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Bharti S, Khera S, Sharma C, Balakrishnan A. Unilateral primary ovarian leiomyoma masqueraded as ovarian fibroma: A histopathological diagnosis. J Family Med Prim Care 2021; 10:3494-3497. [PMID: 34760779 PMCID: PMC8565167 DOI: 10.4103/jfmpc.jfmpc_2546_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 05/23/2021] [Indexed: 11/17/2022] Open
Abstract
Leiomyoma is the commonest benign mesenchymal tumor of the uterus, which can be developed at any site where smooth muscle cells are found. The broad ligament is the most common and ovary is one of the rarest extrauterine sites, accounting for 0.5–1% of all benign ovarian tumors. Herein, we report a case of ovarian leiomyoma in a perimenopausal female, clinically presented with heavy menstrual bleed, radiologically diagnosed as subserosal uterine fibroid. Intraoperatively, it was considered as ovarian fibroma but finally diagnosed as ovarian leiomyoma on histomorphology, which was confirmed on special stains and immunohistochemistry. A review of literature showed that less than 100 cases of primary ovarian leiomyomata have been reported until now. Ovarian leiomyoma is usually small, asymptomatic, and an incidental finding mostly, usually synchronously seen with uterine leiomyoma. Ovarian leiomyoma is a rare tumor, often misdiagnosed prior to surgical removal and it should be differentiated from other spindle cell neoplasm and solid tumors of the ovary.
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Affiliation(s)
- Sushma Bharti
- Department of Pathology, AIIMS, Jodhpur, Rajasthan, India
| | - Sudeep Khera
- Department of Pathology, AIIMS, Jodhpur, Rajasthan, India
| | - Charu Sharma
- Department of Obstetrics and Gynecology, AIIMS, Jodhpur, Rajasthan, India
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Rodríguez Sánchez-Reyman J, Moreno López M, Gutiérrez Domingo Á, Rodríguez Jiménez I, Pantoja Garrido M. Leiomioma ovárico primario en paciente posmenopáusica. Posibilidad dentro del diagnóstico diferencial de las neoplasias de ovario. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2021. [DOI: 10.1016/j.gine.2021.100689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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3
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Alshwairikh K, AlOtaibi W, Alshammari S, Alshammari T, Hakami R, Alswayyed M, Bin Traiki T. Cystic Ovarian Leiomyoma in a Patient with Progressive Abdominal Pain. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e930299. [PMID: 34191791 PMCID: PMC8255085 DOI: 10.12659/ajcr.930299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patient: Female, 45-year-old Final Diagnosis: Leiomyoma with massive cystic hydropic degeneration Symptoms: Abdominal distention and pain Medication:— Clinical Procedure: — Specialty: Surgery
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Affiliation(s)
- Khaloud Alshwairikh
- Department of Anesthesia, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Wadha AlOtaibi
- Colorectal Research Chair, Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Sulaiman Alshammari
- Colorectal Research Chair, Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Turki Alshammari
- Colorectal Research Chair, Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Riyadh Hakami
- Colorectal Research Chair, Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Alswayyed
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Thamer Bin Traiki
- Colorectal Research Chair, Department of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
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Kitamura Y, Ito F, Kokabu T, Mori T, Kusuki I, Kitawaki J. Primary Ovarian Leiomyoma Associated with Multiple Uterine Leiomyomas. Gynecol Minim Invasive Ther 2021; 10:50-52. [PMID: 33747775 PMCID: PMC7968602 DOI: 10.4103/gmit.gmit_97_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/17/2020] [Accepted: 06/03/2020] [Indexed: 11/04/2022] Open
Abstract
Ovarian leiomyomas are very rare. We report the case of a primary ovarian leiomyoma accompanied by multiple uterine leiomyomas. A 50-year-old woman was referred to our department for heavy menstruation, and a hot spot in the uterine lumen was observed on positron emission tomography-computed tomography (PET-CT). Cervical and endometrial cytology and tumor marker tests were negative. Pelvic magnetic resonance imaging revealed an endometrial polyp and submucosal leiomyoma in the uterine lumen and a 5-cm right ovarian tumor. Laparoscopic total hysterectomy, right salpingo-oophorectomy, and left salpingectomy were performed for radical treatment. Histopathology showed that ovarian tumors contained interlacing bundles of fusiform cells encircled by normal ovarian tissue. Immunohistochemical staining showed strong and diffuse positive staining for α-smooth muscle actin. We diagnosed the tumor as a primary ovarian leiomyoma because the leiomyoma was localized in the ovary and was larger than the size of uterine leiomyomas. No metastatic lesion was found on PET-CT. There was no tumor recurrence at the 6-month follow-up.
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Affiliation(s)
- Yoshihiro Kitamura
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Fumitake Ito
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Tetsuya Kokabu
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Taisuke Mori
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Izumi Kusuki
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Jo Kitawaki
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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Thombare P, Chheda P, Parikh R, Shetty R, Verma M, Patkar D. Primary ovarian leiomyoma: Imaging in a rare entity. Radiol Case Rep 2020; 15:1066-1070. [PMID: 32461778 PMCID: PMC7243055 DOI: 10.1016/j.radcr.2020.04.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/24/2020] [Accepted: 04/26/2020] [Indexed: 11/22/2022] Open
Abstract
Primary ovarian leiomyoma is a very rare benign mesenchymal tumor arising from the smooth muscle of walls of ovarian blood vessels. It is usually seen between 20 65 years of age. Being asymptomatic in many patients, these are incidentally detected. Ultrasonography and magnetic resonance imaging are preferred modality while imaging these lesions. Hereby we present a case of a 35-year-old female with incidentally detected right ovarian mass lesion which was hypointense on ultrasonography, hypointense on both T1W and T2W images, and on histopathology confirmed as primary ovarian leiomyoma. T1- and T2-weighted hypointensity on MRI with early homogenous postcontrast enhancement help in its diagnosis, though many a time it is difficult to differentiate it from other mesenchymal fibrous tumors such as fibroma and fibrothecoma. Histopathology and immunohistochemistry remain the mainstay in final confirmatory diagnosis. It is important to keep this entity in the differential diagnosis of solid T1 and T2 hypointense lesions of the ovary.
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Affiliation(s)
- Pranav Thombare
- DNB Resident, Nanavati super-speciality Hospital, Mumbai, India
| | - Pooja Chheda
- DNB Resident, Nanavati super-speciality Hospital, Mumbai, India
| | - Rashmi Parikh
- Consultant Radiologist, Nanavati super-speciality Hospital, Mumbai, India
| | - Roshan Shetty
- Consultant Radiologist, Pinnacle Imaging centre, Mumbai, India
| | - Mitusha Verma
- Consultant Radiologist, Nanavati super-speciality Hospital, Mumbai, India
| | - Deepak Patkar
- Consultant Radiologist, Head of Department, Nanavati super-speciality Hospital, Mumbai, India
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Asada T, Yamada T, Kumano R. Primary ovarian leiomyoma with predominant cystic change. Radiol Case Rep 2019; 14:1315-1319. [PMID: 31516645 PMCID: PMC6732733 DOI: 10.1016/j.radcr.2019.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/16/2019] [Accepted: 08/16/2019] [Indexed: 11/29/2022] Open
Abstract
Ovarian leiomyoma is a rare benign tumor, seen mostly in women 20-65 years old. The case of a 51-year-old woman with a large tumor in the pelvic cavity is reported. The dominant feature of the tumor was its cystic component, but an irregular, solid component was recognized along the dorsal margin of the tumor. The latter area showed signal intensity as low as muscle on T2-weighted images and significant contrast enhancement; however, it did not show restricted diffusion, which implied that it was benign. The large tumor was resected because malignancy could not be ruled out, and it was pathologically diagnosed as ovarian leiomyoma with predominant necrosis. When a low-intensity component without malignant features is seen on magnetic resonance imaging, leiomyoma should be included in the differential diagnosis despite its rare occurrence in the ovary.
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Abstract
Ovarian lipoleiomyoma is an extremely rare neoplasm and may pose a diagnostic challenge for clinicians, radiologists, and pathologists. It is rarely described as case reports in the literature; almost all patients are late middle aged or elderly. Hereby, we encountered a 57-yr-old postmenopausal woman who presented with abdominal pain. Radiologic investigation revealed a heterogenous nonenhancing mass in the left adnexa, suggestive of dermoid cyst. Microscopic examination showed clusters of adipocytes intersecting the fascicles of smooth muscles, diagnostic of lipoleiomyoma. The present case revisits the clinical and morphologic findings of lipoleiomyoma along with previously published cases in literature.
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Abstract
RATIONALE Ovarian leiomyoma is a rare ovarian tumor that occurs in 20-65 year-old women, and is mostly misdiagnosed as malignant tumor. In most reports on this type of tumor, ovarian myoma has a benign histology. Herein,we describe a case of ovarian atypical leiomyoma. PATIENT CONCERNS The patient is a 58-year-old woman. At the age of 40 years old, the patient underwent hysterectomy due to "hysteromyoma" and secondary anemia. The patient was admitted to our hospital due to palpation of lower abdominal mass and abdominal distention. DIAGNOSES A mass was revealed at the left uterine appendage by pelvic ultrasound and CT.Pathology and immunohistochemistry confirmed the diagnosis of the left ovarian atypical leiomyoma. INTERVENTIONS Pelvic cavity resection and right adnexectomy were performed during laparotomy for the patient. OUTCOMES Without radiotherapy or chemotherapy, there were no signs of tumor recurrence in a 9-month follow-up period. LESSONS When a solid mass appears in ovarian tissues, ovarian leiomyoma should be considered. Patients with this type of tumor are mostly asymptomatic. Preoperative diagnosis was difficult, intraoperative frozen section would be helpful for determining the scope of the surgery, and the correct diagnosis was made by identifying the properties of smooth muscles through postoperative pathology and immunohistochemistry.
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Affiliation(s)
- Qiu-Man Wang
- First Clinical Medical College, Shanxi Medical University
| | - Ye Zhao
- Department of Gynecology, First Hospital of Shanxi Medical University,Taiyuan, China
| | - Ying Ma
- Department of Gynecology, First Hospital of Shanxi Medical University,Taiyuan, China
| | - Li-Ting Yao
- First Clinical Medical College, Shanxi Medical University
| | - Xiao Han
- First Clinical Medical College, Shanxi Medical University
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Ellibeş Kaya A, Ökten SB, Başbuğ A, Gamsızkan M, Doğan O, Baki H. Unilateral Ovarian Leiomyoma in a 14-year-old Adolescent: A rare case report. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2018. [DOI: 10.25000/acem.383578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Pecile A, Groppetti D, Grieco V, Barella G, Moioli M, Faverzani S. Asymptomatic Unilateral Ovarian Leiomyoma in a German Shepherd Bitch. MACEDONIAN VETERINARY REVIEW 2017. [DOI: 10.1515/macvetrev-2016-0093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
This report shows for the first time clinical imaging (ultrasound and computed tomography), histological and immunohistochemical findings of an ovarian leiomyoma, coincidentally diagnosed in an asymptomatic unmated nulliparous ten year-old German shepherd bitch concurrently suffering from multiple mammary tumors. A thorough examination allowed the differentiation of ovarian leiomyoma from other spindle cell tumors. An accurate description of the diagnostic procedures useful in the managing of ovarian leiomyoma could provide valuable information to veterinary practitioners. Indeed, despite its rarity and nonspecific symptoms, ovarian leiomyoma may also affect the dog with an unknown potential risk.
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Affiliation(s)
- Alessandro Pecile
- Department of Veterinary Medicine, Faculty of Veterinary Medicine , Università degli Studi di Milano , via G. Celoria 10 - 20133 Milano , Italy
| | - Debora Groppetti
- Department of Veterinary Medicine, Faculty of Veterinary Medicine , Università degli Studi di Milano , via G. Celoria 10 - 20133 Milano , Italy
| | - Valeria Grieco
- Department of Veterinary Medicine, Faculty of Veterinary Medicine , Università degli Studi di Milano , via G. Celoria 10 - 20133 Milano , Italy
| | - Gabriele Barella
- Department of Veterinary Medicine, Faculty of Veterinary Medicine , Università degli Studi di Milano , via G. Celoria 10 - 20133 Milano , Italy
| | - Melania Moioli
- Department of Veterinary Medicine, Faculty of Veterinary Medicine , Università degli Studi di Milano , via G. Celoria 10 - 20133 Milano , Italy
| | - Stefano Faverzani
- Department of Veterinary Medicine, Faculty of Veterinary Medicine , Università degli Studi di Milano , via G. Celoria 10 - 20133 Milano , Italy
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11
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Kim M. Laparoscopic management of a twisted ovarian leiomyoma in a woman with 10 weeks' gestation: Case report and literature review. Medicine (Baltimore) 2016; 95:e5319. [PMID: 27858913 PMCID: PMC5591161 DOI: 10.1097/md.0000000000005319] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Primary leiomyoma of the ovary is a rare benign ovarian tumor that only seldom causes acute abdomen. CASE SUMMARY A 35-year-old gravida 1, para 0 woman presented with a history of acute lower abdominal pain, and 10 weeks of amenorrhea. The patient's physical examination revealed abdominal tenderness, defense, and rebound. On ultrasonographic examination, a solid mass measuring 9.3 × 7.8 cm was detected adjacent to the uterine fundus. The mass was preoperatively diagnosed as a twisted pedunculated subserosal uterine myoma. Upon entering the pelvic cavity, the mass in the right adnexa appeared twisted clockwise. Therefore, a laparoscopic salpingo-oophorectomy was performed. The tumor was pathologically diagnosed as ovarian leiomyoma. The patient delivered a healthy girl at 40 1/7 weeks of pregnancy. CONCLUSION Despite its low incidence, torsion of ovarian leiomyoma should be considered in the differential diagnosis of acute abdomen. Furthermore, laparoscopic exploration should be the preferred way of removing twisted ovarian leiomyoma, even during pregnancy. It seems that primary ovarian leiomyomata have a tendency to grow rapidly during early pregnancy. However, because of the low incidence of ovarian leiomyoma, the effects of estrogen and pregnancy on this condition remain unclear.
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Affiliation(s)
- Myounghwan Kim
- Department of Obstetrics and Gynecology, Sanggye Paik Hospital, Inje University, School of Medicine, Seoul, Korea
- Correspondence: Myounghwan Kim, Department of Obstetrics and Gynecology, Sanggye Paik Hospital, Inje University, School of Medicine, Seoul, Korea (e-mail: )
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A rare combination of ovarian and uterine leiomyomas with goblet cell carcinoid of the appendix. Case Rep Surg 2015; 2015:467243. [PMID: 25685587 PMCID: PMC4313517 DOI: 10.1155/2015/467243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 12/29/2014] [Indexed: 11/23/2022] Open
Abstract
We present a case of the rare combination of unilateral ovarian leiomyoma, uterine leiomyoma, and goblet cell carcinoid tumor of the appendix in a premenopausal woman who presented with right iliac pain. Immunohistochemistry study for desmin (muscle marker) and chromogranin and synaptophysin (neuroendocrine markers) confirmed immunophenotyping origin. Interestingly, both tumors showed positive reaction for estrogen receptor. To our knowledge, such a combination has not been reported previously in the literature. In this paper, the pathogenesis and differential diagnosis of both types of tumors are discussed.
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13
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Zhao X, Chen L, Zeng W, Jin B, DU W. Laparoscopic tumorectomy for a primary ovarian leiomyoma during pregnancy: A case report. Oncol Lett 2014; 8:2523-2526. [PMID: 25360170 PMCID: PMC4214398 DOI: 10.3892/ol.2014.2596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 07/08/2014] [Indexed: 12/05/2022] Open
Abstract
Few reports have explored laparoscopic adnexal tumorectomy as a treatment for large and symptomatic ovarian leiomyomas during pregnancy. The current study presents the case of a patient with a large and symptomatic ovarian leiomyoma at 14 weeks of pregnancy. A laparoscopic adnexal tumorectomy was performed without complications. The laparoscopic management of large primary ovarian leiomyoma during pregnancy has not been reported in literature. Therefore, laparoscopy may be considered as a minimally invasive and feasible alternative to laparotomy for the treatment of large ovarian solid tumors during pregnancy, resulting in reduced postoperative pain, a smaller scar and shorter recovery time. By contrast, with respect to the ovarian solid tumor, surgery prior to gestation is advised, even for tumors of <3 cm in diameter, due to the probability of rapid growth of the tumor during pregnancy.
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Affiliation(s)
- Xiaofeng Zhao
- Department of Gynecology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China
| | - Lifeng Chen
- Department of Gynecology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China
| | - Wenjie Zeng
- Department of Gynecology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China
| | - Bihui Jin
- Department of Gynecology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China
| | - Weijie DU
- Department of Gynecology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, P.R. China
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14
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Taskin MI, Ozturk E, Yildirim F, Ozdemir N, Inceboz U. Primary ovarian leiomyoma: A case report. Int J Surg Case Rep 2014; 5:665-8. [PMID: 25194600 PMCID: PMC4189054 DOI: 10.1016/j.ijscr.2014.07.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 07/24/2014] [Indexed: 11/09/2022] Open
Abstract
Primary ovarian leiomyoma is one of the rarest solid tumours of the ovary. Many patients with ovarian leiomyomas are nulligravidas. Differential diagnosis can be difficult from ovarian solid tumours. The diffuse strong positive staining for SMA is characteristic of leiomyoma. Unilateral and benign tumours can be treated with unilateral salpingo-oopherectomy.
INTRODUCTION Primary ovarian leiomyoma is a rare benign tumour of the ovary seen in women between 20 and 65 years old. It is usually diagnosed incidentally during pelvic examination or pathologic examination after surgery. PRESENTATION OF CASE We describe a case of unilateral, ovarian leiomyoma. Transvaginal ultrasonography and magnetic resonance imaging (MRI) revealed a right adnexial mass. Unilateral salpingo-oophorectomy was performed, and histological examination revealed a leiomyoma arising primarily in the ovary. The diagnosis was confirmed immunohistochemically. DISCUSSION The tumour may be asymptomatic or may manifest with lower abdominal pain like in our case. The definitive diagnosis of these lesions is difficult prior to surgical removal. Because there is no pathognomonic symptoms or characteristic imaging findings. The correct diagnosis of an ovarian leiomyoma requires identification of the smooth muscle nature of the tumour. CONCLUSION This rare tumour of the ovary should be considered in the differential diagnosis of solid ovarian masses. An immunohistochemical analysis is recommended for definitive diagnosis.
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Affiliation(s)
- Mine Islimye Taskin
- Balıkesir University School of Medicine, Department of Obstetrics and Gynecology, Turkey.
| | - Emine Ozturk
- Balıkesir University School of Medicine, Department of Obstetrics and Gynecology, Turkey
| | - Fatma Yildirim
- Ege University School of Medicine, Department of Pathology, Turkey
| | | | - Umit Inceboz
- Balıkesir University School of Medicine, Department of Obstetrics and Gynecology, Turkey
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Blue NR, Felix JC, Jaque J. Primary ovarian leiomyoma in a premenarchal adolescent: first reported case. J Pediatr Adolesc Gynecol 2014; 27:e87-8. [PMID: 24374195 DOI: 10.1016/j.jpag.2013.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 07/29/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Primary ovarian leiomyoma is a rare benign ovarian tumor with only several reported cases in adolescents. Little is known about the origin or natural history of these rare tumors as they have occurred in a variety of presentations and were removed upon presentation without observation. CASE A 14-year-old, premenarchal female was found to have a 4 cm mass which grew to 6.5 cm over two years. It appeared sonographically most consistent with a teratoma; however, during surgical resection it was found to be solid, and on pathologic evaluation was identified as an ovarian leiomyoma. SUMMARY AND CONCLUSION The growth of this patient's tumor with the onset of puberty supports hormonal responsivity, but its presence prior to menarche suggests an alternate origin, independent of gonadal hormones.
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Affiliation(s)
- Nathan R Blue
- Department of Obstetrics and Gynecology, LAC+USC Medical Center, Los Angeles, CA.
| | - Juan C Felix
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jenny Jaque
- Department of Obstetrics and Gynecology, LAC+USC Medical Center, Los Angeles, CA; Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Lee HW, Kang KK, Min CW, Kim AY, Lee EM, Lee EJ, Lee MM, Kim SH, Sung SE, Jeong KS. Primary leiomyoma of the ovaries in a dog. J Biomed Res 2014. [DOI: 10.12729/jbr.2014.15.1.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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17
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Agrawal R, Kumar M, Agrawal L, Agrawal KK. A huge primary ovarian leiomyoma with degenerative changes-an unusual. J Clin Diagn Res 2013; 7:1152-4. [PMID: 23905126 DOI: 10.7860/jcdr/2013/5313.3060] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 03/28/2013] [Indexed: 11/24/2022]
Abstract
Primary ovarian leiomyoma is a rare benign tumour of the ovary, which is seen in women who are aged between 20 years to 65 years. Ovarian leiomyomas can be confused with other spindle cell tumours which display gross anatomical and histological similarities. A case of a primary leiomyoma of the ovary in a pre-menopausal female is being presented here, due to its huge size and unusual presentation.
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Affiliation(s)
- Ranjan Agrawal
- Department of Pathology, Rohilkhand Medical College Hospital , Bareilly, UP, India
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Koo YJ, Cho YJ, Kim JY, Lee JE, Kim ML, Kim JM, Han HW, Joo KY. Ovarian leiomyoma as a potential cause of compromised fertility. Fertil Steril 2010; 95:1120.e11-4. [PMID: 20947074 DOI: 10.1016/j.fertnstert.2010.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2010] [Revised: 08/26/2010] [Accepted: 09/03/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To analyze cases of ovarian leiomyomas and to discuss the proper surgical management. DESIGN A case series and discussion. SETTING General university hospital and healthcare center. PATIENT(S) Nine patients who were diagnosed with ovarian leiomyomas after surgery between 1993 and 2009. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) A preoperative diagnosis that was matched to the postoperative diagnosis and the type of surgery. RESULT(S) In all cases, ovarian leiomyoma was misdiagnosed preoperatively as pedunculated uterine myoma, ovarian fibroma, or even ovarian endometrioma. Seven (77.8%) of the nine patients underwent a salpingo-oophorectomy or an oophorectomy with or without hysterectomy, and only two (22.2%) patients were submitted to an ovary-preserving surgery (i.e., a cystectomy or ovarian wedge resection). CONCLUSION(S) Because of their extreme rarity, ovarian leiomyomas are seldom suspected intraoperatively or preoperatively. However, most of these tumors appear at reproductive age and have a benign nature, similar to uterine myomas. Therefore, surgeons should perform ovary-preserving management, especially in young patients.
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Affiliation(s)
- Yu-Jin Koo
- Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, South Korea
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van Esch EMG, van Wijngaarden SE, Schaafsma HE, Smeets MJGH, Rhemrev JPT. The diagnostic and therapeutic approach of a primary bilateral leiomyoma of the ovaries: a case report and a literature review. Arch Gynecol Obstet 2010; 283:1369-71. [PMID: 20607264 DOI: 10.1007/s00404-010-1576-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 06/17/2010] [Indexed: 11/27/2022]
Abstract
INTRODUCTION A primary fibroid (leiomyoma) arising from both ovaries is rare and can be difficult to diagnose as a result of the low incidence and its indistinctive presentation. A literature review on the diagnostic and therapeutic approach of this rare benign tumour is presented. We describe a case of bilateral primary ovarian fibroid with an unusual presentation to illustrate our recommendations for treatment. CASE PRESENTATION A 37-year-old woman was admitted with symptoms of acute severe abdominal pain. She had a history of faint abdominal discomfort. Due to the acute deterioration of the abdominal pain a diagnostic laparoscopy was performed. A tumour arising from both ovaries was seen and a biopsy was taken in order to decide on further therapy. Histology showed a fibroid for which excision by a second laparoscopic intervention was planned. Due to excessive adhesions conversion to laparotomy was necessary. CONCLUSION We recommend that in the case of an abnormal adnexal mass, particularly in women who want to preserve their fertility, frozen section histology be performed laparoscopically. A frozen section diagnostic procedure, instead of a regular biopsy, seems to be a useful tool during an elective diagnostic laparoscopic procedure in order to prevent potential morbidity as a result of possible future laparoscopy or even laparotomy. Previous laparoscopic procedures can cause massive adhesions that could impede a subsequent laparoscopic approach.
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Affiliation(s)
- E M G van Esch
- Department of Gynecology, Bronovo Hospital, Postbus 96900, 2509 JH The Hague, The Netherlands.
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Affiliation(s)
- U Zafar
- Department of Obstetrics and Gynaecology, Russells Hall Hospital, Dudley DY1 2HQ, UK.
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Tomas D, Lenicek T, Tuckar N, Puljiz Z, Ledinsky M, Kruslin B. Primary ovarian leiomyoma associated with endometriotic cyst presenting with symptoms of acute appendicitis: a case report. Diagn Pathol 2009; 4:25. [PMID: 19642987 PMCID: PMC2724421 DOI: 10.1186/1746-1596-4-25] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Accepted: 07/30/2009] [Indexed: 11/23/2022] Open
Abstract
Background Ovarian leiomyoma is a rare benign tumor that accounts for 0.5 to 1% of all benign ovarian tumors. It probably arises from smooth muscle cells in the ovarian hilar blood vessels but there are other possible origins including cells in the ovarian ligament, smooth muscle cells or multipotential cells in the ovarian stroma, undifferentiated germ cells, or cortical smooth muscle metaplasia. Additionally, smooth muscle metaplasia of endometriotic stroma, smooth muscle present in mature cystic teratomas, and smooth muscle in the walls of mucinous cystic tumor may explain their occurrence in the ovary in some cases. Case presentation A 31-year-old woman was admitted to our surgical emergency service with a one-day history of appendicitis-like symptoms. Upon laparotomy, there was a solid, oval left-sided ovarian tumor located behind the uterus. The tumor was sent to the pathology department. A diagnosis of primary ovarian leiomyoma associated with an endometriotic cyst was established. Conclusion The origin of ovarian leiomyoma is still unresolved. In our case, the tumor probably arose from smooth muscle cells derived from myofibroblasts that originate from metaplastic ovarian stromal cells present in the rim of the endometriotic cyst. Despite its rarity, ovarian leiomyoma should be considered in the differential diagnosis of ovarian spindle cell tumors. Appropriate diagnosis may require additional immunohistochemical analysis in some cases.
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Affiliation(s)
- Davor Tomas
- Department of Pathology, Sestre Milosrdnice University Hospital, Zagreb, Croatia.
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Fasih N, Prasad Shanbhogue AK, Macdonald DB, Fraser-Hill MA, Papadatos D, Kielar AZ, Doherty GP, Walsh C, McInnes M, Atri M. Leiomyomas beyond the Uterus: Unusual Locations, Rare Manifestations. Radiographics 2008; 28:1931-48. [PMID: 19001649 DOI: 10.1148/rg.287085095] [Citation(s) in RCA: 237] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Najla Fasih
- Department of Diagnostic Imaging, Ottawa Hospital, Ottawa, ON, Canada.
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