Abstract
From the histopathological and clinical point of view, tumors of the smooth muscle of the uterine wall form a disparate group. The most common diagnosis of the group is leiomyoma, the malignant variant is leiomyosarcoma.
At the border of these two diagnoses in terms of biological behavior is a group of tumors of unclear biological behavior to borderline malignancy. Currently, about 40% of hysterectomies for uterine fibroids are indicated.
Uterine leiomyomas are a benign, very widespread finding, they are found histopathologically in 70-75% of preparations after hysterectomies. Leiomyomas can be asymptomatic, clinical manifestations can be very diverse - metrorrhagia and abnormal uterine bleeding, pelvic pain, symptoms caused by pelvic resistance, fertility disorders.
The treatment is either conservative (analgesics, hormonal treatment of metrorrhagia, GnRH analogues, LH-RH), surgical treatment is still standard (laparoscopic or laparotomy myomectomy, hysteroscopic transcervical ablation of the fibroid, hysterectomy of various techniques). Embolization of uterine arteries (EUA) is becoming an alternative to the surgical treatment of uterine leiomyomas.