By: Jean Johnson for Fibroids1
Uterine fibroids are present in up to 77 percent of women. In the majority of cases, these benign tumors are not considered risk factors for renal cell cancer.
|Know These Facts|
Fibroids can range in size from as small as tiny nodules 1.5 cm in diameter to the size of a grapefruit.
Uterine fibroids can occur singly, in multiples, or in clusters or many small nodules.
Uterine fibroids associated with cutaneous leiomyomas and renal cell carcinoma typically appear in small clusters.
The prevalence of hereditary leiomyomatosis and renal cell cancer (HLRCC) is unknown, according to researchers from the National Cancer Institute.
But when uterine fibroids are present or have been present alongside similar types of fibrous masses under the skin called cutaneous leiomyomas, research published in the August 2006 issue of Dermatology Nursing states that physicians need to carefully consider screening for renal cell cancer.
It is the cutaneous leiomyomas more than uterine fibroids that led author Laveta Steward, MPH, a cancer research training award fellow in the genetic research branch of the National Cancer Institute (NCI), to single them out as a “prominent marker of hereditary leiomyomatosis and renal cell cancer (HLRCC).”
Leiomyomatosis is a condition that occurs when numerous, often poorly defined nodules invade areas of the skin on the arms, chest, legs, and in extremely rare cases, the uterus. The terms leiomyomas, fibromyomas, myomas, and fibroids are often used interchangeably by experts.
“I’m glad to hear these types of fibroids are extremely rare, since renal cancer is the last thing a woman who is suffering from heavy bleeding and bloating needs to worry about,” says 38-year-old Martha Lewis of San Francisco, who had her fibroids treated with uterine fibroid embolization last year.
Cutaneous leiomyomas were first identified in 1854 and about a century later in 1973, their presence along with uterine fibroids was observed in three generations of families. Since then, Steward notes, “the association between cutaneous and uterine leiomyomas has been known as Reed syndrome.”
The NCI researchers also write that “Males and females with this syndrome are affected by cutaneous leiomyomas, and females also have debilitating uterine leiomyomas (fibroids). Fibroids associated with HLRCC are usually highly symptomatic, vary in size (1.5-10 cm in diameter) and are associated with a high risk of hysterectomy.”
Indeed, separate studies in first 2003 and then 2005 confirmed that 70 to 98 percent of women with cutaneous leiomyomas also had uterine fibroids. The authors stated that the variability in the percentages “may be related to differences in screening methods.”
Because HLRCC is hereditary, Steward and her team emphasize that families in which the sometimes painful cutaneous leiomyomas appear need to work with their physicians so that early detection of potential renal cell cancer can proceed.
They also point out that while “the syndrome is present in families with diverse, racial and ethnic backgrounds, members of Eastern European populations are over-represented in patients with HLRCC.” Also there “is wide age range for the onset of the various manifestations associated with HLRCC with the reported cutaneous leiomyomas age-of-onset ranging from 10 to 47 years of age, with a mean age of 25. The age-at-diagnosis of uterine fibroids ranged from 18 to 52 years, with a mean age of diagnosis of 30 years.”
“I can’t imagine having these types of fibroids and having to have a hysterectomy,” said Lewis. “I just had one fibroid so it was easy to treat it with embolization. But I suppose if a person’s worried about renal cancer, a hysterectomy can pale by comparison. And also the masses under the skin sound as though they could send a person into a real panic as well as cause some serious pain.
“I have worried about the hereditary aspect of fibroids since I have three daughters, but now that I see that in these cases it can be much more complicated and serious, I guess I’m grateful that our family’s health profile isn’t all that bad. Hopefully if any of my girls wind up with fibroids that are symptomatic, they too can have embolization and not have to face the hysterectomies these women with this hereditary problem have to go through.”