Ultrastructural comparison of uterine leiomyoma cells from the same myoma nodule before and after gonadotropin-releasing hormone agonist treatment.
OBJECTIVE
To compare ultrastructural features of leiomyoma cells from the same uterine myoma nodule before and after GnRH agonist (GnRH-a) treatment and to examine the relation between these ultrastructural changes and the extent of myoma volume reduction with GnRH-a treatment.


METHODS
Prospective clinical study.


METHODS
University teaching hospital.


METHODS
Twenty women with uterine leiomyomas who were scheduled for surgery.


METHODS
Transcervical needle biopsy of uterine myoma, s.c. leuprolide acetate injection (3.75 mg) at least three times every 4 weeks before surgery, and hysterectomy or myomectomy.


METHODS
The changes in ultrastructural features of uterine leiomyoma cells and the percentage decrease in the volume of the largest myoma at 12 weeks of GnRH-a treatment measured by magnetic resonance imaging.


RESULTS
A decrease in myofilaments, mitochondrial swelling, and emergence of the lysosomal body were observed in relation to GnRH-a treatment. Furthermore, a positive correlation was observed between the decrease in myofilaments and myoma shrinkage.


CONCLUSIONS
Cellular atrophy due to a decrease in myofilaments plays a major role in the reversible myoma shrinkage resulting from GnRH-a treatment.
Ito
F
F
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Kawamura
N
N
Ichimura
T
T
Tsujimura
A
A
Ishiko
O
O
Ogita
S
S
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007889:Leiomyoma / Q000188:drug therapy* / Q000473:pathology* / Q000648:ultrastructure; D008854:Microscopy, Electron; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000648:ultrastructure
D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone