EVALUATION OF LEUPROLIDE ACETATE TREATMENT ON HISTOPATHOLOGY OF UTERINE MYOMATA

Objective: To determine if short-term, preoperative leuprolide acetate (LA) therapy alters the histologic appearance of uterine leiomyomata. Design: Retrospective evaluation by a pathologist (who was blinded to patient history) of the histologic features of leiomyomata excised fr om 36 women, 12 who received preoperative LA and 24 age-matched contro ls. Setting: Yale-New Haven Hospital, New Haven, Connecticut, from Sep tember 1989 to September 1990. Main Outcome Measure: The histologic sp ecimens were evaluated for the presence of mitotic activity, cellular atypia, cellularity, and secondary changes including edema, fibrosis, calcification, hemorrhage, infarction, hyalinization, and vascular app earance. Results: Of the 12 patients treated with LA, 10 (84%) demonst rated a reduction in uterine volume after 3 to 6 months of LA therapy. There was no difference in any of the histopathologic parameters eval uated between the LA-treated group and the untreated group. Exclusion of leiomyoma, which did not have a reduction in size during LA therapy , did not alter the analysis. Among patients treated with LA, those le iomyoma that did not respond to LA had a greater degree of hyalinizati on than those that responded. Conclusion: Reduction in uterine size by short-term LA therapy did not detectably alter histologic appearance of leiomyoma.