Leiomyoma pseudocapsule after pre-surgical treatment with gonadotropin-releasing hormone agonists: relationship between clinical features and immunohistochemical changes.
OBJECTIVE
To evaluate if pre-operative GnRH-a modify uterine leiomyoma pseudocapsule and the possible clinical effects of these changes.


METHODS
The study was performed at the University Federico II of Naples on 33 premenopausal patients submitted to laparotomic myomectomy after treatment with triptorelin depot. 29 untreated patients formed the control group. The operating time, the intraoperative bleeding and the prompt identification of the cleavage plan between myoma and myometrium were evaluated. The pseudocapsule features and the immunoexpression of PCNA and CD34 in this area were studied.


RESULTS
Treated patients showed lower blood loss and not clearly identifiable cleavage plan, but without any significant increase in the operating time. Treated lesions showed less evident border between myoma and myometrium and lower PCNA and CD34 pseudocapsule immunoexpression than untreated ones.


CONCLUSIONS
We propose the changes of leiomyoma pseudocapsule as partial explanations of the reported clinical and surgical findings after pre-operative GnRH-a.
De Falco
Marianna
M
Department of Obstetrical-Gynaecological and Urological Science and Reproductive Medicine, University "Federico II" of Naples, Italy.
Staibano
Stefania
S
Mascolo
Massimo
M
Mignogna
Chiara
C
Improda
Luigi
L
Ciociola
Francesca
F
Carbone
Ilma F
IF
Di Lieto
Andrea
A
D000328:Adult; D018952:Antigens, CD34 / Q000378:metabolism; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D049109:Cell Proliferation / Q000187:drug effects; D003692:Delayed-Action Preparations; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007889:Leiomyoma / Q000098:blood supply / Q000188:drug therapy* / Q000601:surgery*; D009215:Myometrium / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D009389:Neovascularization, Pathologic / Q000188:drug therapy; D011300:Preoperative Care / Q000379:methods*; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D017329:Triptorelin Pamoate / Q000494:pharmacology / Q000627:therapeutic use*; D014594:Uterine Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000601:surgery*
D018952:Antigens, CD34; D018931:Antineoplastic Agents, Hormonal; D003692:Delayed-Action Preparations; D018809:Proliferating Cell Nuclear Antigen; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone