Dissecting leiomyoma of the uterus with unusual clinical and pathological features
Authors:
J. Lenz 1,2,3; R. Chvátal 4
; P. Konečná 3
Authors‘ workplace:
Patologicko-anatomické oddělení Nemocnice, Znojmo, primář MUDr. J. Lenz, Ph. D.
1; Cytohisto s. r. o., Břeclav, vedoucí lékař MUDr. J. Lenz, CSc.
2; Ústav anatomie, histologie a embryologie FVL VFU, Brno, přednosta prof. MVDr. F. Tichý, CSc.
3; Gynekologicko-porodnické oddělení Nemocnice, Znojmo, primář MUDr. R. Chvátal
4
Published in:
Ceska Gynekol 2020; 85(3): 197-200
Category:
Case Report
Overview
Objective: Case description of dissecting uterine leiomyoma with extrauterine extension and infiltration of right parametrium, ureter and bladder wall.
Design: Case report.
Setting: Department of Pathology, Znojmo Hospital.
Methods: A 64-year-old woman with chronic pelvalgia and loss of renal function of the right kidney due to urinary tract obstruction is presented. Ultrasound examination, magnetic resonance imaging and computer tomography scan revealed a pelvic tumour affecting the right edge of the uterine wall, the right parametrium, distal part of the right ureter, the right and partially the cranial bladder wall. Due to this finding, hysterectomy, unilateral parametrectomy, partial resection of the bladder wall and resection of the distal part of the ureter was performed. Histology revealed morphologically bland spindle-cell smooth-muscle tumour corresponding to conventional uterine leiomyoma. Tumour necrosis, cellular atypia, vascular invasion or hydropic degeneration were not observed. A final diagnosis of dissecting leiomyoma of the uterus was made.
Conclusion: The diagnosis of dissecting leiomyoma should be considered in all malignant tumours affecting the uterine corpus.
Keywords:
uterine leiomyoma – dissecting – cotyledonoid
Sources
1. Boudová, B., Mára, M., Dundr, P., et al. Uterine leiomyomas with bizarre nuclei: analysis of 37 cases after laparoscopic or open myomectomy. Ces Gynek, 2019, 84(5), p. 324–330.
2. Courtoy, GE., Donnez, J., Marbaix, E., et al. In vivo mechanisms of uterine myoma volume reduction with ulipristal acetate treatment. Fertil Steril, 2015, 104(2), p. 426–434.e1.
3. Cramer, SF., Patel, A. The frequency of uterine leiomyomas. Am J Clin Pathol, 1990, 94(4), p. 435–438.
4. David, MP., Homonnai, TZ., Deligdish, L., et al. Grape-like leiomyomas of the uterus. Int. Surg, 1975, 60, p. 238–239.
5. Lobel, MK. The genetic heterogeneity of uterine leiomyomata. Obstet Gynecol Clin North Am, 2006, 33(1), p. 13–39.
6. Makinen, N., Vahteristo, P., Kampjarvi, K., et al. MED12 exon 2 mutations in histopathological uterine leiomyoma variants. Eur J Hum Genet, 2013, 21(1), p. 1300–1303.
7. Menolascino-Bratta, F., García de Barriola, V., Naranjo de Gómez, M., et al. Cotyledonoid dissecting leiomyoma (Sternberg tumor): an unusual form of leiomyoma. Pathol Res Pract, 1999, 195(6), p. 435–438.
8. Oliva, E., Carcangiu, ML., Carinelli, SG., et al. Mesenchymal tumours. In Kurman, RJ., Carcangiu, ML., Herrington, CS., Young, RH., eds. WHO classification of tumours of female reproductive organs. 4th Edn. Lyon, France: WHO Press, 2014, p. 135–147.
9. Quade, BJ. Pathology, cytogenetics and molecular biology of uterine leiomyomas and other smooth muscle lesions. Curr Opin Obstet Gynecol, 1995, 7(1), p. 35–42.
10. Raga, S., Cholvi, C., Pascual, C., et al. More to be learned about cotyledonoid dissecting leiomyoma. Ultrasound Int Open, 2016, 2(2), E73–E74.
11. Roth, LM., Reed, RJ., Sternberg, WH. Cotyledonoid dissecting leiomyoma of the uterus. The Sternberg tumor. Am J Surg Pathol, 1996, 20(12), p. 455–1461.
12. Saeed, AS., Hanaa, B., Faisal, AS., et al. Cotyledonoid dissecting leiomyoma of the uterus: a case report of a benign uterine tumor with sarcoma-like gross appearance and review of literature. Int J Gynecol Pathol, 2006, 25(3), p. 262–267.
13. Smith, CC., Gold, MA., Wile, G., et al. Cotyledonoid dissecting leiomyoma of the uterus: a review of clinical, pathological, and radiological features. Int J Surg Pathol, 2012, 20(4), p. 330–341.
14. Soleymani, MH., Ismail, L., Desai, SA., et al. Epithelioid cotyledonoid dissecting leiomyoma: A case report and review of the literature. Arch Gynecol Obstet, 2011, 283(4), p. 771–774.
15. Šimetka, O., Klát, J. Možnosti užití selektivních modulátorů progesteronových receptorů v léčbě děložních myomů. Ces Gynek, 2016, 81(4), s. 317–320.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
2020 Issue 3
Most read in this issue
- Native IVF cycle at woman in 46-age with clinical pregnancy
- Prolongated pregnancy: unusual case
- New estrogen-free oral hormonal contraceptive (Estrogene free ill-EFP)
- The role of neutrophils in preeclampsia