Case Of Leiomyoma Research Articles

The Use of Smoothelin and Other Antibodies in the Diagnosis of Uterine and Soft Tissue Smooth Muscle Tumors.

Smoothelin is a cytoplasmic protein expressed in differentiated smooth muscle cells. Immunohistochemical evaluation of smoothelin has previously been reported in gastrointestinal (GI) smooth muscle tumors, but has yet to be studied in smooth muscle tumors of uterine and other soft tissue origin. DOG1 expression is reported to be specific for GI stromal tumors; however, variable expression has been reported in leiomyosarcomas (LMS) depending on site of origin. Overexpression of p16 is common in LMS of uterine and other sites of origin, but has not been correlated with tumor grade. This study explores the differential expression of these markers, as well as caldesmon, in LMS cases to assess diagnostic utility. Using tissue microarrays and cases from Tulane Medical Center and Medical College of Wisconsin, expression of smoothelin, DOG1, caldesmon, and p16 was evaluated by immunohistochemistry in 87 cases of LMS. The cases were subdivided by location of origin into uterine (N=31) and nonuterine (N=56) with 10 of the nonuterine of GI origin, as well as by grade into low grade (N=27) and intermediate and high grade (N=60). Differential expression among different grades and locations was evaluated. The same markers were evaluated in atypical leiomyoma cases (N=4) and 1 smooth muscle tumor of uncertain malignant potential case (N=1). Smoothelin expression was also assessed in 20 benign uterine leiomyomas. Weak DOG1 expression is rare but possible in extrauterine LMS. Expression of p16 is common in both uterine and extrauterine LMS, and more frequent in higher grades. Expression of smoothelin in this study differed depending on tumor type, grade, and site of origin. All leiomyomas and most atypical leiomyomas showed cytoplasmic positivity for smoothelin, whereas only 5% of LMS had cytoplasmic expression. The study suggests smoothelin may be downregulated in the cytoplasm of malignant smooth muscle tumor cells and may serve as a supportive aid in the distinction of LMS from benign smooth muscle tumors in cases where it is difficult by morphology alone.

Histomorphological analysis of uterine and cervical lesions in hysterectomy specimens at a tertiary care hospital

Abstract Introduction: The Uterus is a major female hormone responsive reproductive organ which is subjected to vast range physiological changes, benign and malignant disorders. Aims and Objectives: The study was undertaken to see different patterns of histomorphological lesions in uterus and cervix in hysterectomy specimens and to study its correlation with respect to age and clinical presentation. Materials and Methods: This study is a prospective analysis of 155 hysterectomy specimens received in Department of Pathology in DR B R Ambedkar medical college and hospital in Bangalore during a 18 months period from June 2017 to December 2018. Results: In the present study commonest type of hysterectomy was Total abdominal hysterectomy and the commonest clinical indication being Menorrhagia in 63(40.64%) cases. The peak age of incidence of hysterectomy was noted in the 5th decade (38.91%). The commonest lesion encountered was Chronic non specific cervicitis in 86(55.40%) cases and leiomyoma in 57(36.77%) cases, 6 cases (3.87%) of carcinoma endometrium, 9 cases (5.80%) of carcinoma cervix and 11 case (7.00%) of cervical dysplasia were encountered. The rare and interesting lesions encountered in the present study were 2(1.28%) case of blue nevus Cervix and 2 case (1.28%) of Benign Cellular Leiomyoma and 1 case of (0.64%) Lymphoepithelioma like SCC cervix Conclusion: Hysterectomy still remains one of the most commonly done procedure in the gynecology department. Histomorphological analysis of lesions of uterus and cervix is mandatory for establishing final diagnosis. Keywords: Histomorphology, Uterus, Cervix, Hysterectomy, Menorrhagia, Leiomyoma and carcinoma cervix, SCC. Introduction The female reproductive tract is a complicated but fascinating system comprising of the external and the internal genitalia with vagina, uterus, fallopian tubes and ovaries. Uterus, additionally called the womb and the cervix are the vital female reproductive

A rare case of paratesticular leiomyoma in a child.

Leiomyomas are benign, slow-growing, smooth muscle tumors, which can occur at many locations in the body. The male genitourinary tract is seldom affected and scrotal leiomyomas are extremely rare. Most of the scrotal leiomyomas are localized in the testis, epididymis, spermatic cord, subcutaneous tissue, tunica albuginea, and scrotal skin and only a few of them are reported in the origin of isolated tissue without paratesticular structures in the paratesticular region. We are presenting a case of solitary paratesticular leiomyoma in a child, which is very rare in terms of lesion location and patient age, and describing the imaging features of this lesion.

Leiomyoma at gastroesophageal junction causing uncontrolled hypertension and arrhythmia

A case of leiomyoma at gastroesophageal (GE) junction was identified in a male patient with uncontrolled hypertension and arrhythmia. Patient came with chief protestations of body pains, burping, stomach pain and uncontrolled hypertension. He was with oral medications like amlodipine 5 mg, pantoprazole 40mg, clopidogrel 75 mg, vitamin supplements and syrup antacid. His blood pressure was 150/100 mmHg. He has elevations of direct bilirubin-0.03mg/ dl and basic phosphate-192U/L. Esophagus endoscopy determines 23 × 22 mm size mixed echoic lesion with deformed cells at GE junction. His ECG demonstrates cardiac arrhythmias. Endoscopic ultrasonography and cardiac MRI identifies a mass from the submucosal layer at GE junction compressing the esophageal veins. Fibroids at GE junction were removed by thoracoscopy. Histopathological examination confirms leiomyoma with an impression of round mass lesion composed of bundle of spindle cells arranged like braid with minimal abnormal and enlarged nuclei. To his previous prescription ceftriaxone 500 mg and ibuprofen 400 mg were included

Giant Tumor of Vulva: Vulvar Myxoid Leiomyoma—A Rare Entity

Vulvar myxoid leiomyoma are very rare soft tissue tumors of vulva with less than 50 cases being reported in the literature. They are usually misdiagnosed as Bartholin’s cyst; however, it is important that they are diagnosed correctly owing to their ability to recur and metastasize. We present a case of a young multiparous woman, with a slowly progressive perineal swelling who was operated and diagnosed as a case of vulvar myxoid leiomyoma.

Case Report: Parasitic Leiomyoma

Parasitic Leiomyoma (PL) is considered a rare variant of uterine fibroids occurring outside the uterus. We hereby report a challenging case of parasitic leiomyoma that is considered rare in the literature with all its particularities. A 62 YO lady is known to have a history of diabetes, right breast carcinoma, appendectomy and normal vaginal deliveries presenting with a two-year history of back and abdominal pain with recent urinary symptoms. Therefore, an abdominopelvic Ct scan and MRI were done showing uterine fibroids compressing the bladder. The patient underwent an exploratory laparotomy. A palpable intravesical mass was identified. Transurethral cystoscopic resection was performed. Pathology results confirmed the leiomyomatous nature of the mass. Postoperatively, the surgery was complicated with a wound dehiscence and a hematoma formation on the left lateral wall of the bladder that was treated conservatively with a good follow-up outcome.

Rare Case of Symptomatic Ovarian Leiomyoma in Perimenopausal Woman

Rare Case of Symptomatic Ovarian Leiomyoma in Perimenopausal Woman

Primary intracranial leiomyoma - A case report and literature review

Primary intracranial leiomyoma is a rare tumour of mesenchymal origin, with less than 30 cases reported in literature including two cases from the Indian subcontinent. In this article, we describe a case of primary intracranial leiomyoma in an immunocompromised patient with a brief review of literature.

Parasitic leiomyoma with myxoid degeneration mimicking malignancy: A case report and review of literature

Parasitic leiomyoma is a rare, benign smooth muscle tumor occurring in an extrauterine location. Their unusual growth pattern may mimic malignancy and, hence, could pose diagnostic and management challenges. Myxoid degeneration is further rarer finding in leiomyoma. There are few published cases of parasitic leiomyoma in our setting, hence, this report. A 52-year-old female presented with 4-year history of painless, progressive abdominal swelling with associated anorexia, weight loss, and body weakness. Abdominal examination revealed non-tender, nodular mass of 24 weeks size. Ultrasound scan showed a large well-defined heterogeneously hyperechoic right pelvic tumor crossing the midline. She had exploratory laparotomy; however, the histology confirmed parasitic leiomyoma with myxoid degeneration. Parasitic leiomyoma is an uncommon extrauterine benign tumor that mimics abdominopelvic malignancies. Meticulous clinical evaluation with radiologic and pathologic findings is the key to the otherwise challenging diagnosis.

A Case Report with Literature Review: Parasitic Leiomyoma

Leiomyoma is a benign tumour composed mainly of smooth muscle cells. It contains varying amount of fibrous connective tissues. Parasitic leiomyoma is a rare manifestation of uterine leiomyoma defined as a pedunculated subserosal fibroid that undergoes torsion and detaches from the uterus. We are reporting a case of parasitic leiomyoma in a 55 Y/O female patient that had already given her consent for the case to be published. She presented with increased abdominal girth since 6 months and body weight and consulting for possible bariatric surgery 1 month prior to presentation. Ultrasonography revealed a large heterogeneous mass starting from the pelvic region to the middle and upper abdomen of more than 37 cm compatible with an adnexal mass. On abdominopelvic MRI: presence of an enlarged heterogeneous mass that seems taking its origin from the right ovary, an exploratory laparotomy was performed. Identification and complete excision of a huge mass of cystic and solid component adherent to the uterus and the mesentery of the small bowel. Histopathologically mass was confirmed as a hyelanized leiomyoma with a focal necrobiosis with no signs of malignity. Parasitic leiomyomas are rare tumors. Imaging modalities help in diagnosis but not always. The definitive treatment is surgical excision, presenting this case due to its rarity and diagnostic difficulties posed.

Primary Ovarian Leiomyoma—A Common Tumor at an Uncommon Site

AbstractLeiomyoma is a benign mesenchymal tumor that commonly occurs in the uterus, ovary being a rare site. Ovarian leiomyomas constitute 0.5 to 1% of all benign tumors. They probably arise from the smooth muscle cells in the ovarian hilar blood vessels. They occur most commonly in premenopausal women. We report a case of primary ovarian leiomyoma in a 39-year-old female patient.

A rare location and unusual development: Antecubital leiomyoma

<br>Leiomyomas are benign soft tissue neoplasms which are originated from smooth muscle cells. Leiomyomas rarely occur in the upper extremity. To our knowledge, there have been no reports of a leiomyoma of the forearm which occured after intravenous catheterisation in Turkish literature. Herein, we report such a case of antecubital leiomyoma in a 52-year-old man. The case is presented due to its rarity and the risk of tumor misdiagnosis. Leiomyomas should be considered in the differential diagnosis of solitary masses of the extremities.<br>

A Case of Primary Hepatic Leiomyoma Developed in Healthy Patient

A Case of Primary Hepatic Leiomyoma Developed in Healthy Patient

Submucosal Tunnel Endoscopic Resection for Esophageal Submucosal Tumors: A Multicenter Study.

Background Submucosal tumors (SMTs) are primarily benign tumors, but some may have a malignant potential. Endoscopic submucosal dissection that has been used for removing esophageal SMTs could cause perforation. Submucosal tunnel endoscopic resection (STER) is an improved and an effective technique for treating esophageal SMTs. Aims This study was conducted to evaluate the efficacy and safety of STER for treating esophageal SMTs. Methods A retrospective study design was adopted to analyze the baseline characteristics, clinical outcomes, and follow-up data of patients with esophageal SMTs, which originated from the muscularis propria layer and were treated with STER from September 2011 to May 2018. Results A total of 119 lesions were included from 115 patients who were successfully treated with STER. The mean age of the patients was 49.7 ± 10.7 years. The lesions were primarily located in the middle and lower esophagus. The mean size of the lesions was 19.4 ± 10.0 mm. The mean operation duration was 46.7 ± 25.6 min, and the mean duration of hospitalization was 5.9 ± 2.8 days. The total en bloc resection rate and the complete resection rate were 97.5% and 100%, respectively. Regarding complications, there were 9 (7.8%) cases of perforation, 2 (1.7%) cases of pneumothorax, and 9 (7.8%) cases of subcutaneous emphysema. Histopathological results revealed 113 (95.0%) cases of leiomyoma, 5 (4.2%) cases of gastrointestinal stromal tumors, and 1 (0.8%) case of a granular cell tumor. During the mean 15-month follow-up, there were no cases of recurrence and distant metastasis. Conclusions STER is a safe and feasible technique for treating esophageal SMTs originating from the muscularis propria layer.

Uterine Leiomyoma and Reproductive Tract Infections Detected by Polymerase Chain Reaction.

Background and Objective:For nearly a century, it has been suspected that reproductive tract infections play an etio- logic role in uterine leiomyoma. However, no epidemiologic study of leiomyoma has used the polymerase chain reaction (PCR) to compare uterine tissues from cases and non-cases, and to investigate associations between uterine leiomyoma and infections detected by PCR.Methods:In this case-control study, 92 leiomyoma tissues from cases, and 94 myometrial tissue from controls were screened by PCR for cytomegalovirus, Chlamydia trachomatis, herpes simplex virus-1, 2, and human papillomavirus typed as 16/18 or another strain. Multivariable analysis used age-adjusted logistic regression, and generalized linear regression as appropriate.Results:In the uterine tissues of cases and unmatched controls, the prevalence of infection was: cytomegalovirus (32.6%, 7.4%), C. trachomatis (23.9%, 37.2%), herpes simplex virus-1,2 (25.0%, 13.8%), human papillomavirus 16/18 (13.0%, 10.5%). Leiomyoma was associated with cytomegalovirus (Odds Ratio (O.R.) 6.10; 95% confidence interval (C.I.), 2.40, 15.55) and Chlamydia (O.R. 0.47; 95% C.I. 0.23, 0.97). Likewise, the log count of leiomyoma was higherwith cytomegalovirus (+0.65, 95% C.I. +0.34, +0.95) and lower with Chlamydia (-0.71, 95% C.I. -1.12, -0.29).Conclusion:This first application of PCR to leiomyomata and control uterine tissues from non-cases reveals that cytomegalovirus is associated with the presence, number, and volume of uterine leiomyoma, while C. trachomatis is inversely associated with leiomyoma, but only in the absence of cytomegalovirus. Current findings provide preliminary evidence that common reproductive tract infections contribute to the growth and control of at least some cases of uterine leiomyoma.

Atypical localization of intraosseous angioleiomyoma in the rib of a pediatric patient: a case report

BackgroundThis is the first reported case of a primary intraosseous angioleiomyoma and the second case of a primary leiomyoma of the rib, irrespective of age. Angioleiomyomas mostly occur in patients of advanced age, in any part of the body, particularly the lower extremities and present as painful, slow-growing nodules in the dermis, subcutaneous fat or deep fascia. Other localizations, especially bone, are considered extremely rare, as well as their occurrence in paediatric patients.Case presentationA 10-year-old girl was admitted to the orthopaedic surgery department for further assessment of a pain localized in the posterior part of the right hemithorax. After magnetic resonance imaging (MRI) and surgical biopsy, intraosseus angioleiomyoma of the fourth rib was diagnosed by histopathology examination. Atypical costal localization of this type of a benign tumour presents diagnostic difficulty, especially in children. The differential diagnoses included cartilaginous tumours, Ewing sarcoma, fibrous dysplasia, Langerhans cell histiocytosis, intraosseous haemangioma and metastatic tumours. We report a detailed diagnostic procedure including MRI, selective angiography and histopathologic examination.ConclusionDiagnosis of intraosseous angioleiomyoma is difficult due to the extreme rarity of this tumour and absence of pathognomonic radiological signs. Although very rarely identified in bones and young age group, radiographers and reporting doctors should be aware of this possible angioleiomyoma presentation and supported by the provided detailed diagnostic information.

Leiomyoma of the urinary bladder - a case report and review of literature

Most bladder tumors are derived from the urothelium. Benign mesenchymal tumors are rare. Leiomyoma of the bladder is the most common benign neoplasm. A case of leiomyoma of the bladder presented here with confusing finding on imaging, ultra sound and I.V. urography..

An unusual case of hirsutism, baldness and ovarian leiomyoma

An unusual case of hirsutism, baldness and ovarian leiomyoma

Safety and feasibility of contained uterine morcellation in women undergoing laparoscopic hysterectomy

BackgroundWidespread concerns have been raised regarding the safety of power morcellation of uterine specimens because of the potential to disseminate occult malignancy. We sought to assess the safety and feasibility of contained manual uterine morcellation within a plastic specimen bag among women with uterine neoplasms.MethodsA retrospective single-institution descriptive cohort study was conducted from 2003 to 2014. Patients with leiomyoma and/or uterine malignancy who underwent minimally invasive surgery with contained uterine manual morcellation were identified from surgical logs. Demographic data, pathology results, operative details and adjuvant treatments were abstracted.ResultsEighty-eight patients were identified; 35 with leiomyoma and 53 with endometrial cancer. The mean age was 48 and 60, respectively. Uterine size/weight was greater in women with leiomyoma compared to those with cancer (15.1 weeks/448 g vs. 10.7 weeks/322 g). Mean operative time was 206 min (range 115–391) for leiomyoma cases and 238 min (range 131–399) for cancer cases. Median length of stay was 1 day (range 0–3 days). There were no cases of occult leiomyosarcoma and all specimens were successfully manually morcellated within a bag. There were no intraoperative complications. Thirty-day postoperative complications occurred in 7 patients, including one readmission for grade (G) 1 vaginal cuff separation after intercourse, G1 port-site hematoma (1), G2 port-site cellulitis (1), G2 vaginal cuff cellulitis (2), G2 bladder infection (2), G2 pulmonary edema (1), and G1 musculoskeletal injury (1).ConclusionsContained uterine hand morcellation is a feasible procedure with low peri-operative complication rates that allows for minimally invasive surgical procedures for women with large uterine neoplasms. Further evaluation is needed to assess survival outcomes for uterine malignancies.

XPG rs873601 G>A contributes to uterine leiomyoma susceptibility in a Southern Chinese population.

XPG gene contributes to DNA repair defects and genomic instability, which may lead to the initiation of uterine leiomyoma. We hypothesized that genetic variants of XPG gene may alter the carriers’ susceptibility to leiomyoma. The association between five potential functional single nucleotide polymorphisms (SNPs), i.e. rs2094258 C>T, rs751402 C>T, rs2296147 T>C, rs1047768 T>C, rs873601 G>A, and uterine leiomyoma risk in Chinese, was investigated in this case–control study, which included 398 incident leiomyoma cases and 733 controls. We found that rs873601 was significantly associated with tumor risk in a recessive genetic model after being adjusting for age and menopause. When compared with rs873601 GG/GA genotypes, the AA genotype had an increased leiomyoma risk (adjusted OR = 1.59, 95% CI = 1.16–2.18, P=0.004; Bonferroni adjusted P=0.040). Furthermore, stratified analysis revealed that the association between the rs873601 AA genotype and leiomyoma risk was more evident among subjects younger than 40 years old (adjusted OR = 1.58, 95% CI = 1.06–2.35, P=0.023) and patients who had more than three myomas (adjusted OR = 2.05, 95% CI = 1.24–3.41, P=0.006). Yet, no significant association between the other four polymorphisms and leiomyoma risk was observed. To sum up, the present study reported on the association between XPG gene polymorphisms and myoma risk. The observed data indicated that SNP rs873601 G>A contributes to uterine leiomyoma susceptibility in a Southern Chinese population.