1
|
Devins KM, Young RH, Oliva E. Sex Cord-Stromal Tumors of the Ovary: An Update and Review. Part I - Pure Ovarian Stromal Tumors. Adv Anat Pathol 2024; 31:215-230. [PMID: 38369847 DOI: 10.1097/pap.0000000000000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
In two separate reviews, we review the time-honored but still frequently challenging features of ovarian sex cord-stromal tumors, and also emphasize new developments including unusual morphologic appearances that, despite the relative rarity of many of the tumors, result in a disproportionate number of differential diagnostic problems, variant immunohistochemical profiles, and specific molecular and syndromic associations. These neoplasms are also of historical interest as current knowledge is still based in significant part on the contributions of 2 giants of gynecologic pathology, Dr Robert Meyer and Dr Robert E. Scully. In part I, we present the major clinical, pathologic, and genomic features of the pure ovarian stromal tumors including comments on differential diagnosis and briefly note significant historical contributions. In part II we will discuss pure sex cord and sex cord-stromal tumors.
Collapse
Affiliation(s)
- Kyle M Devins
- James Homer Wright Pathology Laboratories, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | | |
Collapse
|
2
|
Zhang M, Hong Y, Wang L, Qin LL, Jing XX. Ultrasonographic manifestations and misdiagnosis analysis of ovarian leiomyoma. Front Med (Lausanne) 2023; 10:1289522. [PMID: 38213912 PMCID: PMC10783815 DOI: 10.3389/fmed.2023.1289522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/30/2023] [Indexed: 01/13/2024] Open
Abstract
Objectives Ovarian leiomyomas (OLs) are rare and account for only 0.5 to 1% of benign ovarian tumors. This study investigated the ultrasonographic manifestations of OL and the potential reasons for misdiagnosis. Methods Between July 2018 and July 2023, 7 patients diagnosed with OL by surgical pathology and immunohistochemistry were enrolled in this retrospective analysis. Ultrasound (US) examinations were performed before surgery. Clinical characteristics, pathological findings, ultrasonographic manifestations, and treatment were reviewed. Results The mean age of the 7 patients was 39.0 ± 11.57 years, with a disease course of 0.1 to 24 months. All ovarian leiomyomas were unilateral. Four cases occurred in the right ovary, and three cases occurred in the left ovary. All lesions presented as hypoechogenic, well-circumscribed, round or oval in shape, and regular in morphology. No significant blood flow signal was detected peripheral to or inside the mass in 3 cases (42.8%), and a minimal flow signal was detected peripheral to or inside the mass in 4 cases (58.2%). A total of 7 ultrasonographic images of OL were misdiagnosed: 1 patient was misdiagnosed with subserosal uterine leiomyoma, and 6 patients were misdiagnosed with a tumor in the ovarian thecoma-fibroma group. Conclusion The imaging manifestation of OL lacks specificity; thus, preoperatively distinguishing OL from other ovarian tumors and subserosal uterine leiomyomas is difficult. Immunohistochemistry may be helpful for the definitive diagnosis of OL. The possibility of ovarian leiomyoma should be considered in patients with uterine leiomyomas coexisting with an adnexal ovarian solid mass.
Collapse
Affiliation(s)
| | | | | | | | - Xiang-xiang Jing
- Department of Ultrasonography, Hainan General Hospital/Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| |
Collapse
|
3
|
Parkash V, Aisagbonhi O, Riddle N, Siddon A, Panse G, Fadare O. Recent Advances in the Classification of Gynecological Tract Tumors: Updates From the 5th Edition of the World Health Organization "Blue Book". Arch Pathol Lab Med 2023; 147:1204-1216. [PMID: 36596270 DOI: 10.5858/arpa.2022-0166-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 01/04/2023]
Abstract
CONTEXT.— The World Health Organization Classification of Tumours: Female Genital Tract Tumors, 5th edition, published in September 2020, comes 6 years after the 4th edition, and reflects the monumental leaps made in knowledge about the biology of gynecological tumors. Major changes include revised criteria for the assignment of the site of origin of ovarian and fallopian tube tumors, a revision in the classification of squamous and glandular lesions of the lower genital tract based on human papillomavirus association, and an entire chapter devoted to genetic tumor syndromes. This article highlights the changes in the 5th edition relative to the 4th edition, with a focus on areas of value to routine clinical practice. OBJECTIVE.— To provide a comprehensive update on the World Health Organization classification of gynecological tumors, highlighting in particular updated diagnostic criteria and terminology. DATA SOURCES.— The 4th and 5th editions of the World Health Organization Classification of Tumours. CONCLUSIONS.— The World Health Organization has made several changes in the 5th edition of the update on female genital tumors. Awareness of the changes is needed for pathologists' translation into contemporary practice.
Collapse
Affiliation(s)
- Vinita Parkash
- From the Department of Pathology (Parkash, Siddon, Panse), Yale University School of Medicine, New Haven, Connecticut
| | - Omonigho Aisagbonhi
- Department of Pathology, University of California at San Diego, La Jolla, California (Aisagbonhi, Fadare)
| | - Nicole Riddle
- The Department of Pathology and Cell Biology, Ruffolo, Hooper, and Associates, University of South Florida College of Medicine, Tampa, Florida (Riddle, Siddon)
| | - Alexa Siddon
- From the Department of Pathology (Parkash, Siddon, Panse), Yale University School of Medicine, New Haven, Connecticut
- Department of Laboratory Medicine (Siddon), Yale University School of Medicine, New Haven, Connecticut
- The Department of Pathology and Cell Biology, Ruffolo, Hooper, and Associates, University of South Florida College of Medicine, Tampa, Florida (Riddle, Siddon)
| | - Gauri Panse
- From the Department of Pathology (Parkash, Siddon, Panse), Yale University School of Medicine, New Haven, Connecticut
- The Department of Dermatology (Panse), Yale University School of Medicine, New Haven, Connecticut
| | - Oluwole Fadare
- Department of Pathology, University of California at San Diego, La Jolla, California (Aisagbonhi, Fadare)
| |
Collapse
|
4
|
Sant'Angelo M, Bartolucci A, Bocciolone L, Taccagni G. Myxoid leiomyosarcoma of the ovary: a very uncommon finding. Int J Gynecol Cancer 2023:ijgc-2022-004254. [PMID: 37657819 DOI: 10.1136/ijgc-2022-004254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023] Open
Affiliation(s)
| | | | - Luca Bocciolone
- Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milan, Italy
| | | |
Collapse
|
5
|
Devins KM, Young RH. Sclerosis in Sex Cord-Stromal Tumors Other Than the Sclerosing Stromal Tumor: A Report of 70 Cases. Am J Surg Pathol 2023; 47:774-784. [PMID: 37184091 DOI: 10.1097/pas.0000000000002049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Sclerosis is well-known in sclerosing stromal tumors (SSTs), as its name indicates, but has not been evaluated in other ovarian sex cord-stromal tumors (SCSTs). Its presence in other SCSTs has sporadically caused diagnostic problems in cases we have seen, and this prompted us to review SCSTs with appreciable sclerosis; tumors containing at least 20% sclerosis were included. Seventy cases were identified: 20 thecomas, 20 juvenile granulosa cell tumors (JGCTs), 8 adult granulosa cell tumors (AGCTs), 5 sex cord tumors with annular tubules, 6 retiform Sertoli-Leydig cell tumors (SLCTs; all of the intermediate differentiation), 4 nonretiform SLCTs (3 well-differentiated, 1 of intermediate differentiation with heterologous elements), 4 Sertoli cell tumors, and 3 microcystic stromal tumors (MSTs). Paucicellular sclerotic zones comprised 20% to 95% of the tumors and when conspicuous often obscured diagnostic features. Thirty-one tumors (10 thecomas, 19 JGCTs, 1 AGCT, and 1 MST) showed sclerotic zones focally enveloping nodules of tumor cells, imparting a pseudolobular appearance, and sclerosis often occurred within lobules as well. Ten of these (5 thecomas and 5 JGCTs) also had prominent staghorn blood vessels, generating a low-power appearance focally similar to SST. In 17 tumors, the sclerosis resulted in "compression" of the tumor cells into cords and/or solid tubules. Correct diagnosis in these cases is dependent on careful examination of the cellular zones of the neoplasms, but awareness of the extent of sclerosis that may be seen in diverse SCSTs may be crucial in suggesting the correct diagnosis particularly when the material is limited as in the intraoperative setting. Our findings highlight for the first time the occurrence and character of sclerosis in sex cord tumors other than SSTs and fibromas. Sclerosis is seen in descending proportion of the tumor types as follows: retiform SLCTs, thecomas, MSTs, JGCTs, sex cord tumors with annular tubules, Sertoli cell tumors, AGCTs, and nonretiform SLCTs. Its character can vary somewhat, having particular features in the sex cord tumor with annular tubules (hyaline material within tubules often coalescing and extending beyond the nests to form confluent aggregates) and retiform SLCTs (common in papillary cores).
Collapse
Affiliation(s)
- Kyle M Devins
- James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | |
Collapse
|
6
|
Mandato VD, Torricelli F, Mastrofilippo V, Palicelli A, Costagliola L, Aguzzoli L. Primary Ovarian Leiomyosarcoma Is a Very Rare Entity: A Narrative Review of the Literature. Cancers (Basel) 2023; 15:cancers15112953. [PMID: 37296915 DOI: 10.3390/cancers15112953] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Primary ovarian leiomyosarcoma is a very rare malignancy characterized by unclear management and poor survival. We reviewed all the cases of primary ovarian leiomyosarcoma to identify prognostic factors and the best treatment. METHODS We collected and analyzed the articles published in the English literature regarding primary ovarian leiomyosarcoma from January 1951 to September 2022, using PubMed research. Clinical and pathological characteristics, different treatments and outcomes were analyzed. RESULTS 113 cases of primary ovarian leiomyosarcoma were included. Most patients received surgical resection, associated with lymphadenectomy in 12.5% of cases. About 40% of patients received chemotherapy. Follow-up information was available for 100/113 (88.5%) patients. Stage and mitotic count were confirmed to affect survival, and lymphadenectomy and chemotherapy were associated with a better survival rate. A total of 43.4% of patients relapsed, and their mean disease-free survival was 12.5 months. CONCLUSIONS Primary ovarian leiomyosarcomas are more common in women in their 50s (mean age 53 years). Most of them are at an early stage at presentation. Advanced stage and mitotic count showed a detrimental effect on survival. Surgical excision associated with lymphadenectomy and chemotherapy are associated with increased survival. An international registry could help collect clear and reliable data to standardize the diagnosis and treatment.
Collapse
Affiliation(s)
- Vincenzo Dario Mandato
- Unit of Obstetrics and Oncological Gynecology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Federica Torricelli
- Laboratory of Translational Research, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Valentina Mastrofilippo
- Unit of Obstetrics and Oncological Gynecology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Andrea Palicelli
- Unit of Pathology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Luigi Costagliola
- Unit of Obstetrics and Gynecology, Santa Maria delle Grazie Hospital, 80100 Naples, Italy
| | - Lorenzo Aguzzoli
- Unit of Obstetrics and Oncological Gynecology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| |
Collapse
|
7
|
Bahadur A, Mundhra R, Verma P, Phulware RH. Primary ovarian leiomyosarcoma in a woman with uterovaginal prolapse. BMJ Case Rep 2022; 15:e251733. [PMID: 36162964 PMCID: PMC9516082 DOI: 10.1136/bcr-2022-251733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Primary ovarian leiomyosarcoma is a very uncommon and aggressive neoplasm. We presented a right-sided ovarian leiomyosarcoma in a woman in her late 40s. No case has been described in the literature till now of primary ovarian leiomyosarcoma in a woman with uterovaginal prolapse. A total abdominal hysterectomy with bilateral adnexectomy, metastasectomy, excision of large tumour deposit over small intestine followed by resection with ileo-ileal anastomosis and omentectomy was performed. The diagnosis was made based on morphology along with immunohistochemistry. The patient was given adjuvant chemotherapy during postoperative period. Due to rarity, there is a dearth of information on the clinical behaviour and best treatment options for these tumours. This case report highlighted the importance of clinical awareness and aimed to provide a baseline to guide clinical practice as well as future research.
Collapse
Affiliation(s)
- Anupama Bahadur
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rajlaxmi Mundhra
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Pallavi Verma
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Hari Phulware
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
8
|
Atwi D, Kamal M, Quinton M, Hassell LA. Malignant transformation of mature cystic teratoma of the ovary. J Obstet Gynaecol Res 2022; 48:3068-3076. [PMID: 36053141 DOI: 10.1111/jog.15409] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/08/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022]
Abstract
Mature cystic teratoma is the most common ovarian germ cell neoplasm. Malignant transformation is a rare occurrence, accounting for 1.5%-2% of cases. Malignant changes can arise from any constituent tissue of a teratoma; however, squamous cell carcinoma is the most common histologic type seen, followed by adenocarcinoma and sarcoma respectively. Tumor marker concentration levels, age, and the tumor maximum diameter are predictive indicators for malignant transformation. Proper diagnosis includes recognizing the possibility of malignant transformation versus excluding other differential options, such as metastasis. Primary cytoreductive surgery, adjuvant chemotherapy, and radiotherapy are the current treatment methods. The aim of the review is to discuss the clinical and pathologic features of malignant transformation within mature cystic teratomas, while reviewing the reported malignant types, differential diagnoses, and treatment options. Data sources include review of pertinent peer-reviewed literature on malignant transformation of mature cystic teratoma and cases seen in authors' institutional practice. Mature cystic teratomas are a commonly encountered benign ovarian tumor. However, the possibility of malignant transformation should remain in consideration, especially with given clinical or pathologic features: increased patient age, tumor size, or tumor marker levels. Thorough sampling of solid tumor foci can help identify malignant components. Awareness and proper diagnosis, along with early detection and clinical management, shows improved patient outcomes.
Collapse
Affiliation(s)
- Doaa Atwi
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Maria Kamal
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Michael Quinton
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lewis A Hassell
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| |
Collapse
|
9
|
Khadjetou V, Cheikh TE, Haiba MVA, Cheikh MAA, Mouhamed BN, Abdi AB. Primary perimenarcheal ovarian leiomyosarcoma: A case report and review of the literature. Int J Surg Case Rep 2022; 94:107094. [PMID: 35468378 PMCID: PMC9046641 DOI: 10.1016/j.ijscr.2022.107094] [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: 03/19/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Leiomyosarcomas of the ovary are extremely rare neoplasia usually occurring in perimenopausal patients. CASE PRESENTATION A 16-year-old female patient, with no particular pathological history, who presented with chronic pelvic pain. On imaging; presence of a suprauterine solid cystic formation of 12 cm long axis. Tumor markers were normal. On exploration, solid cystic formation of 15 cm long axis. A total hysterectomy with bilateral salpingo-oophorectomy associated with bilateral pelvic and para-aortic lymphadenectomy and a total omentectomy were performed. Anatomical pathology; an ovarian leiomyosarcoma. CLINICAL DISCUSSION Leiomyosarcomas of the ovary are extremely rare, representing less than 1% of all ovarian malignancies. They probably derive from the smooth muscle component. No definitive diagnostic criteria for ovarian leiomyosarcomas have been adopted to date, however the histological criteria adopted are those for uterine leiomyosarcomas. The differential diagnosis of these tumors includes fibrosarcomas, rhabdomyosarcomas, thecomas and extradigestive stromal tumors. The prognosis of ovarian leiomyosarcomas is generally poor. Complete surgical resection remains for all authors the cornerstone of treatment. The benefit of adjuvant therapies, namely chemotherapy or radiotherapy, remains to be proven. CONCLUSION Leiomyosarcoma of the ovary, although exceptional, should always be included among the diagnostic possibilities when an ovarian cyst of organic appearance is discovered in a perimenarcheal patient.
Collapse
Affiliation(s)
- Vilaly Khadjetou
- Department of Gynecology and Obstetrics, Mother and Child Hospital, Faculty of Medicine, University of Nouakchott Al Aasriya, Nouakchott, Mauritania
| | - Telmoudi Ely Cheikh
- Department of Gynecology and Obstetrics, Mother and Child Hospital, Faculty of Medicine, University of Nouakchott Al Aasriya, Nouakchott, Mauritania.
| | - Med Vadel Ahmed Haiba
- Department of Gynecology and Obstetrics, Mother and Child Hospital, Faculty of Medicine, University of Nouakchott Al Aasriya, Nouakchott, Mauritania
| | - Med Ahmed Ahmed Cheikh
- Department of Gynecology and Obstetrics, Mother and Child Hospital, Faculty of Medicine, University of Nouakchott Al Aasriya, Nouakchott, Mauritania
| | - Boukhary Nadi Mouhamed
- Department of Gynecology and Obstetrics, Mother and Child Hospital, Faculty of Medicine, University of Nouakchott Al Aasriya, Nouakchott, Mauritania
| | - Ahmed Bonnahy Abdi
- Department of Gynecology and Obstetrics, Mother and Child Hospital, Faculty of Medicine, University of Nouakchott Al Aasriya, Nouakchott, Mauritania
| |
Collapse
|
10
|
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.
Collapse
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
| | | |
Collapse
|
11
|
Chang CH, Li PC, Hsu YH, Ding DC. Vulvar myoma: A case report and review of literature. Taiwan J Obstet Gynecol 2021; 60:924-926. [PMID: 34507676 DOI: 10.1016/j.tjog.2021.07.026] [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] [Accepted: 09/04/2020] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To present a case of vulvar myoma and the factors differentiating this tumor from Bartholin's cyst. CASE REPORT A 50-year-old woman presented with a nodule over the left labia majora. Pelvic examination showed swelling and redness of the left labia majora. A 2-cm nodule with firm consistency was found near the vaginal opening. There was no inguinal lymphadenopathy. Bartholin's cyst was suggested, and oral cephalexin was prescribed for 1 week, but no improvement was seen. Therefore, she underwent excision of the nodule. Pathology revealed it to be a benign vulvar myoma. The patient recovered well, and no recurrence was noted after 2 months of follow-up. CONCLUSION Vulvar myoma is rare. Sexual history, nodule consistency, and imaging are helpful, but the final diagnosis of vulvar myoma is usually made following surgical excision and histopathological analysis.
Collapse
Affiliation(s)
- Chi-Han Chang
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, and Tzu Chi University, Hualien, Taiwan
| | - Pei-Chen Li
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, and Tzu Chi University, Hualien, Taiwan
| | - Yung-Hsian Hsu
- Department of Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, and Tzu Chi University, Hualien, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, Tzu Chi University, Hualien, Taiwan.
| |
Collapse
|
12
|
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
Collapse
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
| |
Collapse
|
13
|
Cojocaru E, Palahepitiva Gamage G, Butler J, Barton DP, Thway K, Fisher C, Messiou C, Miah AB, Zaidi S, Gennatas S, Benson C, Huang P, Jones RL. Clinical management and outcomes of primary ovarian leiomyosarcoma - Experience from a sarcoma specialist unit. Gynecol Oncol Rep 2021; 36:100737. [PMID: 33732852 PMCID: PMC7941038 DOI: 10.1016/j.gore.2021.100737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/07/2021] [Accepted: 02/15/2021] [Indexed: 12/23/2022] Open
Abstract
Ovarian sarcomas account for 1% of all ovarian malignancies and amongst these, primary ovarian leiomyosarcoma is the rarest subtype. Primary ovarian leiomyosarcoma has a very poor prognosis, with less than 20% of patients being alive at 5 years. Only a few cases have been published in the literature and there is very limited knowledge on the clinical behaviour and optimal management of these tumours. We have performed a retrospective analysis of a prospectively maintained database to identify all primary ovarian leiomyosarcoma diagnosed and treated at the Royal Marsden NHS Foundation Trust between 1998 and 2020. Sixteen patients were identified from our database and fifteen were eligible for the analysis. Twelve patients presented with localized disease and underwent initial surgery and three patients had metastatic disease at presentation. Recurrence-free survival post-surgery was 16 months. Eight patients received first-line chemotherapy and four patients received second-line chemotherapy. Two patients had indolent metastatic disease and benefited from local therapies only. The median overall survival in the metastatic setting in our cohort was 51 months, which is consistent with previously published cases. Primary ovarian leiomyosarcoma is an extremely rare malignancy with a poor prognosis. This study is the largest case series of primary ovarian leiomyosarcoma published to date, providing clinically important information regarding survival and metastatic rate as well as treatment outcomes in the metastatic setting.
Collapse
Affiliation(s)
- Elena Cojocaru
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | | | - John Butler
- Gynaecological Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Desmond P Barton
- St George's Hospital, Blackshaw Road, London, Greater London SW17 0QT, UK
| | - Khin Thway
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Cyril Fisher
- Department of Musculoskeletal Pathology, University Hospitals Birmingham, Birmingham B15 2GW, UK
| | - Christina Messiou
- The Institute of Cancer Research, Chester Beatty Laboratories, 237 Fulham Road, London SW3 6JB, UK.,Radiology Department, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Aisha B Miah
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Shane Zaidi
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Spyridon Gennatas
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Charlotte Benson
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK
| | - Paul Huang
- The Institute of Cancer Research, Chester Beatty Laboratories, 237 Fulham Road, London SW3 6JB, UK
| | - Robin L Jones
- Sarcoma Unit, The Royal Marsden Hospital, 203 Fulham Rd, London SW3 6JJ, UK.,The Institute of Cancer Research, Chester Beatty Laboratories, 237 Fulham Road, London SW3 6JB, UK
| |
Collapse
|
14
|
Okayama Y, Minato H, Futatsuya C, Katayanagi K, Kurumaya H, Kondo T, Otsuka K, Sasaki H, Hoshiba T, Kobayashi T. Ovarian smooth muscle tumor of uncertain malignant potential (STUMP) associated with smooth muscle metaplasia of the endometriotic cyst. Pathol Int 2020; 70:828-830. [PMID: 32715612 DOI: 10.1111/pin.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/26/2020] [Accepted: 07/07/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Yurie Okayama
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Hiroshi Minato
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Chizuru Futatsuya
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Kazuyoshi Katayanagi
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Hiroshi Kurumaya
- Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Tsuyoshi Kondo
- Department of Obstetrical and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan.,Department of Obstetrics and Gynecology, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Kaori Otsuka
- Department of Obstetrical and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Hiromasa Sasaki
- Department of Obstetrical and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Tsutomu Hoshiba
- Department of Obstetrical and Gynecology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Takeshi Kobayashi
- Department of Diagnostic and Interventional Radiology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| |
Collapse
|
15
|
Criteria for risk stratification of vulvar and vaginal smooth muscle tumors: a follow-up study with application to leiomyoma variants, smooth muscle tumors of uncertain malignant potential, and leiomyosarcomas. Hum Pathol 2020; 103:83-94. [PMID: 32687944 DOI: 10.1016/j.humpath.2020.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 01/02/2023]
Abstract
Data have shown that uterine diagnostic criteria are universal for smooth muscle tumors (SMTs) originating in the ovary, vulva, vagina, broad ligament, and other supportive connective tissue and that uterine criteria outperform site-specific criteria for vulvar and vaginal SMTs. Classic benign and malignant spindled SMTs were well represented in our recent study comparing uterine and site-specific criteria in vulvovaginal SMTs, but leiomyoma variants and smooth muscle tumors of uncertain malignant potential (STUMPs) were relatively few. Therefore, we evaluated additional leiomyoma variants, STUMPs, and leiomyosarcomas from 17 patients (10 vaginal and 7 vulvar). The 10 vaginal tumors (59%) comprised cellular leiomyoma (n = 2), leiomyoma with bizarre nuclei (n = 3), STUMP (n = 1), and leiomyosarcoma (n = 4). The 7 vulvar tumors (41%) comprised leiomyoma with bizarre nuclei (n = 3), STUMP (n = 1), and leiomyosarcoma (n = 3). Follow-up was available for 13 patients (76.5%) ranging from 1 to 97 months (mean: 17.3; median: 7). Follow-up for some patients with leiomyosarcoma was limited (≤4 months for 4 patients). One vaginal STUMP locally recurred after 19 months, and 2 patients diagnosed with leiomyosarcoma developed distant metastases. All remaining patients had either no evidence of disease at last follow-up (10 patients, 58.8%) or their status was unknown (4 patients, 23.5%). Uterine criteria are valid for vulvovaginal leiomyoma variants and STUMPs and more appropriately classified these tumors than site-specific criteria. Our combined findings from the current and previous studies support use of uterine diagnostic thresholds for the entire spectrum of vulvovaginal SMTs.
Collapse
|
16
|
Öz Atalay F, Akyol S, Bozdogan Ö. Primary low grade myxoid liposarcoma of the ovary: A case report and review of literature. J Obstet Gynaecol Res 2020; 46:1921-1926. [PMID: 32656967 DOI: 10.1111/jog.14395] [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: 10/29/2019] [Revised: 05/25/2020] [Accepted: 06/19/2020] [Indexed: 11/28/2022]
Abstract
A 20-year-old female patient presented with the complaint of pelvic pain. Radiological studies showed a cystic mass in the left ovary. Histological examination revealed a myxoid tumor with a chicken wire-like, thin vascularization. The diagnosis of the lesion, morphologically resembling myxoid liposarcoma was supported by demonstration of rearrangement of the DDIT3 gene by fluorescence in situ hybridization.
Collapse
Affiliation(s)
- Fatma Öz Atalay
- Department of Pathology, Bursa Uludag University, Medicine Faculty, Bursa, Turkey
| | - Sevda Akyol
- Department of Pathology, Bursa Uludag University, Medicine Faculty, Bursa, Turkey
| | - Önder Bozdogan
- Department of Pathology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
17
|
Yuksel D, Cakir C, Kilic C, Karalok A, Kimyon G, Çöteli S, Boyraz G, Tekin ÖM, Turan T. Primary leiomyosarcoma of the ovary: a report of three cases and a systematic review of literature. J Gynecol Obstet Hum Reprod 2020; 50:101825. [PMID: 32497729 DOI: 10.1016/j.jogoh.2020.101825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 11/26/2022]
Abstract
Primary ovarian leiomyosarcomas (POLMs) comprise <0.1 % of all ovarian malignancies. Here we aimed to define the clinical, surgical, and pathological features, as well as the oncologic outcome, of POLM. A systematic review of the medical literature was performed to identify articles about POLMs. An electronic literature search was conducted for English language abstracts of articles published between 1975 and December 2018.51 articles were included in the study. The primary endpoint of the study was disease-free survival (DFS) and overall survival (OS), whereas the secondary endpoint was clinicopathological features. Five-year DFS and OS for the entire cohort was 15 % and 26 %, respectively. The DFS and OS were significantly related to paraaortic lymphadenectomy, a mitotic index>10/high power field, and advanced cancer stages. Eventually, we were unable to obtain clear results, this might be due to the limited number of cases at the literature.With more authors presenting their own cases, it will be possible to have clearer results.
Collapse
Affiliation(s)
- Dilek Yuksel
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Caner Cakir
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Cigdem Kilic
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Alper Karalok
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Günsu Kimyon
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Sinem Çöteli
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Gokhan Boyraz
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| | - Özlem Moraloğlu Tekin
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Department of Gynecology and Obstetrics, Health Sciences University, Turkey.
| | - Taner Turan
- Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Clinic, Health Sciences University, Turkey.
| |
Collapse
|
18
|
Affiliation(s)
| | - Oluwole Fadare
- 21814University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
19
|
A Comprehensive Review of Biomarker Use in the Gynecologic Tract Including Differential Diagnoses and Diagnostic Pitfalls. Adv Anat Pathol 2020; 27:164-192. [PMID: 31149908 DOI: 10.1097/pap.0000000000000238] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Morphologic (ie, hematoxylin and eosin) evaluation of the Mullerian tract remains the gold standard for diagnostic evaluation; nevertheless, ancillary/biomarker studies are increasingly utilized in daily practice to assist in the subclassification of gynecologic lesions and tumors. The most frequently utilized "biomarker" technique is immunohistochemistry; however, in situ hybridization (chromogenic and fluorescence), chromosomal evaluation, and molecular analysis can also be utilized to aid in diagnosis. This review focuses on the use of immunohistochemistry in the Mullerian tract, and discusses common antibody panels, sensitivity and specificity of specific antibodies, and points out potential diagnostic pitfalls when using such antibodies.
Collapse
|
20
|
An Epithelioid Smooth Muscle Neoplasm Mimicking a Signet Ring Cell Carcinoma in the Ovary. Int J Gynecol Pathol 2020; 38:464-469. [PMID: 29750703 DOI: 10.1097/pgp.0000000000000520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 53-yr-old woman who presented with elevated renal indices was discovered to have a 4.5 cm right renal mass and an incidental 9.7 cm left ovarian mass on imaging studies. She underwent a partial nephrectomy and bilateral salpingo-oophorectomy, revealing a chromophobe renal cell carcinoma and an unusual ovarian neoplasm with epithelioid cells displaying prominent signet ring cell-like morphology. Immunohistochemical analysis of the ovarian neoplasm demonstrated that the tumor cells were diffusely immunoreactive for smooth muscle markers and negative for all tested cytokeratins and epithelial membrane antigen. On the basis of these results, the tumor was interpreted as an unusual epithelioid smooth muscle neoplasm with extensive signet ring cell-like features. Along with primary ovarian signet ring stromal tumors and sclerosing stromal tumors, this example adds epithelioid smooth muscle neoplasms with unusual cytologic alterations to the list of uncommon nonepithelial tumors that can simulate metastatic signet ring cell carcinoma (Krukenberg tumor) in the ovary.
Collapse
|
21
|
Smooth Muscle Tumors of the Visceral Adnexal and Uterine Ligaments and Adnexal Connective Tissue. Int J Gynecol Pathol 2020; 39:55-67. [DOI: 10.1097/pgp.0000000000000578] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
22
|
Devereaux KA, Schoolmeester JK. Smooth Muscle Tumors of the Female Genital Tract. Surg Pathol Clin 2019; 12:397-455. [DOI: 10.1016/j.path.2019.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
|
23
|
Pinna AE, Okada CTC, Ferreira CSC, Campos DG, Possidente KS, de Cássia C L Morais R, Oliveira M, Salomão MC, Hataka A. Double ovarian tumour in the mare: Case report. Reprod Domest Anim 2019; 54:912-916. [PMID: 30924202 DOI: 10.1111/rda.13433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/15/2019] [Indexed: 01/19/2023]
Abstract
Ovarian tumours in mares represent 2.5% to 6% of the most frequent neoplasms found in the equine species, with a higher chance of benignity. This study aims to describe a case of two different tumours found in the same ovary of a mare that presented clinical signs of suppressed oestrous cycle during 5 years. After unilateral ovariectomy, the ovary was sent to the histopathology examination which determined a mixed tumour of granulosa cell and leiomyosarcoma. After treatment, the mare returned to oestrus and got pregnant in the next season.
Collapse
Affiliation(s)
- Aline E Pinna
- Fluminense Federal University - UFF, Niterói, Brazil
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
|
25
|
Epithelioid Inflammatory Myofibroblastic Sarcoma of the Ovary With RANB2-ALK Fusion: Report of a Case. Int J Gynecol Pathol 2018; 37:468-472. [PMID: 28787324 DOI: 10.1097/pgp.0000000000000431] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is a recently described, clinically aggressive variant of inflammatory myofibroblastic tumor with a predilection for intraabdominal sites, tendency to arise in male patients and resistance to conventional chemotherapy and radiotherapy. We present a case of a 15-year-old girl with EIMS of the ovary with a RANBP2-ALK fusion. During 2 years of follow up, she experienced multiple recurrences. Following classification of the tumor as EIMS, the patient began treatment with an ALK inhibitor (crizotinib), which led to disease improvement within weeks of administration. To the best of our knowledge, this represents the first reported case of EIMS arising in the female genital tract.
Collapse
|
26
|
MED12 is frequently mutated in ovarian and other adnexal leiomyomas. Hum Pathol 2018; 81:89-95. [DOI: 10.1016/j.humpath.2018.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/29/2018] [Accepted: 06/09/2018] [Indexed: 01/26/2023]
|
27
|
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.
Collapse
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
| |
Collapse
|
28
|
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
|
29
|
Criteria for Risk Stratification of Vulvar and Vaginal Smooth Muscle Tumors: An Evaluation of 71 Cases Comparing Proposed Classification Systems. Am J Surg Pathol 2017; 42:84-94. [PMID: 28786880 DOI: 10.1097/pas.0000000000000920] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Accurate risk stratification of smooth muscle tumors (SMTs) is essential for appropriate patient management. Yet, the rarity of SMTs of the vagina and vulva makes development of a prognostically meaningful classification system challenging. While 2 classification methods for vulvar SMTs and 1 for vaginal SMTs have been proposed, it is our experience that many pathologists tend to apply criteria for uterine SMTs when evaluating vulvovaginal tumors. We retrospectively reviewed a large cohort of vulvovaginal SMTs with clinical follow-up and evaluated which method most accurately classified tumors according to patient outcome. A total of 71 tumors, 53 vaginal (75%) and 18 vulvar (25%), from 71 patients were identified. All tumors were centrally examined for degree of cytologic atypia, morphology (spindled, epithelioid, myxoid), mitotic index per 10 high power fields, atypical mitotic figures, tumor cell necrosis, ischemic necrosis, tumor interface (circumscribed or infiltrative) and margin status. Clinical features were recorded for each patient. Follow-up was available for 63 patients (89%), and ranged from 1 to 234 months (median: 64 mo). While site-specific and uterine criteria showed equally excellent sensitivity in classifying smooth muscle neoplasms as leiomyosarcoma according to patient outcome, uterine criteria showed improved specificity relatively to site-specific methods in classifying tumors as nonsarcoma according to patient outcome. We recommend that uterine SMT criteria and nomenclature be adopted for evaluation and classification of vulvovaginal SMTs.
Collapse
|
30
|
Gemcitabine and docetaxel in a patient with primary ovarian leiomyosarcoma: a case report and review of literature. Int Cancer Conf J 2017; 7:11-15. [PMID: 31149505 DOI: 10.1007/s13691-017-0309-7] [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] [Received: 04/27/2017] [Accepted: 09/06/2017] [Indexed: 12/23/2022] Open
Abstract
Primary ovarian leiomyosarcoma (POLMS) is extremely rare, and optimal therapy for this disease is unknown. A 40-year-old woman presented at a local hospital with abdominal pain. Tumor resection of the left ovary was performed. The pathological diagnosis was leiomyoma of the left ovary. Nine months after surgery, she developed of severe back pain and a subcutaneous tumor on her left shoulder. Magnetic resonance imaging and computed tomography revealed left ovarian tumor recurrence, pelvic bone metastasis, and multiple liver masses. Biopsy of the subcutaneous tumor on her left shoulder demonstrated metastatic leiomyosarcoma. The previously resected left ovarian tumor was re-examined, and the tumor was found to be a leiomyosarcoma. The patient received gemcitabine 800 mg/m2 and docetaxel 60 mg/m2 (GD therapy), administered at 3-week intervals. After three cycles of GD therapy, the patient experienced dyspnea and was diagnosed with mild interstitial pneumonia. Oral corticosteroid therapy resulted in complete symptom improvement. Thereafter, the dosage of GD was decreased, and after 13 cycles of GD therapy, radiofrequency ablation was performed twice for liver metastases. The tumors have shrunk by 65.5% after 23 cycles of GD. She remains alive after undergoing 24 cycles of GD. GD therapy may be effective for POLMS.
Collapse
|
31
|
Leiomyosarcoma and Squamous Cell Carcinoma Arising in Mature Cystic Teratoma of the Ovary. Case Rep Pathol 2017; 2017:7907359. [PMID: 28751996 PMCID: PMC5511680 DOI: 10.1155/2017/7907359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 05/28/2017] [Indexed: 11/17/2022] Open
Abstract
The occurrence of malignant transformation in mature cystic teratoma of the ovary is rare, with squamous cell carcinoma being the most common histologic type. Sarcomatous transformation has been rarely described in the literature. We present a case of leiomyosarcoma with a minor component of squamous cell carcinoma arising in mature cystic teratoma of ovary in a 65-year-old woman. The malignant tumor showed two distinct components of sarcomatous and invasive epithelial elements, which were confirmed by immunostaining. To our knowledge, only four cases of leiomyosarcoma in ovarian mature cystic teratoma have been reported and this is a unique case report of leiomyosarcoma and squamous cell carcinoma arising in a mature cystic teratoma of ovary.
Collapse
|
32
|
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.
Collapse
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
| |
Collapse
|
33
|
López-Ruiz ME, Yébenes L, Berjón A, Hardisson D. Primary Leiomyosarcoma of the Ovarian Vein: Case Report and Literature Review. Int J Surg Pathol 2016; 25:339-343. [DOI: 10.1177/1066896916679888] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Primary leiomyosarcoma arising from the ovarian vein is extremely rare, with only 10 cases reported in the literature. We report on a case of leiomyosarcoma of the left ovarian vein in a 67-year-old woman who presented with abdominal discomfort. Pelvic ultrasound revealed a large, solid, irregular mass in close relation to the left ovary. The patient subsequently underwent a total hysterectomy with bilateral salpingo-oophorectomy. Histologically, the tumor was composed of interlacing fascicles of spindle cells with abundant eosinophilic cytoplasm, hyperchromatic nuclei, and prominent nucleoli. Mitotic activity was high, with 24 mitoses in 10 high-power fields. Areas of necrosis and hemorrhage were present within the tumor. Immunohistochemically, the tumor cells showed diffuse immunoreactivity for vimentin, muscle-specific actin, desmin, and caldesmon. The patient received chemotherapy postoperatively but subsequently developed disseminated metastatic disease (lung, liver, iliac lymph nodes, and peritoneum). Primary leiomyosarcomas arising from the ovarian vein are aggressive neoplasms, and the prognosis correlates with stage.
Collapse
Affiliation(s)
| | - Laura Yébenes
- Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | | | - David Hardisson
- Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
- Universidad Autónoma de Madrid, Madrid, Spain
| |
Collapse
|
34
|
SMA-Positive Fibroma With an Intramural Endometriotic Cyst Mimicking Ovarian Leiomyoma. Appl Immunohistochem Mol Morphol 2016; 25:e38-e39. [PMID: 27299189 DOI: 10.1097/pai.0000000000000403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
35
|
He M, Deng YJ, Zhao DY, Zhang Y, Wu T. Synchronous leiomyosarcoma and fibroma in a single ovary: A case report and review of the literature. Oncol Lett 2016; 11:2510-2514. [PMID: 27073508 DOI: 10.3892/ol.2016.4241] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 12/15/2015] [Indexed: 12/17/2022] Open
Abstract
Primary ovarian leiomyosarcoma (POLMS) is a rare disease. To the best of our knowledge, only 72 cases, including the present case, have been reported in the English literature, while synchronous POLMS and fibroma in a single ovary have not previously been reported at all. In the present study, a 46-year-old premenopausal woman was diagnosed with a mass in the left ovary in 2005. A total of 5 years after the diagnosis of this mass, the patient was admitted to hospital exhibiting lower abdominal pain, and two masses were observed in the left ovary. An exploratory laparoscopy was performed. Frozen section analysis led to a diagnosis of fibroma. Furthermore, the observed second mass was hypothesized to be a malignant form of the original fibroma. A hysterectomy and bilateral salpingo-oophorectomy were performed. Pathological reports following surgery revealed concurrent stage Ic POLMS and fibroma in the left ovary. A total of 13 months after the initial surgery, recurrent leiomyosarcoma was detected. Although the patient underwent multiple cytoreductive surgeries and chemotherapy cycles, as well as interstitial brachytherapy and conventional therapy, a poor state of health ensued. Due to the rarity of POLMS, particularly in combination with ovarian fibroma, the current report presents a detailed overview of the literature and discusses a number of histogenetic and clinical issues.
Collapse
Affiliation(s)
- Meng He
- Department of Oncology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
| | - Yan-Jie Deng
- Department of Gynecology, Dalian Women and Children's Health Hospital, Dalian, Liaoning 116033, P.R. China
| | - Dan-Yi Zhao
- Department of Oncology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
| | - Yang Zhang
- Department of Oncology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
| | - Tao Wu
- Department of Oncology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
| |
Collapse
|
36
|
Gunasekaran I, Phansalkar M, Palo LB, Varghese RG. Ovarian Leiomyoma Along with Uterine Leiomyomata: A Common Tumour at an Uncommon Site. J Clin Diagn Res 2015; 9:ED01-2. [PMID: 26674537 DOI: 10.7860/jcdr/2015/13378.6703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 08/24/2015] [Indexed: 11/24/2022]
Abstract
Ovarian leiomyoma is one of the rarest benign tumours of the ovary, mostly seen in women of reproductive age group. Here we report a case of ovarian leiomyoma as an incidental finding in a patient of 38-year-old woman with uterine leiomyomata. Peroperatively, her left ovary appeared bulky & she underwent total abdominal hysterectomy with left salpingo-oophorectomy. Macroscopically, in addition to uterine leiomyomata, a grey-white solid mass was seen entirely within the ovary without any capsular breach. Microscopically, the ovarian mass resembled its uterine counterpart without any evidence of atypia or necrosis. Masson trichrome stain & immunohistochemistry for desmin positivity confirmed the smooth muscle origin of the tumour cells. Despite its rarity, ovarian leiomyoma has to be considered as one of the differential diagnosis of ovarian spindle cell tumours. In difficult cases, immunohistochemistry aids the diagnosis.
Collapse
Affiliation(s)
- Indira Gunasekaran
- Post Graduate Student, Department of Pathology, PIMS , Puducherry, India
| | | | - Lal Bahadur Palo
- Associate Professor, Department of Obstetrics and Gynaecology, PIMS , Puducherry, India
| | | |
Collapse
|
37
|
Daniel A, McCue P, Ferris R, Miller C, Leise B. Bilateral ovarian leiomyoma treated by standing laparoscopic ovariectomy. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12438] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A. Daniel
- Clinical Sciences Department; Colorado State University; Veterinary Teaching Hospital; Fort Collins USA
| | - P. McCue
- Equine Reproduction Laboratory & Department of Clinical Sciences College of Veterinary Medicine; Fort Collins Colorado USA
| | - R. Ferris
- Equine Reproduction Laboratory & Department of Clinical Sciences College of Veterinary Medicine; Fort Collins Colorado USA
| | - C. Miller
- Microbiology, Immunology and Pathology; Colorado State University; Fort Collins USA
| | - B. Leise
- Clinical Sciences Department; Colorado State University; Veterinary Teaching Hospital; Fort Collins USA
| |
Collapse
|
38
|
Lipoleiomyoma of the uterus and primary ovarian leiomyoma in a postmenopausal woman: two rare entities in the same individual. Case Rep Pathol 2015; 2015:564846. [PMID: 26000188 PMCID: PMC4426777 DOI: 10.1155/2015/564846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 03/11/2015] [Accepted: 04/14/2015] [Indexed: 11/24/2022] Open
Abstract
Uterine lipoleiomyomas are rare benign tumours that are composed of various mixtures of smooth muscle and mature fat tissue. Leiomyomas, which arise primarily in the ovary, are extremely rare tumours that account for 0.5–1% of all benign ovarian tumours. To the best of our knowledge, we present the first case of an ovarian leiomyoma coexisting with a uterine lipoleiomyoma in the postmenopausal period.
A 59-year-old, gravida 4, para 3, postmenopausal woman exhibited pelvic discomfort and increased frequency of micturition. A pelvic examination revealed a solid, tender mass on the left side that could not be clearly separated from the uterus. She underwent a laparotomy with an initial diagnosis of a left ovarian mass. She had previously undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy. A histopathological examination revealed a uterine lipoleiomyoma, composed of variable amounts of smooth muscle cells and mature adipocytes and a right ovarian leiomyoma composed of interlacing bundles and fascicles of spindle cells. The coexistence of these two rare entities in the same individual may represent a common pathway as a stimulating agent. This case may help to clarify the pathogenesis of these lesions.
Collapse
|
39
|
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.
Collapse
|
40
|
R S, K R, R R, Amel Ivan E. Postmenopausal huge ovarian leiomyoma: a rare presentation. J Clin Diagn Res 2015; 8:OD03-4. [PMID: 25584274 DOI: 10.7860/jcdr/2014/10369.5204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/08/2014] [Indexed: 11/24/2022]
Abstract
Ovarian leiomyoma is one of the rare solid tumours of ovary, accounting for 0.5-1% of the benign tumours of the ovary. We report one such case which presented in a postmenopausal woman. The differential diagnosis includes ovarian fibroma, thecoma, cellular fibroma and sclerosing stromal tumour. Masson's trichrome staining helps to distinguish fibrous and smooth muscle components of the lesion and confirms the diagnosis of ovarian leiomyoma. Hence, ovarian leiomyoma should be considered in the differential diagnosis of ovarian spindle cell tumours.
Collapse
Affiliation(s)
- Sasikala R
- Professor, Department of Obstetrics and Gynecology, Sri Manakula Vinayagar Medical College , Puducherry, Tamil Nadu, India
| | - Rupavani K
- Assistant Professor, Department of Obstetrics and Gynecology, Sri Manakula Vinayagar Medical College , Puducherry, Tamil Nadu, India
| | - Rekha R
- Postgraduate Student, Department of Obstetrics and Gynecology, Sri Manakula Vinayagar Medical College , Puducherry, Tamil Nadu, India
| | - Erli Amel Ivan
- Professor, Department of Pathology, Sri Manakula Vinayagar Medical College , Puducherry, Tamil Nadu, India
| |
Collapse
|
41
|
|
42
|
|
43
|
|
44
|
Huanwen W, Hui Z, Xiaowei X, Zhaohui L. Extrauterine adenomyoma of the liver with a focally cellular smooth muscle component occurring in a patient with a history of myomectomy: case report and review of the literature. Diagn Pathol 2013; 8:131. [PMID: 23915210 PMCID: PMC3771407 DOI: 10.1186/1746-1596-8-131] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 07/25/2013] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED Since first reported in 1986, 14 cases of extrauterine adenomyoma have been reported in the English literature, most often occurring in the ovaries. In this report, we present the first case of extrauterine adenomyoma involving the liver in a 29-year-old woman who presented with a 2-year history of low back pain with recent worsening and a history of laparoscopic myomectomy 5 years previously. Gross inspection of the specimen revealed a subcapsular mass that had a well-circumscribed margin with the adjacent liver tissue. By histopathologic examination, the multilobular mass was composed of a smooth muscle component and benign endometrioid glands and stroma. The smooth muscle component was focally cellular, and the endometrioid glands had secretory features. Both the smooth muscle component and endometrioid tissue were positive for ER and PR. The smooth muscle component was also positive for desmin and SMA, while the endometrioid stroma was positive for CD10. Other extrauterine lesions composed of a mixture of smooth muscle tissue and heterotopic endometrioid tissue, including endometriosis with a smooth muscle component, leiomyomatosis/leiomyomas associated with endometriosis and uterus-like masses, should be included in differential diagnoses. The patient was free from recurrence 5 months after liver tumor resection. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1327125766102291.
Collapse
|
45
|
Abscessed uterine and extrauterine adenomyomas with uterus-like features in a 56-year-old woman. Case Rep Obstet Gynecol 2013; 2013:238156. [PMID: 23956896 PMCID: PMC3730194 DOI: 10.1155/2013/238156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 07/01/2013] [Indexed: 11/18/2022] Open
Abstract
Adenomyosis, also known as endometriosis interna, is the presence of endometrial glands and stroma within the myometrium. Its localised form is called adenomyoma and mimics a leiomyoma. Rarely, adenomyomas are located outside the uterus and some of them form uterus-like masses with a thick muscle wall and an endometrium-lined central cavity. They are generally located in the ovary or broad ligament, and, although they are closely related to endometriosis, their pathogenetic mechanisms are different from each other. Müllerian duct fusion defect and subcoelomic mesenchyme transformation theory are two possible pathogenetic mechanisms for this rare entity. Here we report abscessed uterine and extrauterine adenomyomas forming uterus-like masses in the left and right broad ligament and an ectopic adrenal tissue in the left paraovarian region in a 56-year-old woman. Although there is a reported abscessed adenomyosis in the literature, this is the first abscessed extrauterine uterus-like masses with synchronous pelvic pathologies like endometriosis, leiomyomas, adenomyosis, an endometrial polyp, an endocervical polyp, and an ectopic adrenal tissue. This benign lesion gives the impression of leiomyoma, a uterine malformation, or even malignancy preoperatively. Frozen section helps in differential diagnosis.
Collapse
|
46
|
Joo HJ, Han SS, Kwon JT, Park ES, Jung YY, Kim HK. Epidural intracranial metastasis from benign leiomyoma: A case report with literature review. Clin Neurol Neurosurg 2013. [DOI: 10.1016/j.clineuro.2012.10.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
47
|
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.
Collapse
Affiliation(s)
- Ranjan Agrawal
- Department of Pathology, Rohilkhand Medical College Hospital , Bareilly, UP, India
| | | | | | | |
Collapse
|
48
|
Tanaka YO, Okada S, Satoh T, Matsumoto K, Saida T, Oki A, Yoshikawa H, Minami M. Solid non-invasive ovarian masses on MR: Histopathology and a diagnostic approach. Eur J Radiol 2011; 80:e91-7. [DOI: 10.1016/j.ejrad.2010.05.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 05/27/2010] [Indexed: 11/16/2022]
|
49
|
Epithelioid Clear Cell Smooth Muscle Tumor of the Ovary Presenting as a Mural Nodule in an Endometrioid Adenocarcinoma With Clear Cell Changes. Int J Gynecol Pathol 2011; 30:58-61. [DOI: 10.1097/pgp.0b013e3181f0c4fb] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
50
|
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.
Collapse
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
| | | | | | | | | | | | | | | |
Collapse
|