Article

Epithelioid vascular leiomyoma of the uterus mimicking glomangiomyoma.

Department of Pathology, Japan Self Defense Forces Sapporo General Hospital, 12-1-32 Hiragishi 1 Jo, Toyohira-ku, Sapporo, Hokkaido 062-0931, Japan.
Archives of Gynecology and Obstetrics (Impact Factor: 1.28). 02/2007; 275(1):59-61. DOI: 10.1007/s00404-006-0167-6
Source: PubMed

ABSTRACT CASE REPORT: An unusual case of epithelioid vascular leiomyoma mimicking glomangiomyoma arising in the uterine corpus of a 55-year-old Japanese woman is presented. The surgically resected uterine mass, measuring 4.0x3.5 cm2, demonstrated a dark red well-circumscribed tumor. Histologically, the rounded epithelioid cells around the dilated vessels showed gradual transition to spindled smooth muscle cells. Immunohistochemistry was positive for smooth muscle actin, but negative for collagen IV. CONCLUSION: The experience in this case emphasizes that glomangiomyoma-like feature is interesting and might indeed be a new histological variant of uterine leiomyomas.

0 Bookmarks
 · 
91 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The female genital tract is a rare site for angioleiomyoma. Here, we present an unusual case of bilateral large angioleiomyoma in the broad ligaments. A 52-year-old woman underwent total hysterectomy with bilateral salpingo-oophorectomy due to massive tumors in the bilateral adnexal regions. Gross examination revealed a hemangioma-like mass each in the bilateral broad ligaments. The right one extended into the uterine myometrium. Histologically, both tumors had a mixed pattern of prominent thick-walled blood vessels and cellular short spindle myoid cells throughout. The spindle cells often swirled around the vessels, displaying an overlapping feature with angiomyofibroblastoma or myopericytoma. Immunostaining demonstrated that the tumor cells were positive for alpha-smooth muscle actin, desmin, estrogen receptor, and progesterone receptor. We believe that angioleiomyoma should be recognized as a delineated variant of leiomyoma in the female genital tract. This rare benign tumor should be differentiated from other mesenchymal neoplasms with prominent blood vessels.
    International journal of gynecological pathology: official journal of the International Society of Gynecological Pathologists 11/2009; 29(1):39-43. · 2.07 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pure sarcomas of the uterine corpus are uncommon, constituting less than 3% of all malignancies at this site, and most of them are leiomyosarcomas and endometrial stromal sarcomas. Rare histotypes of homologous sarcomas and heterologous sarcomas are occasionally encountered, and the absence of significant accumulated experience with these histotypes at this location may potentially raise diagnostic and patient management difficulties. In this article, the clinicopathologic attributes of all earlier reported sarcomas of the uterine corpus other than leiomyosarcomas and endometrial stromal sarcomas are summarized. Included are embryonal rhabdomyosarcoma, pleomorphic rhabdomyosarcoma, angiosarcoma, alveolar soft part sarcoma, malignant perivascular epithelioid cell tumors (PEComas), osteosarcoma, chondrosarcoma, liposarcomatous tumors, malignant extrarenal rhabdoid tumors, Ewing sarcoma/primitive neuroectodermal tumor, and other rare histotypes. Embryonal rhabdomyosarcoma (20%), Ewing sarcoma/primitive neuroectodermal tumor (17%), angiosarcoma (14%), and pleomorphic rhabdomyosarcoma (13%) appeared to be more common than the others, although there was no single overwhelmingly prevalent histotype in the group. A subset, including embryonal rhabdomyosarcoma, alveolar soft part sarcoma, and PEComas, peak in the premenopausal years, but most of the others were observed in postmenopausal women. Favorable outcomes have been reported for the patients diagnosed with alveolar soft part sarcoma, and the prognosis for their counterparts with PEComa remains a matter of debate. Multimodal therapeutic approaches to contemporary patients with embryonal rhabdomyosarcomas have resulted in significantly improved outcomes. Unfortunately, most of the other sarcomas have been associated with rapid tumor progression and unfavorable patient outcomes. The differential diagnosis for these sarcomas is often extensive and varies by histotype, but their accurate diagnosis fundamentally requires the careful exclusion of biphasic malignancies.
    Advances in anatomic pathology 01/2011; 18(1):60-74. · 3.22 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Here we describe an uterine vascular leiomyoma with a fat component which occurred in a 43-year-old woman. The tumor arose on the left parametrial wall of the uterine body. Pathologically, it was composed of thick-walled tortuous vessels and irregular bundles of smooth muscle cells, and was mixed with fat. The smooth muscle cells were immunoreactive for actin, desmin and vimentin. They were negative for cytokeratin, HMB-45, CD34, S-100 protein, progesterone receptor and estrogen receptor. Retrospectively, abdominal magnetic resonance images showed a well-demarcated mass of isointense signal on T1-weighted image, heterogeneous high signal intensity on T2-weighted images with thin tubule-like enhancement, suggesting tortuous vascular structures within the mass. Albeit rare, these radiologic findings may be helpful in distinguishing the vascular leiomyoma from other smooth muscle tumors. In our opinion, the histologic and immunohistochemical sharing features of uterine smooth muscle tumors may be responsible for underestimated incidence of this type of leiomyoma.
    Journal of Women's Medicine. 01/2010; 3(3).