Clinicomorphological Study of Leiomyoma Associated Endometrial Changes in Correlation with LMP: In a Tertiary Care Hospital in Rural Tamil Nadu

Introduction: Leiomyomas are benign smooth muscle tumors. They are the single most common cause for hysterectomy in the reproductive and peri-menopausal age group associated with abnormal uterine bleeding. There are certain endometrial changes with leiomoyomas due to hormonal and mechanical influences of the leiomyomas. Aim: To study the incidence of leiomyomas of uterus in a rural area of Tamil Nadu and the endometrial changes associated with it correlating it to the LMP, in hysterectomy specimens. Materials and Methods: This is a retrospective study of three hundred thirty one patients who underwent hysterectomy for uterine leiomyoma between 2013 and 2015, histopathological analysis of the cases for endometrial changes was done. Results: A total of 331 hysterectomy specimens done for leiomyomas were studied. The most common age group was observed as 41-50 years (56.50%). Multiparous women (94.86%) are more commonly affected. Menorrhagia was the most common symptom seen in 46.53%. Majority of the cases had a single leiomyoma (59.82%). The most common location was intramural (49.85%). The most common degenerative change associated with a leiomyoma was hyaline change (23.87%). The most common type of endometrium was proliferative endometrium observed in 44.41%. The percentage of mailignacy associated with a leiomyoma was 0.60%. Conclusion: Leiomyomas are the most common causes for hysterectomy. The associated endometrial change is proliferative in nature suggesting the role of harmones such as oestrogen and progesterone on the leiomyoma and simultaneously on the corresponding endometrium.