Submucosal leiomyoma

Depending on their location, leiomyomas can be resected or enucleated using a hysteroscopic or laparoscopic access or open laparotomy. Hysteroscopic resection is suitable to remove submucosal leiomyomas. Hysteroscopic resection is generally considered unsuitable for submucosal leiomyomas larger than 5 cm in size, if more than three fibroids are present, or if the uterine cavity is very large (length of uterine probe > 12 cm). Moreover, the size of the intramural... 

The localization of leiomyomas by imaging is of clinical importance because symptoms are related to and treatment varies based on the position of a fibroid within the uterus. Whether a submucosal leiomyoma can be resected depends on its size and ingrowth into... 

Myometrial contractions can mimic submucosal leiomyomas or focal adenomyosis [193]. Uterine contractions involve the endo- and myometrium but... 

Both transvaginal ultrasound and MRI are reliable methods for identification of leiomyomas. Sonohys-terography can clearly demonstrate the relationship between the endometrium and submucosal leiomyomas and thus serves as an important adjunct to transvaginal US [39]. 

Another Japanese group used a system of 3D endoscopic ultrasonography to analyze the surface, the echo density, and the echo patterns of cross-sectional images of submucosal lesions. They evaluated the quality of the 3D image and cross-sectional images of lipomas, leiomyomas, and cysts. They stated that analysis of 3D EUS images was useful in making a... 

Leiomyomas originate within the uterine wall, but can extend into the uterine cavity from the submucosal surface (see Fig. 10.2.1) and into the abdominal cavity from the subserosal surface. Like... 

Fig. 10.2.1a,b. Sonographic appearance of a submucosal fibroid, a A well circumscribed hypoechoic round mass with some internal heterogeneity is characteristic of a leiomyoma, b Doppler can be used to show the hypervascularity of this benign tumor... 

Fibroid location within the uterus may correlate with outcome. Spies et al. [32] reported that smaller baseline leiomyoma size and submucosal location were more likely to result in a positive imaging outcome (Fig 10.4.2). Jha et al. [33] confirmed that... 

Magnetic resonance imaging (MRl) is the most accurate diagnostic modality for assessing uterine leiomyomas [37]. MRI enables assessment of the uterus in multiplanar orientation and without interference from superimposed structures. MRI provides not only accurate information on the number and size of fibroids but also on their location within the uterus (cervix, corpus, fundus) and within the wall (submucosal, intramural. 

Fig. 2.32a-c. Leiomyoma of the duodenum. Double Contrast barium study (a) shows a round well delineated non-ulcerated lesion in the second part of the duodenum, bordering the major papilla. Endoscopic-ultrasound (b) demonstrates the submucosal lesion, typical of a benign leiomyoma. A CT examination (c) of another patient demonstrates the typical smooth impression of a duodenal leiomyoma... 

Benign tumours of the oesophagus are incidental and rare findings of which leiomyomas are the most common. These submucosal lesions are usually situated in the proximal part of the oesophagus. In contrast to gastric leiomyomas, oesophageal ones rarely ulcerate. 

There are a variety of tumours which originate from supporting tissue components of the gastric wall, and which are mainly submucosal in distribution covered by normal mucosa. The most common are gastro-intestinal stromal tumours (GISTs) formerly known as leiomyomas and leiomyosarco-... 

Submucosal and extrinsic disease If the mucosa is uninterrupted then appreciation and diagnosis are difficult Leiomyomas, pseudodiverticulo-sis of the oesophagus... 

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