IMR Press / CEOG / Volume 46 / Issue 5 / DOI: 10.12891/ceog4974.2019

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research
Histological pattern of leiomyomas after ulipristal acetate treatment in women: a case-control study
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1 Department of Morphology, Surgery and Experimental Medicine, Section of Obstetric and Gynaecology, University of Ferrara, Ferrara, Italy
2 Maternal-Infantile Department. Section of Obstetrics and Gynecology. Sant'Anna University Hospital of Ferrara, Cona, Italy
3 Department of Surgical Pathology, Sant'Anna University Hospital of Ferrara, Cona, Italy
*Correspondence: ugo.indraccolo@libero.it (U. INDRACCOLO)
Clin. Exp. Obstet. Gynecol. 2019, 46(5), 792–796; https://doi.org/10.12891/ceog4974.2019
Published: 10 October 2019
Abstract

Purpose of Investigation: Assessing cytological and extracellular matrix histological patterns of uterine leiomyomas, in women previously treated with ulipristal acetate (UPA). Materials and Methods: Patients underwent surgical intervention for uterine leiomyomas between 2017 and 2018 were screened for previous use of UPA and were considered as cases. Controls were matched for race and nonmenopausal status among patients with surgeries for leiomyomas. Fibrosis, hyalinosis, edema, necrosis, cellularity, phlogosis, and mitosis were assessed in the specimens of fibroids by a semiquantitative score. The rates of scores for each histological pattern were compared among cases and controls, and described in a two-dimensional correspondence analysis. Results: There is not significance among scores between cases and controls fibroids, except than for the hyalinosis of moderate grade, that seems more likely in the ulipristal acetate group. The fibroids after ulipristals appear to have less mitosis and cellularity, while it seems to have more hyalinosis, edema and, in case of two cycles of ulipristal, fibrosis. Conclusions: Histological changes of leiomyomas after UPA therapy are heterogeneous. UPA mostly acts on extracellular matrix and, to a lesser extent, on histological parameters of smooth muscle cell proliferation.

Keywords
Leiomyomas
Ulipristal acetate
Fibroids
Extracellular matrix
Histological pattern
Figures
Figure 1.
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