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González-Guerra E, Conde Taboada A, Cortés Toro JA, López Bran E, Pérez Segura P. Dermatologists might be the first to suspect hereditary leiomyomatosis and renal cell carcinoma syndrome. An Bras Dermatol 2023; 98:696-698. [PMID: 37230921 PMCID: PMC10404549 DOI: 10.1016/j.abd.2021.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 05/27/2023] Open
Affiliation(s)
- Elena González-Guerra
- Department of Dermatology, Hospital Clinico Universitario San Carlos, Madrid, Spain.
| | | | | | - Eduardo López Bran
- Department of Dermatology, Hospital Clinico Universitario San Carlos, Madrid, Spain
| | - Pedro Pérez Segura
- Department of Genetics, Hospital Clinico Universitario San Carlos, Madrid, Spain
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2
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Campione E, Di Prete M, Costanza G, Saggini A, Agostinelli S, Terrinoni A, Centofanti F, Rapanotti MC, Bianchi L, Ferlosio A, Scioli MG, Orlandi A. Increased Occurrence of Cutaneous Leiomyomas and Dermatofibromas in Patients with Uterine Leiomyomas without Fumarate Hydratase Gene Mutations. Dermatopathology (Basel) 2023; 10:231-243. [PMID: 37606484 PMCID: PMC10443243 DOI: 10.3390/dermatopathology10030032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023] Open
Abstract
Leiomyomas are smooth muscle-derived benign neoplasms that can affect all organs, most frequently in the uterus. Fumarate hydratase gene (FH) mutation is characterised by an autosomal dominant disease with increased occurrence of renal tumours, but also by cutaneous (CLs) and uterine leiomyomas (ULs). So far, an increased occurrence of skin tumours in non-mutated patients with ULs has not been verified. To this aim, a case-group of women who were FH non-mutated patients surgically treated for ULs (n = 34) was compared with a control-group (n = 37) of consecutive age-matched healthy women. The occurrence of skin neoplasms, including CLs and dermatofibromas (DFs), was evaluated. Moreover, the microscopic features of FH non-mutated skin tumours were compared with those of an age-matched population group (n = 70) who presented, in their clinical history, only one type of skin tumour and no ULs. Immunohistochemical and in vitro studies analysed TGFβ and vitamin D receptor expression. FH non-mutated patients with ULs displayed a higher occurrence of CLs and DFs (p < 0.03 and p < 0.001), but not of other types of skin tumours. Immunohistochemistry revealed a lower vitamin D receptor (VDR) expression in CLs and DFs from the ULs group compared with those from the population group (p < 0.01), but a similar distribution of TGFβ-receptors and SMAD3. In vitro studies documented that TGFβ-1 treatment and vitamin D3 have opposite effects on α-SMA, TGFβR2 and VDR expression on dermal fibroblast and leiomyoma cell cultures. This unreported increased occurrence of CLs and DFs in FH non-mutated patients with symptomatic ULs with vitamin D deficiency suggests a potential pathogenetic role of vitamin D bioavailability also for CLs and DFs.
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Affiliation(s)
- Elena Campione
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.C.); (L.B.)
| | - Monia Di Prete
- Institute of Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.P.); (G.C.); (A.S.); (S.A.); (F.C.); (M.C.R.); (A.F.); (M.G.S.)
| | - Gaetana Costanza
- Institute of Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.P.); (G.C.); (A.S.); (S.A.); (F.C.); (M.C.R.); (A.F.); (M.G.S.)
| | - Andrea Saggini
- Institute of Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.P.); (G.C.); (A.S.); (S.A.); (F.C.); (M.C.R.); (A.F.); (M.G.S.)
| | - Sara Agostinelli
- Institute of Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.P.); (G.C.); (A.S.); (S.A.); (F.C.); (M.C.R.); (A.F.); (M.G.S.)
| | - Alessandro Terrinoni
- Department of Experimental Medicine and Biochemical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Federica Centofanti
- Institute of Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.P.); (G.C.); (A.S.); (S.A.); (F.C.); (M.C.R.); (A.F.); (M.G.S.)
| | - Maria Cristina Rapanotti
- Institute of Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.P.); (G.C.); (A.S.); (S.A.); (F.C.); (M.C.R.); (A.F.); (M.G.S.)
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.C.); (L.B.)
| | - Amedeo Ferlosio
- Institute of Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.P.); (G.C.); (A.S.); (S.A.); (F.C.); (M.C.R.); (A.F.); (M.G.S.)
| | - Maria Giovanna Scioli
- Institute of Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.P.); (G.C.); (A.S.); (S.A.); (F.C.); (M.C.R.); (A.F.); (M.G.S.)
| | - Augusto Orlandi
- Institute of Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (M.D.P.); (G.C.); (A.S.); (S.A.); (F.C.); (M.C.R.); (A.F.); (M.G.S.)
- Department of Biomedical Sciences, Catholic University Our Lady of Good Counsel, 1000 Tirana, Albania
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Shrestha E, Mishra A. Zosteriform pilar leiomyoma associated with uterine leiomyoma: A case report. Clin Case Rep 2023; 11:e6904. [PMID: 36777791 PMCID: PMC9900235 DOI: 10.1002/ccr3.6904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/16/2023] [Indexed: 02/08/2023] Open
Abstract
Cutaneous leiomyomas are benign tumors arising from smooth muscles of the skin. Multiple lesions may be arranged in segmental, zosteriform, disseminated patterns. Multiple pilar leiomyomas may be inherited in an autosomal dominant pattern and may be associated with uterine fibroids and renal cell carcinoma, also known as Reed Syndrome.
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Affiliation(s)
- Elisha Shrestha
- Dhulikhel Hospital Kathmandu University HospitalDhulikhelNepal
| | - Aditi Mishra
- Dhulikhel Hospital Kathmandu University HospitalDhulikhelNepal
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Daneshjou R, Vodrahalli K, Novoa RA, Jenkins M, Liang W, Rotemberg V, Ko J, Swetter SM, Bailey EE, Gevaert O, Mukherjee P, Phung M, Yekrang K, Fong B, Sahasrabudhe R, Allerup JAC, Okata-Karigane U, Zou J, Chiou AS. Disparities in dermatology AI performance on a diverse, curated clinical image set. SCIENCE ADVANCES 2022; 8:eabq6147. [PMID: 35960806 PMCID: PMC9374341 DOI: 10.1126/sciadv.abq6147] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/30/2022] [Indexed: 06/10/2023]
Abstract
An estimated 3 billion people lack access to dermatological care globally. Artificial intelligence (AI) may aid in triaging skin diseases and identifying malignancies. However, most AI models have not been assessed on images of diverse skin tones or uncommon diseases. Thus, we created the Diverse Dermatology Images (DDI) dataset-the first publicly available, expertly curated, and pathologically confirmed image dataset with diverse skin tones. We show that state-of-the-art dermatology AI models exhibit substantial limitations on the DDI dataset, particularly on dark skin tones and uncommon diseases. We find that dermatologists, who often label AI datasets, also perform worse on images of dark skin tones and uncommon diseases. Fine-tuning AI models on the DDI images closes the performance gap between light and dark skin tones. These findings identify important weaknesses and biases in dermatology AI that should be addressed for reliable application to diverse patients and diseases.
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Affiliation(s)
- Roxana Daneshjou
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford, CA, USA
| | - Kailas Vodrahalli
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Roberto A. Novoa
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
- Department of Pathology, Stanford School of Medicine, Stanford, CA, USA
| | - Melissa Jenkins
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Weixin Liang
- Department of Computer Science, Stanford University, Stanford, CA, USA
| | - Veronica Rotemberg
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Justin Ko
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Susan M. Swetter
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Elizabeth E. Bailey
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Olivier Gevaert
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford, CA, USA
| | - Pritam Mukherjee
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford, CA, USA
| | - Michelle Phung
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Kiana Yekrang
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Bradley Fong
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Rachna Sahasrabudhe
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | - Johan A. C. Allerup
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
| | | | - James Zou
- Department of Biomedical Data Science, Stanford School of Medicine, Stanford, CA, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
- Department of Computer Science, Stanford University, Stanford, CA, USA
- Chan-Zuckerberg Biohub, San Francisco, CA, USA
| | - Albert S. Chiou
- Department of Dermatology, Stanford School of Medicine, Redwood City, CA, USA
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Marcoval J, Llobera-Ris C, Moreno-Vílchez C, Penín RM. Cutaneous Leiomyoma: A Clinical Study of 152 Patients. Dermatology 2021; 238:587-593. [PMID: 34569484 DOI: 10.1159/000518542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cutaneous leiomyoma (CL) is a benign smooth muscle tumour included in painful skin tumours. Multiple CLs are cutaneous markers of hereditary leiomyomatosis and renal cell cancer (HLRCC). OBJECTIVES To retrospectively review our series of patients with CLs to analyse their clinical features and the association with HLRCC. METHODS Cases coded as CL in the database of the pathology department between 2004 and 2019 were included in the study. Medical records were retrospectively reviewed to obtain the following data: age, sex, location, number of lesions, diameter, evolution time at diagnosis, suspected clinical diagnosis, tenderness, status of resection margins, development of recurrence, follow-up time, and association with HLRCC. RESULTS 152 patients had CLs, 89 women and 63 men, mean age 56.26, SD 16.030 years. Subtypes were piloleiomyoma in 62 patients, angioleiomyoma in 80, and genital leiomyoma in 10. All of our 11 patients with multiple lesions corresponded to piloleiomyomas, and HLRCC was confirmed in 8 of them (73%). Patients with HLRCC were younger than patients with piloleiomyomas without HLRCC (34.88 vs. 56.17 years, p = 0.009). Vascular and genital leiomyomyomas were solitary and were not associated with HLRCC. CONCLUSION In patients with multiple piloleiomyomas HLRCC must be ruled out as it is confirmed in a high proportion of cases. The probability of fumarate hydratase mutation is greater in multiple piloleiomyomas involving both the trunk and upper extremities in the same patient.
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Affiliation(s)
- Joaquim Marcoval
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain
| | - Clàudia Llobera-Ris
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain
| | - Carlos Moreno-Vílchez
- Department of Dermatology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain
| | - Rosa María Penín
- Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, Barcelona, Spain
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Bailleux S, Somja J, Martin M, De Prijck B, Nikkels AF. HEREDITARY LEIOMYOMATOSIS AND ACUTE LYMPHOBLASTIC LEUKEMIA: a LINK THROUGH FUMARATE DYSHYDRATASE MUTATION? Acta Clin Belg 2021; 77:778-781. [PMID: 34515613 DOI: 10.1080/17843286.2021.1980669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND : Hereditary leiomyomatosis (HL) is an autosomal dominant condition due to a variety of fumarate hydratase (FH) mutations in which individuals tend to develop cutaneous leiomyomas, multiple uterine leiomyomas and are at risk for developing aggressive papillary renal cell carcinoma. CASE PRESENTATION : A 26-year-old man with a past history of acute lymphoblastic leukemia (T-ALL) presented with numerous painful light brown papules and nodules spread all over his body except for the head, appearing since infancy. Similar lesions were present in his mother's family. A cutaneous biopsy revealed a cutaneous leiomyoma. His mother died from metastatic uterine neoplasia and his sister suffered from leiomyoma of the uterus. No renal cancer was reported in his family. A heterozygous pathogenic variant was detected in the FH gene. CONCLUSION : To our knowledge, this is the first case possibly linking HL and T-ALL through FH deficiency.
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Affiliation(s)
- Sophie Bailleux
- Departments of Dermatology, Centre Hospitalier Universitaire De Liege, Belgium
| | - Joan Somja
- Departments of Dermatopathology, Centre Hospitalier Universitaire De Liege, Belgium
| | - Marie Martin
- Departments of Genetics, and Centre Hospitalier Universitaire De Liege, Belgium
| | - Bernard De Prijck
- Departments of Hematology, Chu Du Sart Tilman, University of Liège, Liège, Belgium
| | - Arjen F. Nikkels
- Departments of Dermatology, Centre Hospitalier Universitaire De Liege, Belgium
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Huang L, Qiu C, Chen F, Cheng F, Xiang Y, Zhou H, Zhang H, Wang X, Li D. A Large Vascular Leiomyoma Arising from the Superficial Femoral Artery: Case Report and Systematic Review. Ann Vasc Surg 2021; 76:601.e1-601.e6. [PMID: 34182108 DOI: 10.1016/j.avsg.2021.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 03/25/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Vascular leiomyomas are rare begin tumor comprising mature vascular smooth muscles that originate in the tunica media of the blood vessels. Most of the tumors arise from the veins. Only a dozen cases of artery-arising vascular leiomyoma have been reported, most of which are presented as small nodules in the hand. METHODS Here we report an interesting case of a large artery-arising vascular leiomyoma and perform a systematic review. RESULTS A 55-year-old man complained a 6 × 3 cm firm, mobile, tender and pulseless mass in the medial region of his left thigh. The computed tomography showed a well-demarcated fusiform tumor encircling the superficial femoral artery and was enhanced significantly with contrast. The patency of the superficial femoral artery was intact. The magnetic resonance image exhibited slightly hypointense relative to skeletal muscle on T1-weighted images and a heterogeneous appearance on T2-weighted images. We performed the en bloc resection of the tumor and used a vascular graft to revascularize the artery through end-to-end anastomosis. After histopathological assessments, the tumor was diagnosed as an artery-arising vascular leiomyoma. We also performed a systematic review on artery-arising leiomyomas, discovering 21 cases. Most of the artery-arising vascular leiomyomas were small nodules (mean length: 2.4cm) and most of them were superficial solitary mass located in the hand (13 cases, 62%). Excision of the tumor was an effective treatment. The histological subtype of the artery-arising vascular leiomyoma in all cases was solid type. During the follow-up of each patient, there was no recurrence. CONCLUSIONS Artery-arising vascular leiomyomas are extremely rare. Most of them are painless and locate in the hand. Their pathological subtype is solid type in all patients. Due to their begin nature, excision is a cure with little chance of recurrence.
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Affiliation(s)
- Lirui Huang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Chenyang Qiu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Fang Chen
- Nursing Department, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Fei Cheng
- Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Yilang Xiang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Huaji Zhou
- Department of Vascular Surgery, The NO .1 People's Hospital of Pinghu, Zhejiang Province, People's Republic of China
| | - Hongkun Zhang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
| | - Xiaohui Wang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
| | - Donglin Li
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
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Piloleiomyoma Presented by Multiple Cutaneous Nodules: a Case Report. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2021. [DOI: 10.2478/sjdv-2020-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction. Piloleiomyoma is a rare benign tumor which is caused by erector pili muscle and makes up 5% of all leiomyomas. They can be solitary and multiple. Multiple lesions still pose challenges for clinicians since their treatment option is very limited.
Case report. We report a case of a 25-year-old male patient who had painful papules and nodules on the neck and chest for three years. Multiple red-brown papules and nodules in the skin of regio mammaria dextra and regio submandibularis on the left were seen on physical examination. Histopathological examination of punch bi-were seen on physical examination. Histopathological examination of punch biopsy sample revealed well-circumscribed nodule composed of spindle cells. The case was reported as cutaneous leiomyoma (piloleiomyoma). The patient was given 5 mg/day amlodipin and kept under control.
Conclusion. The ideal treatment option for piloleiomyoma is surgical excision, but the problem with that treatment is that the lesions have tendency to recur. Medicamentous therapy plays a limited role; however, calcium-channel blockers and α-adrenergic blockers may help in palliating or eliminating associated pain through inhibition of smooth muscle contraction.
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9
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González IA, Dehner LP. Smooth muscle hamartoma and striated muscle hamartoma: Clinicopathologic characterization of two rare entities and literature review. J Cutan Pathol 2020; 48:237-246. [PMID: 32804407 DOI: 10.1111/cup.13850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/04/2020] [Accepted: 08/12/2020] [Indexed: 12/13/2022]
Abstract
Smooth muscle hamartoma (SMH) and striated muscle hamartoma (STH) are anomalous proliferations of smooth muscle or striated muscle, respectively, in anatomic sites where these tissues are normally present. To date, only limited cases have been reported describing these lesions. In this study, we sought to characterize the clinicopathologic features of both SMH and STH. A total of 27 cases of SMH and 12 cases of STH from 1990 to 2020 were identified. SMH cases had a slight male predominance (63%) and a mean age of presentation of 20 years (range: 4 months-91 years), with a mean size of 9.3 mm (±13.3). In contrast, STH were equally distributed in gender, with a mean age of presentation of 40 years (range: 3 months-66 years) and a mean size of 5.7 mm (±3.6). SMH were more commonly located in the torso and extremities (70%) and STH in the head and neck area (92%). One case of SMH recurred after 1.1 years and in the initial diagnosis the lesion was present at the tissue edge. None of the cases of STH had a recurrence. We present the largest cohort of SMH and STH, and report the first case of a recurrent SMH, suggesting the importance of obtaining a clean margin for these lesions.
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Affiliation(s)
- Iván A González
- The Lauren V. Ackerman Laboratory of Surgical Pathology, Department of Pathology and Immunology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA.,The Lauren V. Ackerman Laboratory of Surgical Pathology, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Louis P Dehner
- The Lauren V. Ackerman Laboratory of Surgical Pathology, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
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10
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Alam S, Banerjee P, Krishnakumar S. A rare case of congenital piloleiomyoma of the eyelid. Orbit 2020; 40:518-520. [PMID: 32847448 DOI: 10.1080/01676830.2020.1812671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cutaneous leiomyoma is an infrequently occurring benign smooth muscle neoplasm of skin. Piloleiomyoma, angioleiomyoma, and genital leiomyoma are the three forms of the cutaneous leiomyoma. Piloleiomyoma arises from arrector pili muscle and is commonly seen in the adult population. Congenital piloleiomyoma is extremely rare and has never been reported to arise from the eyelid. We report a case of a neonate presenting with upper eyelid mass lesion since birth causing mechanical ptosis. Incisional biopsy followed by histopathology and immunohistochemistry established the diagnosis of piloleiomyoma. There was associated cryptorchidism in our case, a systemic association that has never been reported. Considering the benign nature of the lesion the child was kept under regular follow up without attempting any further removal.
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Affiliation(s)
- Shahid Alam
- Aditya Birla Sankara Nethralaya, Kolkata, India.,A Unit of Medical Research Foundation, Chennai, India
| | - Prabrisha Banerjee
- Orbit, Oculoplasty, Reconstructive & Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, India
| | - Subramanian Krishnakumar
- Larson and Turbo Department of Ocular Pathology, Vision Research Foundation, Sankara Nethralaya, Chennai, India
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11
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Multiple Cutaneous Leiomyomas Showing Increased FDG Uptake. Clin Nucl Med 2020; 45:827-829. [PMID: 32701814 DOI: 10.1097/rlu.0000000000003213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cutaneous leiomyomas are rare, sporadic, or inherited benign tumors arising from smooth muscle cells of the skin associated with various disorders. We present a case of multiple cutaneous leiomyomas showing increased FDG uptake with SUVmax of 19.9. This case indicates cutaneous leiomyoma should be considered as a rare differential diagnosis in patients with hypermetabolic cutaneous lesions. Careful correlation with clinical history is needed to avoid misdiagnosis.
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12
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Li XX, Zheng M, Man XY. A tender sweaty plaque on the foot of an adolescent boy. Pediatr Dermatol 2019; 36:538-539. [PMID: 31290610 DOI: 10.1111/pde.13815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Xin-Xin Li
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Min Zheng
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiao-Yong Man
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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13
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Bevans SL, Mayo TT, Pavlidakey PG, Cannon AD, Korf BR, Mercado PJ. Unusual presentation of hereditary leiomyomatosis mimicking neurofibromatosis. JAAD Case Rep 2018; 4:440-441. [PMID: 29984275 PMCID: PMC6031563 DOI: 10.1016/j.jdcr.2017.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
| | - Tiffany T Mayo
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Peter G Pavlidakey
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ashley D Cannon
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Bruce R Korf
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Patricia J Mercado
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
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14
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Gupta G, Sudan R, Mushtaq S. Multiple Cutaneous and Uterine Leiomyomatosis with Renal Involvement: Report of a Rare Association. Indian J Dermatol 2018. [PMID: 29527031 PMCID: PMC5838760 DOI: 10.4103/ijd.ijd_355_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Cutaneous leiomyomas (CLs) are uncommon benign smooth muscle tumours characterised by solitary or multiple painful nodules. Based on origin, three types are recognised, namely piloleiomyoma, dartoic leiomyoma, and angioleiomyoma, with piloleiomyomas being the commonest one. Reed's syndrome also known as multiple cutaneous and uterine leiomyomatosis (MCULs) is characterised by CLs in men and CLs and uterine fibroids in women. Association of Reed's syndrome with renal cell carcinoma is labelled as hereditary leiomyomatosis and renal cell carcinoma (HLRCC). Both MCUL and HLRCC are caused by a heterozygous mutation in the fumarate hydratase gene. Besides renal cell carcinoma, there were extremely rare reports of association of MCUL with benign renal lesions. We report a case of a 55-year-old female with segmental tender papulonodular lesions suggestive of leiomyoma associated with uterine leiomyomas and unilateral renal cyst. The case is reported here for its rarity and uncommon association with asymptomatic benign renal cyst.
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Affiliation(s)
- Gunjan Gupta
- Department of Dermatology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
| | - Rahul Sudan
- Department of Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India
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Adams A, Sharpe KK, Peters P, Freeman M. Hereditary leiomyomatosis and renal cell cancer (HLRCC): cutaneous and renal manifestations requiring a multidisciplinary team approach. BMJ Case Rep 2017; 2017:bcr-2016-215115. [PMID: 28400389 DOI: 10.1136/bcr-2016-215115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Cutaneous leiomyomasare rare tumours of smooth muscle origin associated with disorders such as hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome. HLRCC is an autosomal dominant syndrome caused by loss of function mutations in the fumarate hydratase gene. Sufferers of this disorder are predisposed to the development of tumours of the skin and/or uterus, with a further subset of HLRCC families at risk of renal cell carcinoma with papillary features. This syndrome is rare and carries with it a significant rate of mortality. A multidisciplinary approach to care is critical in the management of these patients and their families. The dermatologist can play a central role in this process, coordinating care between specialist medical and allied health teams.
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Affiliation(s)
- Agnieszka Adams
- Royal Australian College of General Practitioners, Graceville, Australia
| | - Kendall Katie Sharpe
- Department of Otolaryngology, Sir Charles Gairdner Hospital, Nedlands, Australia .,Department of Medical Education, Gold Coast Hospital and Health Service, Southport, Australia
| | - Peter Peters
- Gold Coast University Hospital, Gold Coast, Australia
| | - Michael Freeman
- Department of Dermatology, Gold Coast Hospital and Health Service, Southport, Australia
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Rare Leiomyoma of the Tunica Dartos: A Case Report with Clinical Relevance for Malignant Transformation and HLRCC. Case Rep Pathol 2016; 2016:6471520. [PMID: 27529047 PMCID: PMC4978837 DOI: 10.1155/2016/6471520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 06/24/2016] [Accepted: 06/30/2016] [Indexed: 11/17/2022] Open
Abstract
Background. Genital leiomyomas fall under the broader category of cutaneous leiomyomas, which are rare smooth muscle neoplasms accounting for 5% of all leiomyomas. Genital leiomyomas arising from the dartos muscle are exceedingly rare with fewer than 30 cases reported in the literature. They are typically benign and adequately treated with simple surgical excision; however, previously reported cases of malignant transformation and a possible link to the hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome warrant closer follow-up. Case Presentation. We report a case of a 47-year-old male refugee from Rwanda found to have a mobile, pea-sized, mildly painful scrotal lesion near the left penoscrotal junction and 1.5 cm indeterminate vascular mass in the right kidney. Surgical excision of the scrotal nodule was performed and the diagnosis of a dartoic leiomyoma was rendered. The presence of moderate nuclear atypia, rare mitotic activity, and close surgical margins prompted a wide reexcision. We report the surgical approach, pathologic findings, and clinical follow-up related to this scrotal lesion. Conclusion. Scrotal leiomyomas demonstrate a high rate of recurrence and pose a risk for malignant transformation. They may also indicate an underlying autosomal dominant syndrome associated with increased risk for development of an aggressive form of renal cell carcinoma. When discovered, management should include surgical excision, screening for syndromic features, and routine follow-up.
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