Leiomyoma: Difference between revisions

Jump to navigation Jump to search
Line 29: Line 29:


==Causes==
==Causes==
* [Disease name] may be caused by either [cause1], [cause2], or cause3].
* Chromosome aberrations such as t(12;14)(q14-q15;q23–24), del(7)(q22q32), rearrangements involving 6p21, 10q, trisomy 12, and deletions of 1p3q has been associated with the development of leiomyoma.
* [Disease name] is caused by a mutation in the [gene1], [gene2], or [gene3] gene[s].
 
* There are no established causes for [disease name].
==Differentiating [disease name] from other Diseases==
==Differentiating [disease name] from other Diseases==
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:

Revision as of 19:27, 19 April 2016

WikiDoc Resources for Leiomyoma

Articles

Most recent articles on Leiomyoma

Most cited articles on Leiomyoma

Review articles on Leiomyoma

Articles on Leiomyoma in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Leiomyoma

Images of Leiomyoma

Photos of Leiomyoma

Podcasts & MP3s on Leiomyoma

Videos on Leiomyoma

Evidence Based Medicine

Cochrane Collaboration on Leiomyoma

Bandolier on Leiomyoma

TRIP on Leiomyoma

Clinical Trials

Ongoing Trials on Leiomyoma at Clinical Trials.gov

Trial results on Leiomyoma

Clinical Trials on Leiomyoma at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Leiomyoma

NICE Guidance on Leiomyoma

NHS PRODIGY Guidance

FDA on Leiomyoma

CDC on Leiomyoma

Books

Books on Leiomyoma

News

Leiomyoma in the news

Be alerted to news on Leiomyoma

News trends on Leiomyoma

Commentary

Blogs on Leiomyoma

Definitions

Definitions of Leiomyoma

Patient Resources / Community

Patient resources on Leiomyoma

Discussion groups on Leiomyoma

Patient Handouts on Leiomyoma

Directions to Hospitals Treating Leiomyoma

Risk calculators and risk factors for Leiomyoma

Healthcare Provider Resources

Symptoms of Leiomyoma

Causes & Risk Factors for Leiomyoma

Diagnostic studies for Leiomyoma

Treatment of Leiomyoma

Continuing Medical Education (CME)

CME Programs on Leiomyoma

International

Leiomyoma en Espanol

Leiomyoma en Francais

Business

Leiomyoma in the Marketplace

Patents on Leiomyoma

Experimental / Informatics

List of terms related to Leiomyoma

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Synonyms and keywords:

Overview

Historical Perspective

  • Leiomyoma was first discovered by Hippocrates, a greek physician also called as father of modern medicine in 460-375 B.C and called it “uterine stone”.
  • In the second centruary of Christian era, Galen described the lesion as "scleromas".[1]
  • In 1860 and 1863, Rokitansky and Klob coined the term fibroid.
  • In 1854, Virchow a German pathologist demonstrated that those tumors originated from the uterine smooth muscle. Thus, the term "myoma" became current in clinical use.
  • In 1809, the first laparotomy consequent to myoma indication was conducted by Ephraim McDowell to treat Leiomyoma in Danville, USA.
  • The first successful myomectomy was performed by Amussat in 1840, after a clinical diagnosis of ovarian tumor because pelvic examination showed a pediculate and large uterine leiomyoma.
  • The first scientific report of a uterus conserving myomectomy through the vagina appeared in 1845 in the American Journal of the Medical Science, accomplished by Washington Atlee, in Pennsylvania.
  • In 1898, Alexander Adam presented 11 cases of myomectomy through an abdominal route, in Liverpool.
  • In 1940, Carlos R. Círio proposed a technique of the myometrium emptying, called myometrectomy.

Classification

  • Leiomyoma may be classified according to their location into 3 subtypes:

Pathophysiology

  • The pathogenesis of leiomyoma is characterized by benign smooth muscle neoplasm.
  • The chromosome aberrations such as t(12;14)(q14-q15;q23–24), del(7)(q22q32), rearrangements involving 6p21, 10q, trisomy 12, and deletions of 1p3q has been associated with the development of leiomyoma.
  • On gross pathology, round, well circumscribed (but not encapsulated), solid nodules that are white or tan, and whorled are characteristic findings of leiomyoma .
  • On microscopic histopathological analysis, elongated, spindle-shaped cells with a cigar-shaped nucleus are characteristic findings of leiomyoma.

Causes

  • Chromosome aberrations such as t(12;14)(q14-q15;q23–24), del(7)(q22q32), rearrangements involving 6p21, 10q, trisomy 12, and deletions of 1p3q has been associated with the development of leiomyoma.

Differentiating [disease name] from other Diseases

  • [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
  • [Differential dx1]
  • [Differential dx2]
  • [Differential dx3]

Epidemiology and Demographics

  • The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
  • In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

  • Patients of all age groups may develop [disease name].
  • [Disease name] is more commonly observed among patients aged [age range] years old.
  • [Disease name] is more commonly observed among [elderly patients/young patients/children].

Gender

  • [Disease name] affects men and women equally.
  • [Gender 1] are more commonly affected with [disease name] than [gender 2].
  • The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.

Race

  • There is no racial predilection for [disease name].
  • [Disease name] usually affects individuals of the [race 1] race.
  • [Race 2] individuals are less likely to develop [disease name].

Risk Factors

  • Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

Natural History, Complications and Prognosis

  • The majority of patients with [disease name] remain asymptomatic for [duration/years].
  • Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
  • If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is pproximately [#%].

Diagnosis

Diagnostic Criteria

  • The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

Symptoms

  • [Disease name] is usually asymptomatic.
  • Symptoms of [disease name] may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with [disease name] usually appear [general appearance].
  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with [disease name].
  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
  • Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings

  • There are no [imaging study] findings associated with [disease name].
  • [Imaging study 1] is the imaging modality of choice for [disease name].
  • On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
  • [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

  • [Disease name] may also be diagnosed using [diagnostic study name].
  • Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

  • There is no treatment for [disease name]; the mainstay of therapy is supportive care.
  • The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
  • [Medical therapy 1] acts by [mechanism of action1].
  • Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

  • Surgery is the mainstay of therapy for [disease name].
  • [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
  • [Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

  • There are no primary preventive measures available for [disease name].
  • Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
  • Once diagnosed and successfully treated, patients with [disease name] are followedup every [duration]. Followup testing includes [test 1], [test 2], and [test 3].

References

  1. Bozini, Nilo; Baracat, Edmund C (2007). "The history of myomectomy at the Medical School of University of São Paulo". Clinics. 62 (3). doi:10.1590/S1807-59322007000300002. ISSN 1807-5932.