Grigoriadis C, Papaconstantinou E, Mellou A, Hassiakos D, Liapis A, Kondi-Pafiti A
2nd Department of Obstetrics-Gynecology Aretaieion Hospital, University of Athens, Medical School, Athens, Greece.
Clin Exp Obstet Gynecol. 2012;39(2):191-4.
Gonadotrophin-releasing hormone agonist (GnRHa) has been commonly used for the medical treatment of prostate cancer, precocious puberty, endometriosis, adenomyosis and uterine leiomyomas. GnRHa therapy in cases of symptomatic uterine leiomyomas aims for the reduction of their size and remission of symptoms such as menometrorrhagia, causing a state of hypoestrogenemia. This is considered to be a helpful preoperative strategy in cases of large myomas, or anemia because of abnormal vaginal bleeding. The aim of this retrospective study was to examine the clinicopathological changes in uterine leiomyomas exposed to preoperative GnRHa therapy for two up to six months.
The study group consisted of 10 premenopausal patients who were treated with GnRHa prior to surgery.
In all cases the size of leiomyomas was reduced after GnRHa therapy. A microscopic review of the surgical specimens showed increased cellularity and ischemic type of necrosis.
Morphological changes of uterine leiomyomas are often associated with preoperative GnRH agonist therapy. The differential diagnosis from uterine leiomyosarcomas includes absence of mitotic activity.
促性腺激素释放激素激动剂（GnRHa）已普遍用于前列腺癌、性早熟、子宫内膜异位症、子宫腺肌病和子宫肌瘤的医学治疗。对有症状的子宫肌瘤进行GnRHa治疗旨在缩小其大小并缓解诸如月经过多等症状，从而导致低雌激素血症状态。这被认为是大肌瘤或因异常阴道出血导致贫血病例中的一种有用的术前策略。这项回顾性研究的目的是检查术前接受GnRHa治疗两至六个月的子宫肌瘤的临床病理变化。
研究组由10名术前接受GnRHa治疗的绝经前患者组成。
所有病例中，GnRHa治疗后肌瘤大小均减小。对手术标本的显微镜检查显示细胞增多和缺血性坏死类型。
子宫肌瘤的形态学变化常与术前GnRH激动剂治疗相关。与子宫平滑肌肉瘤的鉴别诊断包括无有丝分裂活性。
