Centini Gabriele, Cannoni Alberto, Ginetti Alessandro, Colombi Irene, Giorgi Matteo, Schettini Giorgia, Martire Francesco Giuseppe, Lazzeri Lucia, Zupi Errico
Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy.
Diagnostics (Basel). 2024 Sep 14;14(18):2046. doi: 10.3390/diagnostics14182046.
Uterine leiomyomas are the most common benign uterine tumors in women and are often asymptomatic, with clinical manifestation occurring in 20-25% of cases. The diagnostic pathway begins with clinical suspicion and includes an ultrasound examination, diagnostic hysteroscopy, and, when deemed necessary, magnetic resonance imaging. The decision-making process should consider the impairment of quality of life due to symptoms, reproductive desire, suspicion of malignancy, and, of course, the woman's preferences. Despite the absence of a definitive cure, the management of fibroid-related symptoms can benefit from various medical therapies, ranging from symptomatic treatments to the latest hormonal drugs aimed at reducing the clinical impact of fibroids on women's well-being. When medical therapy is not a definitive solution for a patient, it can be used as a bridge to prepare the patient for surgery. Surgical approaches continue to play a crucial role in the treatment of fibroids, as the gynecologist has the opportunity to choose from various surgical options and tailor the intervention to the patient's needs. This review aims to summarize the clinical pathway necessary for the diagnostic assessment of a patient with uterine fibromatosis, presenting all available treatment options to address the needs of different types of women.
子宫平滑肌瘤是女性最常见的良性子宫肿瘤，通常无症状，仅20% - 25%的病例会出现临床表现。诊断流程始于临床怀疑，包括超声检查、诊断性宫腔镜检查，必要时还包括磁共振成像。决策过程应考虑症状对生活质量的损害、生育意愿、恶性肿瘤怀疑，当然还有患者的偏好。尽管尚无根治方法，但子宫肌瘤相关症状的管理可受益于各种医学疗法，从对症治疗到旨在减轻肌瘤对女性健康临床影响的最新激素药物。当医学治疗对患者并非最终解决方案时，它可作为桥梁为手术做准备。手术方法在肌瘤治疗中仍起着关键作用，因为妇科医生有机会从各种手术选择中进行挑选，并根据患者需求调整干预措施。本综述旨在总结子宫纤维瘤病患者诊断评估所需的临床路径，呈现所有可用治疗方案以满足不同类型女性的需求。
