Evaluation of leuprolide acetate treatment on histopathology of uterine myomata

To determine if short-term, preoperative leuprolide acetate (LA) therapy alters the histologic appearance of uterine leiomyomata. Retrospective evaluation by a pathologist (who was blinded to patient history) of the histologic features of leiomyomata excised from 36 women, 12 who received preoperative LA and 24 age-matched controls. Yale-New Haven Hospital, New Haven, Connecticut, from September 1989 to September 1990. The histologic specimens were evaluated for the presence of mitotic activity, cellular atypia, cellularity, and secondary changes including edema, fibrosis, calcification, hemorrhage, infarction, hyalinization, and vascular appearance. Of the 12 patients treated with LA, 10 (84%) demonstrated a reduction in uterine volume after 3 to 6months of LA therapy. There was no difference in any of the histopathologic parameters evaluated 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 leiomyoma that did not respond to LA had a greater degree of hyalinization than those that responded. Reduction in uterine size by short-term LA therapy did not detectably alter histologic appearance of leiomyoma.