Uterine leiomyoma is the most common benign tumor in women and is thought to arise from the clonal expansion of a single myometrial smooth muscle cell transformed by a cellular insult. Leiomyomas cause a variety of symptoms, including abnormal uterine bleeding, pelvic pain, bladder or bowel dysfunction, and recurrent pregnancy loss, and are the most common indication for hysterectomy in the USA. Aim of the work: This review focuses on the most recent discoveries regarding genetic abnormalities and the role of stem-progenitor cells in the pathogenesis of uterine leiomyoma, and discusses the therapeutic implications of the current state of knowledge of these pathways. Conclusion: The recent shift in focus from hormones to fibroid stem cells and genetic aberrations should lead not only to a deeper understanding of the specific etiology of fibroids, but also to the discovery of new therapeutic targets.
