Effect of Dose, Timing and Delivery of Tumor Necrosis Factor Alpha as a Cryoadjuvant in Cryosurgery of ELT-3 Uterine Leiomyoma (Fibroid) Tumor

Uterine leiomyoma (fibroid) is the most common indication for hysterectomy in premenopausal women. Cryomyolysis is a uterus sparing procedure in which a myoma is frozen by a cryoprobe, and that causes tissue necrosis upon thawing of the frozen tissue and eventual reduction in myoma size. Cryomyolysis allows both the placement of the minimally invasive cryoprobe and the ensuing iceball growth to be controlled under image guidance (ultrasound - US or magnetic resonance - MR) [1, 2]. Unfortunately, although the iceball is readily visualized, the tissue at the periphery of the iceball is not completely destroyed. This not only potentiates the later recurrence of the myoma, but also limits the predictability of the procedure by imaging techniques. Clearly, techniques that can improve the correspondence between the imaged iceball and the destroyed tissue will improve cryomyolysis and other cryosurgical procedures.