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Histologic features of uterine leiomyomata treated with microsphere embolization
Franz Fogt1, Nicolai Hinds, Robert L Zimmerman
1Department of Pathology, University of Pennsylvania, Presbyterian Medical Center, Philadelphia, Pennsylvania 19104, USA. fogt@mail.med.upenn.edu
Background:
Therapeutic embolization is a new treatment for symptomatic leiomyomata. Material available in the United States for uterine embolization includes precisely calibrated hydrophilic microporous microspheres made of a cross-linked acrylic copolymer.
Case:
A 42-year-old woman with a longstanding history of symptomatic leiomyomatous uterus underwent uterine artery embolization with microspheres. Because of continuous intractable pelvic pain, an abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. The gross and histologic findings included large amounts of microspheres and pus within the uterine cavity, infarcted leiomyomata with microspheres, and intravascular microspheres within hyalinized leiomyomas.
Conclusion:
Microsphere embolization leads to hyalinizing and ischemic necrosis with residual microsphere material in the myometrium, uterine cavity, fallopian tubes, and ovaries.