Histologic features of uterine leiomyomata treated with microsphere embolization

BACKGROUND: 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. CASE: 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. CONCLUSION: Microsphere embolization leads to hyalinizing and ischemic necrosis with residual microsphere material in the myometrium, uterine cavity, fallopian tubes, and ovaries.