Elsevier

Fertility and Sterility

Volume 99, Issue 7, June 2013, Pages 2017-2024
Fertility and Sterility

Original article
Novel hormone treatment of benign metastasizing leiomyoma: an analysis of five cases and literature review

https://doi.org/10.1016/j.fertnstert.2013.01.147Get rights and content
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Objective

To evaluate novel hormonal therapies in patients with unresectable benign metastasizing leiomyoma (BML) disease.

Design

Case series.

Setting

National Institutes of Health (NIH).

Patient(s)

Five subjects with the diagnosis of BML based on imaging and/or histopathologic diagnosis.

Intervention(s)

Four patients were treated with single or combination therapy of leuprolide acetate and/or an aromatase inhibitor. One patient was treated with an antiprogestin (CDB-2914).

Main Outcome Measure(s)

Response to therapy was measured by tumor burden on cross-sectional imaging employing RECIST (Response Evaluation Criteria in Solid Tumors) 1.1 guidelines.

Result(s)

Four patients treated with single or combination therapy of leuprolide acetate and/or an aromatase inhibitor demonstrated stable disease with reduction in tumor burden. The fifth patient treated with antiprogestin (CDB-2914) had degeneration of her tumor, progression of its size, and an improvement in symptoms.

Conclusion(s)

Hormone treatment with GnRH agonist and/or aromatase inhibition may be a therapeutic option to reduce tumor burden in unresectable BML disease or for those patients who wish to avoid surgical intervention. RECIST 1.1 guidelines, while traditionally used to evaluate tumor response to cancer therapeutics, may be useful in evaluating BML tumor burden response to hormone therapy.

Key Words

Benign metastasizing leiomyoma
uterine leiomyoma
hormone therapy
intravenous leiomyomatosis
leiomyomatosis peritonealis disseminata

Cited by (0)

E.I.L. has nothing to disclose. R.J.C. has nothing to disclose. A.H.D. has nothing to disclose. A.A. has nothing to disclose. J.E. has nothing to disclose. A.M.V. has nothing to disclose.

This research was supported in part by the Intramural Research Program of the National Institutes of Health; the Program in Reproductive and Adult Endocrinology, the Eunice Kennedy Shriver National Institute of Child Health and Human Development; and the National Institutes of Health Clinical Center.