559:
4546:
4545:
4541:
4531:
4529:
4516:
4515:
4511:
4501:
4499:
4486:
4485:
4481:
4435:
4434:
4430:
4394:
4393:
4389:
4345:
4344:
4340:
4331:
4329:
4320:
4319:
4315:
4301:
4300:
4296:
4267:
4266:
4262:
4210:
4209:
4205:
4159:
4158:
4154:
4124:
4123:
4119:
4088:(1): CD003857.
4075:
4074:
4070:
4061:
4060:
4056:
4018:
4017:
4013:
3977:
3976:
3972:
3936:
3935:
3931:
3891:
3890:
3881:
3868:
3867:
3863:
3832:(8): CD007687.
3819:
3818:
3814:
3805:
3803:
3794:
3793:
3789:
3780:
3779:
3775:
3739:
3738:
3734:
3698:
3697:
3693:
3655:
3654:
3650:
3614:
3613:
3609:
3573:
3572:
3568:
3532:
3531:
3527:
3489:
3488:
3484:
3446:
3445:
3441:
3395:
3394:
3390:
3360:
3359:
3344:
3314:
3313:
3309:
3300:
3298:
3296:Washington Post
3289:
3288:
3281:
3237:
3236:
3232:
3215:
3174:
3173:
3169:
3154:
3153:
3149:
3140:
3138:
3130:
3129:
3125:
3086:
3085:
3076:
3044:
3043:
3039:
2995:
2994:
2981:
2940:
2939:
2935:
2897:
2896:
2892:
2848:
2847:
2840:
2804:
2803:
2799:
2769:
2768:
2764:
2712:
2711:
2707:
2698:
2697:
2690:
2680:
2678:
2669:
2665:
2664:
2660:
2630:
2629:
2625:
2579:
2578:
2574:
2567:
2552:
2551:
2547:
2495:
2494:
2490:
2473:
2472:
2465:
2427:
2426:
2422:
2413:
2411:
2404:"Reed syndrome"
2402:
2401:
2397:
2353:
2352:
2348:
2312:
2311:
2307:
2253:
2252:
2248:
2204:
2203:
2199:
2171:
2170:
2166:
2153:
2152:
2148:
2134:
2127:
2089:
2088:
2065:
2021:
2020:
2016:
2011:Wayback Machine
1998:
1985:
1976:
1974:
1966:
1965:
1961:
1954:
1939:
1938:
1934:
1888:
1887:
1874:
1836:
1835:
1828:
1784:
1783:
1776:
1736:
1735:
1731:
1722:
1720:
1716:
1715:
1711:
1704:
1691:
1690:
1686:
1676:
1674:
1661:
1660:
1583:
1578:
1573:
1549:
1537:
1516:
1511:
1488:
1480:
1466:
1451:
1431:
1401:
1390:
1379:
1276:
1249:
1170:is a synthetic
1138:
1086:
1051:iron deficiency
1043:
1025:
1015:
1006:
999:
990:
984:
975:
972:
963:
960:
951:
948:
939:
936:
927:
920:
911:
908:
899:
893:
884:
877:
860:
848:ovarian steroid
826:dizygotic twins
671:
628:
537:uterine cavity.
517:
470:
468:Pathophysiology
446:Reed's syndrome
442:
436:
423:
414:
405:
389:premature labor
376:
352:leiomyosarcomas
346:may also help.
317:medical imaging
290:lower back pain
158:medical imaging
40:
37:
28:
23:
22:
15:
12:
11:
5:
5360:
5358:
5350:
5349:
5347:Uterine tumour
5344:
5339:
5329:
5328:
5322:
5321:
5319:
5318:
5313:
5308:
5303:
5298:
5293:
5287:
5285:
5279:
5278:
5276:
5275:
5270:
5265:
5260:
5255:
5249:
5247:
5241:
5240:
5237:
5236:
5234:
5233:
5228:
5222:
5220:
5216:
5215:
5213:
5212:
5207:
5201:
5199:
5193:
5192:
5190:
5189:
5184:
5179:
5174:
5169:
5163:
5161:
5155:
5154:
5152:
5151:
5146:
5141:
5136:
5130:
5128:
5122:
5121:
5119:
5118:
5113:
5111:Leiomyosarcoma
5108:
5102:
5100:
5091:
5085:
5084:
5081:
5080:
5078:
5077:
5071:
5069:
5067:Fallopian tube
5063:
5062:
5059:
5058:
5056:
5055:
5049:
5047:
5041:
5040:
5038:
5037:
5036:
5035:
5030:
5021:
5019:Gonadoblastoma
5016:
5011:
5001:
4995:
4993:
4987:
4986:
4984:
4983:
4978:
4973:
4968:
4963:
4958:
4953:
4947:
4945:
4939:
4938:
4935:
4934:
4932:
4931:
4929:Brenner tumour
4926:
4921:
4915:
4912:
4911:
4909:
4908:
4903:
4902:
4901:
4891:
4886:
4880:
4878:
4871:
4855:
4846:
4840:
4839:
4834:of the female
4830:
4828:
4827:
4820:
4813:
4805:
4799:
4798:
4789:
4788:
4785:
4784:
4773:
4762:
4750:
4749:
4747:
4743:
4742:
4739:
4738:
4727:
4716:
4705:
4690:
4674:
4669:
4668:
4666:
4665:Classification
4658:
4657:External links
4655:
4652:
4651:
4610:
4592:
4557:
4554:on 2010-08-30.
4539:
4509:
4479:
4428:
4401:Fertil. Steril
4387:
4338:
4313:
4294:
4260:
4223:(7): 823–831.
4203:
4152:
4117:
4068:
4054:
4011:
3970:
3929:
3879:
3861:
3812:
3787:
3773:
3732:
3691:
3664:(2): 224–233.
3648:
3607:
3566:
3525:
3482:
3439:
3388:
3342:
3307:
3279:
3230:
3167:
3147:
3123:
3074:
3037:
2979:
2952:(1–5): 19–25.
2933:
2890:
2861:(3): 1078–83.
2855:Fertil. Steril
2838:
2817:(3): 207–220.
2797:
2778:(4): 571–588.
2762:
2705:
2688:
2658:
2639:(5): 544–550.
2623:
2592:(2): e90–e96.
2572:
2565:
2545:
2488:
2463:
2420:
2395:
2372:10.1086/376435
2360:Am J Hum Genet
2346:
2305:
2246:
2217:(9): 1136–41.
2211:Human Mutation
2197:
2164:
2146:
2125:
2063:
2014:
1983:
1959:
1952:
1932:
1872:
1845:(2): 393–406.
1839:Obstet Gynecol
1826:
1774:
1729:
1709:
1702:
1684:
1580:
1579:
1577:
1574:
1572:
1569:
1548:
1545:
1536:
1533:
1515:
1512:
1510:
1507:
1487:
1484:
1479:
1476:
1465:
1462:
1450:
1447:
1435:leiomyosarcoma
1430:
1427:
1400:
1397:
1389:
1386:
1378:
1375:
1370:
1369:
1352:
1338:
1275:
1272:
1248:
1247:Uterine artery
1245:
1152:levonorgestrel
1137:
1134:
1122:
1121:
1116:
1111:
1102:
1099:
1096:
1085:
1082:
1074:leiomyosarcoma
1059:hydronephrosis
1042:
1039:
1027:
1026:
1016:
1009:
1007:
1000:
993:
991:
987:Histopathology
985:
978:
976:
973:
966:
964:
961:
954:
952:
949:
942:
940:
937:
930:
928:
921:
914:
912:
909:
902:
900:
894:
887:
885:
878:
871:
859:
856:
749:growth factors
703:karyotypically
670:
667:
666:
665:
661:
654:
647:
627:
624:
609:
608:
605:
602:
599:
596:
593:
590:
587:
584:
573:
572:
565:broad ligament
561:round ligament
554:
544:
538:
516:
513:
469:
466:
435:
432:
422:
419:
413:
410:
404:
401:
375:
372:
264:, part of the
241:
240:
237:
233:
232:
228:Improve after
226:
220:
219:
202:
196:
195:
189:
185:
184:
182:ovarian cancer
170:Leiomyosarcoma
167:
161:
160:
151:
145:
144:
134:
128:
127:
124:
120:
119:
116:
112:
111:
106:
100:
99:
90:
84:
83:
78:
72:
71:
64:
63:
55:
54:
51:
47:
46:
38:
34:Leiomyosarcoma
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
5359:
5348:
5345:
5343:
5340:
5338:
5335:
5334:
5332:
5317:
5314:
5312:
5309:
5307:
5304:
5302:
5299:
5297:
5294:
5292:
5289:
5288:
5286:
5284:
5280:
5274:
5273:Vaginal cysts
5271:
5269:
5266:
5264:
5261:
5259:
5256:
5254:
5251:
5250:
5248:
5246:
5242:
5232:
5229:
5227:
5224:
5223:
5221:
5217:
5211:
5208:
5206:
5203:
5202:
5200:
5198:
5194:
5188:
5185:
5183:
5180:
5178:
5175:
5173:
5170:
5168:
5165:
5164:
5162:
5160:
5156:
5150:
5147:
5145:
5142:
5140:
5137:
5135:
5132:
5131:
5129:
5127:
5123:
5117:
5114:
5112:
5109:
5107:
5104:
5103:
5101:
5099:
5095:
5092:
5090:
5086:
5076:
5073:
5072:
5070:
5068:
5064:
5054:
5051:
5050:
5048:
5046:
5042:
5034:
5031:
5029:
5028:Struma ovarii
5025:
5022:
5020:
5017:
5015:
5012:
5010:
5007:
5006:
5005:
5002:
5000:
4997:
4996:
4994:
4992:
4988:
4982:
4979:
4977:
4974:
4972:
4969:
4967:
4964:
4962:
4959:
4957:
4954:
4952:
4949:
4948:
4946:
4944:
4940:
4930:
4927:
4925:
4922:
4920:
4917:
4916:
4913:
4907:
4904:
4900:
4897:
4896:
4895:
4892:
4890:
4887:
4885:
4882:
4881:
4879:
4875:
4872:
4870:
4869:stromal tumor
4863:
4859:
4856:
4854:
4850:
4847:
4845:
4841:
4837:
4833:
4826:
4821:
4819:
4814:
4812:
4807:
4806:
4803:
4797:
4794:
4793:
4783:
4779:
4778:
4774:
4772:
4768:
4767:
4763:
4761:
4757:
4756:
4752:
4751:
4748:
4744:
4737:
4733:
4732:
4728:
4726:
4722:
4721:
4717:
4715:
4711:
4710:
4706:
4704:
4700:
4699:
4695:
4691:
4689:
4685:
4684:
4680:
4676:
4675:
4672:
4667:
4663:
4656:
4647:
4643:
4638:
4633:
4630:(2): 175–80.
4629:
4625:
4621:
4614:
4611:
4608:
4604:
4601:
4596:
4593:
4580:
4576:
4572:
4566:
4564:
4562:
4558:
4553:
4549:
4543:
4540:
4527:
4523:
4519:
4513:
4510:
4497:
4493:
4489:
4483:
4480:
4475:
4471:
4466:
4461:
4456:
4451:
4447:
4443:
4439:
4432:
4429:
4424:
4420:
4415:
4410:
4406:
4402:
4398:
4391:
4388:
4383:
4379:
4374:
4369:
4365:
4361:
4358:(2): 91–104.
4357:
4353:
4349:
4342:
4339:
4327:
4323:
4317:
4314:
4309:
4305:
4298:
4295:
4290:
4286:
4282:
4278:
4274:
4273:NIHR Evidence
4270:
4264:
4261:
4256:
4252:
4248:
4244:
4240:
4236:
4231:
4226:
4222:
4218:
4214:
4207:
4204:
4199:
4195:
4190:
4185:
4180:
4175:
4171:
4167:
4163:
4156:
4153:
4148:
4144:
4140:
4136:
4133:(4): 707–16.
4132:
4128:
4121:
4118:
4113:
4109:
4104:
4099:
4095:
4091:
4087:
4083:
4079:
4072:
4069:
4065:. 2017-02-23.
4064:
4058:
4055:
4050:
4046:
4042:
4038:
4034:
4030:
4027:(2): 137–40.
4026:
4022:
4015:
4012:
4007:
4003:
3998:
3993:
3990:(2): 417–22.
3989:
3985:
3981:
3974:
3971:
3966:
3962:
3957:
3952:
3949:(1): 324–30.
3948:
3944:
3943:Fertil Steril
3940:
3933:
3930:
3925:
3921:
3916:
3911:
3907:
3903:
3899:
3895:
3888:
3886:
3884:
3880:
3875:
3871:
3865:
3862:
3857:
3853:
3848:
3843:
3839:
3835:
3831:
3827:
3823:
3816:
3813:
3802:
3798:
3791:
3788:
3783:
3777:
3774:
3769:
3765:
3760:
3755:
3751:
3747:
3746:Fertil Steril
3743:
3736:
3733:
3728:
3724:
3719:
3714:
3710:
3706:
3702:
3695:
3692:
3687:
3683:
3679:
3675:
3671:
3667:
3663:
3659:
3652:
3649:
3644:
3640:
3635:
3630:
3626:
3622:
3621:Fertil Steril
3618:
3611:
3608:
3603:
3599:
3594:
3589:
3586:(5): 1404–9.
3585:
3581:
3580:Fertil Steril
3577:
3570:
3567:
3562:
3558:
3553:
3548:
3545:(5): 421–32.
3544:
3540:
3536:
3529:
3526:
3521:
3517:
3513:
3509:
3505:
3501:
3498:(2): 177–81.
3497:
3493:
3486:
3483:
3478:
3474:
3470:
3466:
3462:
3458:
3455:(8): 655–63.
3454:
3450:
3443:
3440:
3435:
3431:
3426:
3421:
3416:
3411:
3407:
3403:
3399:
3392:
3389:
3384:
3380:
3376:
3372:
3369:(4): 655–76.
3368:
3364:
3357:
3355:
3353:
3351:
3349:
3347:
3343:
3338:
3334:
3330:
3326:
3322:
3318:
3317:Contraception
3311:
3308:
3297:
3293:
3286:
3284:
3280:
3275:
3271:
3266:
3261:
3257:
3253:
3249:
3245:
3241:
3234:
3231:
3226:
3220:
3212:
3208:
3203:
3198:
3194:
3190:
3186:
3182:
3178:
3171:
3168:
3162:
3158:
3151:
3148:
3137:
3133:
3127:
3124:
3119:
3115:
3111:
3107:
3103:
3099:
3095:
3091:
3083:
3081:
3079:
3075:
3070:
3066:
3061:
3056:
3052:
3048:
3041:
3038:
3033:
3029:
3024:
3019:
3015:
3011:
3007:
3003:
2999:
2992:
2990:
2988:
2986:
2984:
2980:
2975:
2971:
2967:
2963:
2959:
2955:
2951:
2947:
2943:
2937:
2934:
2929:
2925:
2921:
2917:
2913:
2909:
2905:
2901:
2894:
2891:
2886:
2882:
2877:
2872:
2868:
2864:
2860:
2856:
2852:
2845:
2843:
2839:
2834:
2830:
2825:
2820:
2816:
2812:
2808:
2801:
2798:
2793:
2789:
2785:
2781:
2777:
2773:
2766:
2763:
2758:
2754:
2750:
2746:
2741:
2736:
2732:
2728:
2724:
2720:
2716:
2709:
2706:
2701:
2695:
2693:
2689:
2677:
2676:
2668:
2662:
2659:
2654:
2650:
2646:
2642:
2638:
2634:
2627:
2624:
2619:
2615:
2610:
2605:
2600:
2595:
2591:
2587:
2583:
2576:
2573:
2568:
2562:
2558:
2557:
2549:
2546:
2541:
2537:
2533:
2529:
2525:
2521:
2516:
2511:
2507:
2503:
2499:
2492:
2489:
2484:
2480:
2476:
2470:
2468:
2464:
2459:
2455:
2451:
2447:
2443:
2439:
2435:
2431:
2424:
2421:
2410:on 2012-02-24
2409:
2405:
2399:
2396:
2391:
2387:
2382:
2377:
2373:
2369:
2366:(1): 95–106.
2365:
2361:
2357:
2350:
2347:
2342:
2338:
2333:
2328:
2325:(6): 1865–9.
2324:
2320:
2316:
2309:
2306:
2301:
2297:
2292:
2287:
2282:
2277:
2273:
2269:
2265:
2261:
2257:
2250:
2247:
2242:
2238:
2234:
2230:
2225:
2220:
2216:
2212:
2208:
2201:
2198:
2192:
2187:
2183:
2179:
2175:
2168:
2165:
2160:
2156:
2150:
2147:
2143:
2142:
2137:
2132:
2130:
2126:
2121:
2117:
2113:
2109:
2105:
2101:
2098:(4): 569–79.
2097:
2093:
2086:
2084:
2082:
2080:
2078:
2076:
2074:
2072:
2070:
2068:
2064:
2059:
2055:
2050:
2045:
2041:
2037:
2034:(3): 309–33.
2033:
2029:
2025:
2018:
2015:
2012:
2008:
2005:
2003:
1996:
1994:
1992:
1990:
1988:
1984:
1973:
1969:
1963:
1960:
1955:
1949:
1945:
1944:
1936:
1933:
1928:
1924:
1919:
1914:
1909:
1904:
1900:
1896:
1892:
1885:
1883:
1881:
1879:
1877:
1873:
1868:
1864:
1860:
1856:
1852:
1848:
1844:
1840:
1833:
1831:
1827:
1822:
1818:
1813:
1808:
1804:
1800:
1796:
1792:
1788:
1781:
1779:
1775:
1770:
1766:
1761:
1760:11365/1031597
1756:
1752:
1748:
1744:
1740:
1733:
1730:
1719:
1713:
1710:
1705:
1699:
1695:
1688:
1685:
1672:
1668:
1664:
1658:
1656:
1654:
1652:
1650:
1648:
1646:
1644:
1642:
1640:
1638:
1636:
1634:
1632:
1630:
1628:
1626:
1624:
1622:
1620:
1618:
1616:
1614:
1612:
1610:
1608:
1606:
1604:
1602:
1600:
1598:
1596:
1594:
1592:
1590:
1588:
1586:
1582:
1575:
1570:
1568:
1566:
1561:
1557:
1553:
1546:
1544:
1542:
1535:Other animals
1534:
1532:
1529:
1525:
1521:
1514:United States
1513:
1508:
1506:
1504:
1500:
1495:
1493:
1486:United States
1485:
1483:
1477:
1475:
1472:
1463:
1461:
1459:
1454:
1448:
1446:
1444:
1440:
1436:
1428:
1426:
1424:
1420:
1416:
1412:
1410:
1405:
1398:
1396:
1394:
1387:
1385:
1383:
1376:
1374:
1367:
1363:
1359:
1358:
1353:
1350:
1345:
1344:
1339:
1336:
1332:
1330:
1324:
1323:
1322:hysteroscopic
1318:
1317:
1316:
1313:
1307:
1302:
1296:
1291:
1285:
1280:
1273:
1271:
1268:
1263:
1259:
1257:
1253:
1246:
1244:
1242:
1241:endometriosis
1237:
1233:
1230:
1226:
1222:
1220:
1216:
1212:
1208:
1203:
1198:
1194:
1191:
1187:
1185:
1181:
1177:
1173:
1169:
1165:
1163:
1159:
1157:
1153:
1149:
1145:
1143:
1135:
1133:
1129:
1127:
1120:
1117:
1115:
1112:
1110:
1106:
1103:
1100:
1097:
1094:
1093:
1092:
1089:
1083:
1081:
1079:
1075:
1070:
1068:
1064:
1063:endometriosis
1060:
1056:
1052:
1048:
1040:
1038:
1036:
1033:staining for
1032:
1023:
1019:
1013:
1008:
1004:
997:
992:
988:
982:
977:
970:
965:
958:
953:
946:
941:
934:
929:
925:
918:
913:
906:
901:
898:
891:
886:
883:as seen on CT
882:
875:
870:
868:
864:
857:
855:
853:
849:
845:
841:
836:
834:
829:
827:
823:
817:
814:
813:endometriosis
808:
806:
802:
798:
794:
790:
786:
782:
778:
774:
770:
766:
762:
758:
754:
750:
746:
741:
739:
735:
731:
727:
723:
719:
718:xenoestrogens
714:
712:
708:
704:
700:
697:Fibroids are
691:
683:
675:
668:
662:
659:
655:
652:
648:
645:
644:
643:
640:
636:
634:
625:
623:
621:
616:
612:
606:
603:
600:
597:
594:
591:
588:
585:
582:
581:
580:
579:
570:
566:
562:
558:
555:
552:
548:
545:
542:
539:
535:
532:
531:
530:
521:
514:
512:
508:
506:
497:
496:H&E stain
493:
489:
485:
483:
474:
467:
465:
463:
459:
455:
451:
447:
441:
433:
431:
429:
420:
418:
411:
409:
402:
400:
398:
392:
390:
386:
382:
373:
371:
369:
365:
364:United States
361:
355:
353:
349:
345:
341:
337:
333:
329:
325:
320:
318:
314:
310:
306:
302:
297:
295:
291:
287:
283:
279:
275:
274:heavy periods
271:
267:
263:
259:
255:
251:
247:
238:
234:
231:
227:
225:
221:
218:
214:
210:
206:
203:
201:
197:
194:
190:
186:
183:
179:
175:
171:
168:
166:
162:
159:
155:
152:
150:
146:
143:
139:
135:
133:
129:
125:
121:
117:
113:
110:
107:
105:
104:Complications
101:
98:
97:heavy periods
94:
91:
89:
85:
82:
79:
77:
73:
70:
65:
61:
56:
52:
48:
43:
35:
30:
19:
18:Uterine myoma
5105:
4999:Dysgerminoma
4775:
4764:
4753:
4729:
4718:
4707:
4692:
4677:
4627:
4623:
4613:
4595:
4583:. Retrieved
4574:
4552:the original
4542:
4530:. Retrieved
4521:
4512:
4500:. Retrieved
4491:
4482:
4445:
4441:
4431:
4404:
4400:
4390:
4355:
4351:
4341:
4330:. Retrieved
4316:
4307:
4297:
4272:
4263:
4220:
4216:
4206:
4169:
4165:
4155:
4130:
4126:
4120:
4085:
4081:
4071:
4057:
4024:
4020:
4014:
3987:
3983:
3973:
3946:
3942:
3932:
3897:
3864:
3829:
3825:
3815:
3804:. Retrieved
3800:
3790:
3776:
3749:
3745:
3735:
3708:
3704:
3694:
3661:
3657:
3651:
3624:
3620:
3610:
3583:
3579:
3569:
3542:
3539:N Engl J Med
3538:
3528:
3495:
3491:
3485:
3452:
3448:
3442:
3405:
3401:
3391:
3366:
3362:
3323:(1): 41–55.
3320:
3316:
3310:
3299:. Retrieved
3295:
3247:
3243:
3233:
3219:cite journal
3184:
3180:
3170:
3160:
3150:
3139:. Retrieved
3135:
3126:
3093:
3089:
3050:
3040:
3005:
3001:
2949:
2945:
2936:
2906:(1): 51–60.
2903:
2899:
2893:
2858:
2854:
2814:
2810:
2800:
2775:
2771:
2765:
2722:
2718:
2708:
2699:
2679:. Retrieved
2673:
2661:
2636:
2632:
2626:
2589:
2585:
2575:
2555:
2548:
2505:
2501:
2491:
2478:
2433:
2429:
2423:
2412:. Retrieved
2408:the original
2398:
2363:
2359:
2349:
2322:
2318:
2308:
2263:
2259:
2249:
2214:
2210:
2200:
2184:(1): 33–42.
2181:
2177:
2167:
2149:
2139:
2095:
2091:
2031:
2027:
2017:
2001:
1975:. Retrieved
1971:
1962:
1942:
1935:
1898:
1894:
1842:
1838:
1794:
1790:
1742:
1738:
1732:
1721:. Retrieved
1712:
1693:
1687:
1675:. Retrieved
1666:
1550:
1538:
1528:hysterectomy
1517:
1496:
1489:
1481:
1467:
1464:Epidemiology
1455:
1452:
1432:
1413:
1402:
1391:
1382:Hysterectomy
1380:
1377:Hysterectomy
1371:
1365:
1361:
1355:
1343:laparoscopic
1341:
1326:
1320:
1314:
1310:
1284:hysteroscopy
1264:
1260:
1250:
1234:
1229:mifepristone
1225:Progesterone
1223:
1215:progestogens
1202:osteoporosis
1195:
1188:
1166:
1160:
1146:
1139:
1130:
1123:
1114:hysterectomy
1090:
1087:
1071:
1055:constipation
1044:
1028:
865:
861:
837:
830:
818:
809:
742:
734:hypertension
715:
696:
669:Pathogenesis
641:
637:
629:
619:
617:
613:
610:
574:
556:
546:
540:
533:
527:
509:
501:
479:
458:chromosome 1
444:A syndrome (
443:
424:
415:
406:
403:Risk factors
393:
387:, bleeding,
377:
356:
321:
298:
280:, causing a
253:
249:
245:
244:
178:ovarian cyst
132:Risk factors
29:
5126:Endometrium
4755:MedlinePlus
4624:Vet. Pathol
4407:(1): 22–9.
3492:Climacteric
3408:: 293–302.
3008:(1): 1–12.
2681:23 December
2609:10447/77912
2508:(1): 3–13.
2479:NHS Choices
2266:(1): 1015.
2092:Nutr Cancer
1357:laparotomic
1256:miscarriage
1162:Cabergoline
1067:Adenomyosis
705:detectable
551:infertility
505:mitotically
385:miscarriage
332:paracetamol
307:and eating
209:paracetamol
115:Usual onset
109:Infertility
50:Other names
5331:Categories
5116:Adenomyoma
5098:Myometrium
4777:Patient UK
4731:DiseasesDB
4332:2008-05-26
3806:2021-03-17
3301:2022-12-11
3141:2022-10-08
2475:"Fibroids"
2414:2012-04-09
1977:2022-10-08
1745:: 85–103.
1723:2018-11-07
1576:References
1560:asoprisnil
1554:, such as
1541:grey seals
1449:Metastasis
1419:ultrasound
1335:endoscopic
1274:Myomectomy
1211:raloxifene
1136:Medication
1105:myomectomy
1080:syndrome.
924:myometrium
897:ultrasound
840:stem cells
785:PPAR-gamma
699:monoclonal
492:Micrograph
326:, such as
200:Medication
81:Gynecology
4991:Germ cell
4771:radio/777
4766:eMedicine
4289:262209805
4255:256325720
4239:1470-0328
3118:248725335
2928:260319833
2540:205260568
2524:1879-3479
1565:vitamin D
1503:vitamin D
1471:menopause
1443:leiomyoma
1439:menopause
1429:Prognosis
1366:abdominal
1349:morbidity
1331:resection
1176:apoptosis
1156:progestin
1084:Treatment
1035:β-catenin
1029:Negative
1022:β-catenin
858:Diagnosis
797:TNF-alpha
769:TGF-beta1
757:prolactin
753:cytokines
745:mitogenic
664:benignly.
633:leiomyoma
482:leiomyoma
381:pregnancy
360:menopause
348:Cancerous
328:ibuprofen
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