Perinodular hydropic degeneration of a uterine leiomyoma: A diagnostic challenge

Multinodular hydropic leiomyoma of the uterus with perinodular hydropic degeneration and extrauterine extension

“…in three cases 1 . Thereafter, another two cases were reported 2,3 . Multinodular hydropic leiomyomas typically consist of two types of hydropic degeneration, including hydropic degeneration within leiomyoma and leiomyoma with perinodular hydropic degeneration 1–3 .…”

“…Thereafter, another two cases were reported 2,3 . Multinodular hydropic leiomyomas typically consist of two types of hydropic degeneration, including hydropic degeneration within leiomyoma and leiomyoma with perinodular hydropic degeneration 1–3 . In the first group, hydropic changes are inside the leiomyoma, and hydropic foci have rare fibroblasts, strands, rounded collagen fibers and thick‐walled vessels within a pale background.…”

“…Intramural dissecting growth pattern, satellite smooth muscle nodules simulating intravascular growth, minor true vascular invasion and diffuse hydropic degeneration within non‐neoplastic myometrium are the other characteristic features of MHL (Table 2). 1–3 Yet, these features are not unique to MHL and may also occur in other unusual uterine leiomyoma variants, such as intravascular leiomyomatosis (IVL), cotyledonoid dissecting leiomyoma (CDL) and uncomplicated intramural dissecting leiomyoma (IDL) 3,5–11 …”

“…Perinodular hydropic degeneration areas of MHL might mimic IVL 1–4 . The presence of artifactual stromal retraction of hydropic degeneration might give the false impression of vascular invasion.…”

“…Hydropic degeneration is a common degenerative change in uterine leiomyomas 1 . Perinodular hydropic degeneration (PHD) is a rare form of hydropic degeneration and is characterized by numerous small smooth muscle nodules separated by edematous connective tissue 1–4 . Multinodular hydropic leiomyoma (MHL) with PHD, one of the unusual uterine leiomyoma variants (Table 1), was first described by Clement et al .…”