Angioleiomyoma of the Uterus with Extensive Hyaline Degeneration- A Rare Case Report with Brief Review of Literature

Abstract

Angioleiomyoma (AL) or vascular leiomyoma is a distinct variant of leiomyoma with prominent vascular component, usually occurs in extremities very rarely arise in internal organ. It has been documented in female genital tract including cervix, uterus, ovary and broad ligament. Uterine leiomyoma is very rare and distinct variant of conventional leiomyoma which has prominent vascular component. The diagnosis of this variant requires histopathological examination since it does not have specific clinical and radiological features unlike in soft tissues where it presents as subcutaneous painful swelling. Like conventional leiomyomyoma, AL can also undergo degenerative changes like hyalinisation, infarction, calcification and myxoid change. Here, a rare case of uterine AL with ovarian seromucinous cystadenoma is reported in a 38-year-old female who was diagnosed incidentally when she was evaluated for abnormal uterine bleeding. MRI pelvis revealed a intramural fibroid of size 5×4.5 cm noted in anterolateral myometrium of uterus and a large multiloculated cystic lesion of size 12.5×12.5×8.8 cm seen arising from left ovary. Abdominal hysterectomy was done. Grossly, sectioning of myometrium showed well circumscribed grey white to grey brown intramural fibroid measuring 4.5×3.5 cm. Histologically the lesion showed fascicles of spindle cells swirling around the thick walled blood vessels and immunohistochemically these cells were positive for Smooth Muscle Actin (SMA). Here, this rare case of uterine AL with brief review of literature is reported.