Definition:

Myoma is a benign growth of smooth muscle in the wall of the uterus.

Description:

A Myoma is a solid tumor made of fibrous tissue; hence it is often called a “fibroid”

tumor. Myomas vary in size and number, are most often slow- growing and usually cause no

symptoms. Myomas that do not produce symptoms do not need to be treated. Approximately

25% of myomas will cause symptoms and need medical treatment.

Myomas may grow a single nodule or in a clusters and many range in size from 1mm to

more than 20cm in diameter. Myomas are the most frequently diagnosed tumor of the female

pelvis and the most common reason for a woman to have a hysterectomy. Although they are

often referred to as tumors, they are not cancerous.

The cause of myoma has not actually been determined, but most myomas develop in woman

during their reproductive years. Myomas do not develop before the body begins producing

estrogen. Myomas tend to grow very quickly during pregnancy when the body is producing

extra estrogen. Once menopause has begun, myomas generally stop growing and can begin to

shrink due to the loss of estrogen.

About Uterine Fibroids

Uterine fibroids (also referred to as myoma, leimyoma, leiomyomata, and fibromyoma)

are benign (non-cancerous) tumors that grow within the muscle tissue of the uterus. Between 20-

50% of woman of childbearing age have uterine fibroids. While many women do not experience

any problems, symptoms can be severe enough to require treatment.

Fibrous ranges in size from very small (coined-shaped) to larger than a melon. A very large

uterine fibroid can cause the uterus to expand to the size of a six or seven-month pregnancy.

There can be either be one dominant fibroid or a cluster of many small fibroids.

There are four primary types of uterine fibroids, classified primarily according to location in the

uterus.

Figure 1.1

Subserosal uterine fibroids These fibroids develop in the outer portion of the uterus and

continue to grow outward.

Intramural uterine fibroids

The most common type of fibroid. These develop within the uterine

wall and expand making the uterus fell larger than normal(which

may cause “bulk symptoms”).

Submucosal uterine fibroid

These fibroid develop just under the lining of the uterine cavity.

These are the fibroids that can have the most effect on heavy

menstrual bleeding and the ones that can cause problems with

infertility and miscarriage.

Pedunculated Fibrous that grows on a small stalk that connects them to the inner

or outer wall of the uterus.

Etiology

The cause of fibroids is incompletely understood. It is known that each tumor result from

an original single muscle cell. Each individual uterine myoma is monoclonal. Cytogenetic

analysis has demonstrated multiple chromosomal abnormalities. Pathologists have two different

theories as to the cell of origin of this smooth muscle tumor. One hypothesis proposes that the

cell of origin is from persistent, small, embryonic cell rests, whereas the other theories proposes

that myomas originate from the smooth muscle of blood vessels. However, their development

seems to be associated with the female hormone, estrogen. Fibroids appear during childbearing

years when a woman’s estrogen levels are high.

Myoma has no known cause. Doctors believe that it is cause by hormones that it became

hardened due to misuse. Ladies should exercise daily to burn this hormone.

Risk Factors

A number of factors increase the risk of developing a fibroid. Not all people with risk factors

will develop a fibroid. Risk factors include:

African American ethnicity

High weight of obesity

No history of giving birth

Symptoms

You may experience fibrous symptoms daily or only occasionally. Any of these symptoms

can be severe:

Abdominal, pelvic, or lower back pain that can be severe.

Abdominal pressure.

Abdominal swelling, distension or bloating.

Heavy bleeding during menstrual period (menorrhagia)

Longer than normal menstrual periods

Pain during sexual intercourse

Urgent need to urinate

Vaginal bleeding between menstrual periods

Treatment

Treatment for fibroids(myoma) begins with seeking medical care from your health care

provider. To determine whether you have fibroids, your health care provider will ask you to

undergo diagnostic testing.

Some women with fibroids never have any symptoms. When symptoms do occur,

however, you may be asked to undergo a pelvic examination and an abdominal ultrasound to

determine the size and location of the fibroid. If it is deemed medically necessary, such as when

the fibroid continuous to grow and you experience pain or abdominal bleeding, you health care

provider will determine the most appropriate treatment for you based on your age and your

symptoms and the characteristics of the fibroids.

Option includes:

Hormones to regulate the menstrual cycle or to reduce symptoms such as oral

contraceptive pill

Hysterectomy (removal of the uterus)

Hysteroscopic removal of the uterine fibroids using a hysteroscope (instrument to

visualize the endometrial cavity)

Intrauterine device to release progestine within uterus to stop bleeding and pain

Myomectomy (surgical removal of the fibroids)

Pain control medications

Uterine artery embolization (procedure that interrupts the blood supply to fibroids)

CASE STUDY

Our patient resides at Sta. Cruz Ballesteros, Cagayan. She is 49 years old, a teacher in

profession and a mother of three children. She was diagnosed to have a Myoma when she was 33

years old. According to her, every time she has a menstrual period she experience pain, as days

goes by her abdomen is getting bigger as if she’s pregnant, his legs seems heavy and can hardly

breath.

As she experienced this kind of symptoms she urgently goes to consult a doctor. The

doctor recommended her to have an Ultrasound for further test and diagnosis. According to the

result of the Ultrasound a 3cm in diameter tumor has grown within the right side of the uterine

wall of her uterus, so the doctor advice and recommended her to take some pain reliever. For 7

years all she know that the tumor did not develop, but when she was 40 years old the tumor

rapidly grow so she went to the doctor for further analysis and the doctor recommend her to

undergo an operation. The process need to be done is called TAH-BSO or Total Abdominal

Hysterectomy and Bilateral Salpingo-Oopherectomy, which means the removal of the uterus

including cervix as well the tubes in the ovaries using incision in abdomen. The removed benign

tumor is as big as a fully grown fetus.

In God’s grace, the operation was successfully done. For good maintenance, she takes

dolfenal for pain control, calcium and vitamin E. In terms of food, she seldom eats salty dishes

and she only drinks distilled water. The doctor also recommends her not to perform heavy loads.

REFERNCES:

Books

Mishell, Stenchever, Droegemueller, Herbst- Comprehensive Gynecology, 5th Edition.

Internet

http://www.nichd.nih.gov/health/topics/uterine_fibroids.cfm

http://www.nichd.nih.gov/medicneplus/ency/article/000914.htm.