Histologic features of uterine leiomyomata treated with microsphere embolization.

Abstract

Therapeutic embolization is a new treatment for symptomatic leiomyomata. Material available in the United States for uterine embolization includes precisely calibrated hydrophilic microporous microspheres made of a cross-linked acrylic copolymer. A 42-year-old woman with a longstanding history of symptomatic leiomyomatous uterus underwent uterine artery embolization with microspheres. Because of continuous intractable pelvic pain, an abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. The gross and histologic findings included large amounts of microspheres and pus within the uterine cavity, infarcted leiomyomata with microspheres, and intravascular microspheres within hyalinized leiomyomas. Microsphere embolization leads to hyalinizing and ischemic necrosis with residual microsphere material in the myometrium, uterine cavity, fallopian tubes, and ovaries.