Ulipristal Acetate for the Preoperative Management of Hypoechoic Cellular Leiomyomas
Status:
Unknown status
Trial end date:
2017-09-01
Target enrollment:
Participant gender:
Summary
Cellular leiomyomas (CLs) are described as leiomyomas that are significantly more cellular
than the surrounding myometrium, often with crowding and overlapping of nuclei. they often
are soft and appear more tan or yellow and less circumscribed than the usual leiomyomas.
Pre-operatively CLs can be recognized at ultrasound evaluation because they appear as
hypoechoic uterine lesions. patients with hypoechoic myoma have a significantly longer
surgery time after treatment with a gonadotropin-releasing hormone (GnRH) analog probably
related to degenerative changes induced by this treatment. Hypoechoic CLs should be more
responsive to ulipristal acetate treatment than common leiomyomas. The antiproliferative
ulipristal effect, moreover, induces a condition of apoptotic necrosis that, compared to
GnRH-a myxoid necrosis, probably allows an easier surgical enucleation of the tumor.