Abstract
BackgroundAdenomatoid tumors (AT) are benign neoplasms of mesothelial origin that occur more frequently in the genital tracts. In uterus, AT are usually located in the subserosa of the cornual myometrium. Microscopically, it is characterized by interanastomosing pseudoglands or pseudovascular spaces and striking smooth-muscle hypertrophy is often present. In some cases, the prominence of smooth muscle component simulates a leiomyoma and the lesion is denoted as a leiomyoadenomatoid tumor. The microscopic appearance of the adenomatoid component (AC) may mimic a malignant tumor due to irregular pseudoinfiltration with tubular formations. Just 16 cases with this morphological presentation were found in the literature review.Case presentationsThe first case, a 38-year-old female, showed lower abdominal pain, menorrhagia, postcoital bleeding and previous history of uterin leiomyoma. The second case, a 26-year-old female, had clinical complaint of metrorrhagia and received diagnostic hypothesis of leiomyoma after ultrasound image. Both underwent myomectomy. Microscopically, the uterine masses showed intersecting smooth muscle bundles and gland like areas lined by cuboidal epithelioid cells that stained positive for WT1, D2–40 and calretinin in immunohistochemical analysis.ConclusionsThe cases were diagnosed as leiomyoadenomatoid tumor of the uterus. This is a benign and rare entity that may mimic malignant tumors due to the pseudo infiltrative appereance of the adenomatoid component, possibly leading to misdiagnosis.
Highlights
Adenomatoid tumors (AT) are benign neoplasms of mesothelial origin that occur more frequently in the genital tracts
AT are usually located in the subserosa of the cornual myometrium
The prominence of smooth muscle component simulates a leiomyoma and the lesion is denoted as a “leiomyoadenomatoid tumor”
Summary
Adenomatoid tumors (AT) are benign neoplasms of mesothelial origin that occur more frequently in the genital tracts of both men and women. The prominence of smooth muscle component simulates a leiomyoma and the lesion is denoted as a “leiomyoadenomatoid tumor”. In this morphological pattern, the microscopic appearance of the adenomatoid component (AC) may mimic a malignant tumor due to irregular pseudoinfiltration with tubular formations (Amre et al 2005; Bedir et al 2014; Kurman et al 2014). The second case presented positivity for cytokeratins EA1-AE3 and low proliferative Ki-67 index. Both tumors showed expression of WT-1, D2–40 and calretinin, supporting the hypothesis of mesothelial nature of the lining epithelial cells in AC. Immunohistochemical study showed positivity for Calretinin, D2–40, WT1, CK7, and SMA, and negative results for CD34 and CD31 (10x)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have