00:01
Another benign condition,
apart from the
endometrial polyp,
would be something
called a leiomyoma.
00:08
A leiomyoma is a
smooth muscle tumor
that is of absolutely
benign nature
that occurs in a reproductive
age of a female,
usually young African American,
but very much could be a
Caucasian lady as well.
00:20
The most common tumor in women
is estrogen responsive.
00:24
What does that mean to you?
It means that every time that
she’s having her menstrual cycle
and/or she is pregnant.
00:32
And if she’s pregnant, there’s
obviously increased estrogen and
you’ll find the size of the tumor
that then increases.
00:38
That becomes important.
00:40
Leiomyoma, a fibroid.
00:42
It presents with
abnormal bleeding
and what may then
happen with the fibroid
is the fact that it might
then cause compression
of the adjacent structures.
00:50
You want to keep in mind, bladder
and may result in infertility,
which is unfortunate
for a young lady.
00:57
A leiomyoma.
00:59
There are different
locations of leiomyoma.
01:01
You can have something
called pedunculated
and that would be on the
superficial side, pedunculated.
01:06
Or you could have one
that’s subserosal,
meaning to say right underneath
the serosa of your uterus.
01:13
You can have one that is
intramural, meaning the wall.
01:17
And you can have ones
that are submucosal.
01:21
Leiomyoma.
01:23
Look at this.
01:24
Well circumscribed, white tumor,
bulging into endometrial cavity.
01:30
That’s what this looks
like with the leiomyoma.
01:36
Next topic is the
leiomyosarcoma.
01:38
What does this mean to you?
This did not come
from leiomyoma.
01:43
It arose, as you
shall see, de novo.
01:47
For the most part, as far
as you’re concerned,
it never comes from a leiomyoma.
01:51
It’s a malignant tumor
of smooth muscle
that will then invade
the uterine wall.
01:56
Arises de novo.
01:57
What does that mean?
It did not come from leiomyoma.
02:01
It started of its own.
02:04
Clinical features here,
the peak incidence will be
between 40 to 60 years of age.
02:11
Leiomyoma versus a
leiomyosarcoma.
02:14
On your left, you end
up finding a picture
in which it’s well-encapsulated
and well-differentiated.
02:19
Where on the right you end
up finding leiomyosarcoma,
where it’s completely
increased proliferation and
you cannot make
out a darn thing.
02:28
Remember please that one leiomyoma
did not give rise to leiomyosarcoma.
02:33
Leiomyosarcoma obviously is the
malignant smooth muscle tumor
that will then invade
the leiomyoma.
02:40
Let me repeat once again,
you can have that’s pedunculated
or it should be in the
surface of the uterus.
02:46
You can have one
that is subserosal,
which is just
underneath the serosa.
02:50
You can have one
that’s in the mall –
wall, excuse me, that
is called intramural
and then you can have
one that’s submucosal,
meaning to say it’s closer
to the uterine cavity.
03:00
Different locations
of leiomyoma:
From the surface of the uterus,
all the way through the
wall and into the cavity.
03:07
Leiomyoma is definitely something
that you very much need to know,
a very common cause
in a young lady
who is going to be suffering from
dysfunctional uterine bleeding
and lots of pain, lots of pain.
03:18
Well-encapsulated.