Leiomyoma of deep soft tissue mimicking calcific myonecrosis

Abstract

Leiomyoma of deep soft tissue is an unusual entity reported in less than 60 cases in the English literature. The lesion is now accepted as a rare neoplasm. Leiomyomata of deep soft tissue have been divided into 2 groups, those occurring primarily in women in the retroperitoneum, histologically similar to leiomyomata of the uterus, and those occurring equally in both sexes in the somatic deep soft tissues. Irrespective of location, these lesions can demonstrate calcification, and even less commonly ossification. We report a unique case of a leiomyoma of deep soft tissue that mimicked the clinical and radiographic features of calcific myonecrosis, also a rare mass forming soft-tissue lesion. Clinical and radiographic information are often critical in the diagnosis of soft-tissue lesions; however, this case demonstrates that a lesion can deviate from the standard clinical and radiographic interpretations most commonly attributed to it.

Calcified deep somatic soft tissue leiomyoma of the leg: A case report

“…3 To date, there have been approximately 60 case reports describing deep somatic soft tissue leiomyomas, mainly in children and elderly patients. [4][5][6][7][8][9] The average tumor diameter of these leiomyomas is 5 cm, with the previously reported maximum size being 14 cm. 2,4 Herein, we report a rare case of a huge, calcified, deep somatic soft tissue leiomyoma arising in the peroneus longus muscle of a young, adult, male patient.…”

Incidental deep soft tissue leiomyoma of the groin – a case report and comprehensive review of literature

“…Billings et al . highlight the importance of stringent histologic criteria by which accurate diagnosis is assured [ 7 ]. Actin or desmin staining can show the presence of smooth muscle.…”

“…The articles were divided into case reports about DSTL of the lower extremities [ 3 , 4 , 7 , 8 , 10–16 ] ( Table 1 ), upper extremities [ 2 , 9 , 17–21 , 22 ] ( Table 2 ), other locations [ 23–33 ] ( Table 3 ) and case series [ 34–38 ] ( Table 4 ). In summary, of all publications found, the extremities were involved in 35 cases.…”

“…According to Weiss [ 5 ], there is a clinicopathological distinction between tumors with no sex prevalence arising from deep somatic soft tissue and tumors occurring particularly in women in the pelvic retroperitoneum. In contrast to the more common leiomyoma of the uterus or the retroperitoneum [ 6 , 7 ], DSTL of the lower extremity are extremely rare findings and in literature, mainly case reports exist [ 4 ].…”

Calcific myonecrosis: diagnostic dilemma

“…A growing mass will understandably raise alarms with patients and treating physicians for potential malignancy, as it can mimic a soft-tissue tumours. [7][8][9][10] An inquisitive history and a thorough clinical examination, together with plain radiographs and advanced imaging, are essential tools for reaching an accurate diagnosis and managing this rare condition.…”