Myoma Uteri

myomauteri-1-0-25kapak

Etiology of Leiomyomas

İnci Halilzade

Ankara Bilkent City Hospital, Department of Gynecology and Obstetrics, Ankara, Türkiye

Halilzade İ. Etiology of Leiomyomas. Yavuz AF, ed. Myoma Uteri. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.7-12.

ABSTRACT

Uterine leiomyomas are the most common pelvic tumors in women of reproductive age, and are pre- dominantly benign. These tumors originate from uterine smooth muscle cells and myometrial fibro- blasts. However, their etiology is complex and involves a combination of genetic, hormonal, and vas- cular factors. Each uterine leiomyoma arises from a single progenitor myocyte, giving each uterine tumor an independent cytogenetic origin. Genetic studies have identified mutations such as those in the MED12 gene, COL4A5/COL4A6, and HMGA2 overexpression, which are associated with leiomyoma development. Additionally, hereditary mutations in the fumarate hydratase (FH) gene are linked to he- reditary leiomyomatosis and renal cell carcinoma syndrome (HLRCC). Leiomyomas are also sensitive to gonadal steroid hormones, with studies showing that both estrogen and progesterone play significant roles in their growth and development. Various growth factors, particularly VEGF and TGF-b, have been implicated in promoting the fibrosis necessary for leiomyoma growth. In summary, genetic muta- tions, hormonal imbalances, fibrotic processes, and vascular abnormalities are key factors that contrib- ute to the development of leiomyomas. Future research is essential to further elucidate the interactions between these factors and to advance treatment strategies for uterine leiomyomas. This article reviews in detail the primary factors influencing the etiology of uterine leiomyomas.

Keywords: Leiomyoma; Etiology; Genetics; Steroid hormones

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