Morphological features of embolised myomata

Selective arterial embolisation is an alternative to surgery for haemorrhagic uterine leiomyomata. Our aim was to describe morphological aspects of 34 embolised myomata; obtained between 1 day and 2 years after selective arterial embolisation using polyvinyl alcohol (PVA) particles. The findings differed according to the time elapsed since embolisation. One day to one week: macroscopic examination showed red degeneration of the myoma. Histologically, ischaemic necrosis with infiltration by lymphocytes and polymorphonuclear leucocytes was seen in some part of the myoma, always sparing the surrounding myometrium. PVA was sometimes noted in the lumen of small arteries. More than one week: fibrotic or hyaline changes were seen. The fibrous pseudocapsule of the myoma and the surrounding myometrium were always normal. PVA was found outside of the vessel, surrounded by foreign-body type giant cell granuloma. Ischaemic changes were observed that were strictly localised to the leiomyomata.