Uterine fibroid vascularization: from morphological evidence to clinical implications

Pasquapina Ciarmela, Giovanni Delli Carpini, Stefania Greco, Alessandro Zannotti, Zannotti A, Nina Montik, Montik N, Luca Giannella, Giannella L, Lucia Giuliani, Giuliani L, Camilla Grelloni, Panfoli F, Francesca Panfoli, Michela Paolucci, Paolucci M, Gloria Pierucci, Pierucci G, Federica Ragno, Ragno F, Pamela Pellegrino, Pellegrino P, Petraglia F, Felice Petraglia, Andrea Ciavattini
Reproductive BioMedicine Online · 2021 · vol. 44(2) , pp. 281–294 · doi:10.1016/j.rbmo.2021.09.005 · PMID:34848152 · W3200863463
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This paper examines uterine fibroid vascularization using morphological evidence to explore its clinical implications.

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Abstract

Uterine fibroids are the most common cause of solid pelvic tumours, occurring in 20-30% of fertile women and presenting clinical complications that seriously affect women's health. They commonly cause severe symptoms, such as heavy, prolonged menstrual bleeding and anaemia. The study of microscopic and macroscopic vascular aspects of uterine fibroids is important for understanding the clinical manifestations of uterine fibroids, for predicting the effectiveness of alternative treatments to surgery, i.e. uterine artery embolization, for improving surgery outcomes and for carrying out a differential diagnosis with other benign conditions, e.g. adenomyosis, or malignancy, e.g. leiomyosarcoma, and to develop new therapeutic approaches. In this review, current knowledge of how the vascular network and angiogenesis are implied in the formation of uterine fibroids and in the pathogenesis of related symptoms is explored, and evidence on the role of ultrasound in evaluating fibroid vascularization is summarized. This review combines anatomical, morphological and biomolecular information related to angiogenic mechanisms with diagnostic and clinical information, highlighting the various interconnections. Uterine and fibroid vascularization need further investigation to gain a deeper understanding of the pathogenetic elements that lead to the formation of uterine fibroids and their clinical manifestations.

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MeSH descriptors

Adenomyosis Adenomyosis Leiomyoma Leiomyoma Uterine Artery Embolization Uterine Neoplasms Uterine Neoplasms Female Humans Neovascularization, Pathologic Neovascularization, Pathologic Uterus Uterus

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