Massive Multilocular Cystic Leiomyoma of the Uterus: An Extreme Example of Hydropic Degeneration

Coard, K. C. M.; Plummer, Joseph M

doi:10.1097/01.smj.0000257639.52322.7d

Cited by 8 publications

(4 citation statements)

References 12 publications

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“…In fact, Coard et al . [27] described a case of a leiomyoma with massive hydropic degeneration similar to our case, and they reported that the hydropic degeneration resulted in multilocular and microcystic changes and marked splaying of the individual smooth muscle cells. The main pathological textbook [16] described leiomyomas with hydropic degeneration to have a delicate filigree pattern rather than thick fascicles.…”

Section: Discussionsupporting

confidence: 69%

A subserosal, pedunculated, multilocular uterine leiomyoma with ovarian tumor-like morphology and histological architecture of adenomatoid tumors: a case report and review of the literature

et al. 2016

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BackgroundUterine leiomyomas are common uterine tumors, and typical cases of leiomyoma are easily diagnosed by imaging study. However, uterine leiomyomas are often altered by degenerative changes, which can cause difficulty and confusion in their clinical diagnosis. We describe the 17th reported case of a uterine leiomyoma clinically diagnosed as an ovarian tumor; however, the present case shows the most detailed radiological evaluation, including contrast-enhanced magnetic resonance imaging. We first show that a uterine leiomyoma can histologically mimic an adenomatoid tumor.Case presentationA 47-year-old premenopausal, nulliparous Japanese woman with a history of type 2 diabetes mellitus, hypertension, and hyperlipidemia had lower abdominal pain. Ultrasonography confirmed a 6-cm mass in the right-sided space of the pelvic cavity. Magnetic resonance imaging evaluation showed that a multilocular mass was present near the uterus, and a mucinous ovarian tumor was considered. Emergency surgery due to acute abdomen was performed under the diagnosis of pedicle torsion of the ovarian tumor. During surgery, a pedunculated uterine mass without stalk torsion was seen. The mass grossly contained serous and hemorrhagic fluids in the cavities, and pathology examination confirmed that the mass was a leiomyoma with hydropic and cystic degeneration. Anastomosing thin cord-like arrangements of the leiomyoma cells mimicked the architecture of adenomatoid tumors. The tumor cells were positive for the microphthalmia transcription factor but negative for other melanoma markers. Three days postoperatively, she was discharged without sequelae.ConclusionsMarked intratumoral deposition of fluids may induce the multilocular morphology of a tumor, and the cellular arrangement of the tumor cells with hydropic degeneration mimicked an adenomatoid tumor in this case. Clinicians need to be aware that a subserosal leiomyoma with cystic and hydropic degeneration can mimic an ovarian tumor, and pathologists should be aware that such leiomyomas can mimic adenomatoid tumors. Additionally, perivascular epithelioid cell tumors should not be diagnosed only based on its immunoreactivity for the microphthalmia transcription factor.

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Section: Discussionsupporting

confidence: 69%

A subserosal, pedunculated, multilocular uterine leiomyoma with ovarian tumor-like morphology and histological architecture of adenomatoid tumors: a case report and review of the literature

et al. 2016

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“…Moreover, it sometimes behaves in ways that suggest malignancy. Hydropic change is poorly reported as perinodular hydropic degeneration [[2], [3], [4], [5]], and many cases have been documented under names such as multinodular hydropic, multilocular cystic, cystic degenerated, or hydropic leiomyomas [[5], [6], [7], [8]].…”

Section: Discussionmentioning

confidence: 99%

Perinodular hydropic degeneration in uterine leiomyoma causing rapid enlargement and mimicking a myxoid smooth muscle tumor: Case report of a diagnostic challenge

Khader

Nsour

Abdallat

2019

Case Reports in Women's Health

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“…A fair number of the previously reported human uterine LMS exhibit multilocular pseudocystic morphology, which often makes them confused with ovarian tumors ( 26 ). Hydropic degeneration, which is characterized by the intra-tumoral accumulation of edematous fluid, has been thought to be the main cause of inducing the pseudocystic morphology of human uterine LM; however, the etiology of the degeneration remains unclear ( 26 , 27 ). Rarely, the pseudocystic morphology may be associated with myxoid degeneration that produces mucinous materials, but most LMS are represented by hydropic degeneration in which clear, yellow, and hemorrhagic fluid accumulated in the multiloculated pseudocystic spaces ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Giant Multiloculated Pseudocystic Jejunal Leiomyosarcoma in a Dog: Atypical Morphologic Features of Canine Intestinal Leiomyosarcoma

et al. 2022

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A 10-year-old intact female Rottweiler dog weighing 29 kg presented with 2 days history of vomiting, anorexia, and lethargy to KonKuk University Teaching Hospital, Seoul, South Korea. Ultrasonography and computed tomography (CT) scannings revealed a well-demarcated, large mass (29 × 19 × 11 cm) with numerous fluid-filled cavities. Metastases to adjacent lymph nodes were also identified on CT. This large mass and the affected intestinal segments were excised for palliative purposes. Postoperatively, the dog recovered uneventfully without any complications. The cut surface of the mass showed an exophytic growth pattern of multiloculated cystic lesions filled with serosanguineous fluid, large cavities filled with necrotic exudate, and fistulous connections between the intestinal lumen and the necrotic cavity in the mass. On histopathology, the mass was a spindle cell neoplasm expanding from the jejunal muscular layer and with pseudocystic changes. Additional immunohistochemical analysis using antibodies against smooth muscle actin, desmin, and CD-117 demonstrated that the mass was consistent with a leiomyosarcoma. Six months post-operatively, plain radiography revealed an abdominal mass, suspected to be recurrence from jejunal leiomyosarcoma. The owner decided to euthanize the dog due to financial constraints. This case report describes the atypical morphology and clinical progression of a large canine jejunal leiomyosarcoma, which had similar clinical features as those of human leiomyoma and leiomyosarcoma.

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Massive Multilocular Cystic Leiomyoma of the Uterus: An Extreme Example of Hydropic Degeneration

Cited by 8 publications

References 12 publications

A subserosal, pedunculated, multilocular uterine leiomyoma with ovarian tumor-like morphology and histological architecture of adenomatoid tumors: a case report and review of the literature

A subserosal, pedunculated, multilocular uterine leiomyoma with ovarian tumor-like morphology and histological architecture of adenomatoid tumors: a case report and review of the literature

Perinodular hydropic degeneration in uterine leiomyoma causing rapid enlargement and mimicking a myxoid smooth muscle tumor: Case report of a diagnostic challenge

Case Report: Giant Multiloculated Pseudocystic Jejunal Leiomyosarcoma in a Dog: Atypical Morphologic Features of Canine Intestinal Leiomyosarcoma

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