Renal Leiomyoma: Ultrasonography and Computed Tomography Features with Histopathologic Correlation

Onur, Mehmet Ruhi; Akın, Mehmet; Onur, Ahmet Rahmi

doi:10.5152/eajm.2013.42

Cited by 3 publications

(6 citation statements)

References 10 publications

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“…Renal leiomyomas are incidentally detected with ultrasonography. 3 Uterine leiomyomas can be hypoechoic to normal myometrium. 8 However, it can be iso-oechoic or even hyperechoic.…”

Section: Discussionmentioning

confidence: 99%

“…CECT cannot precisely diagnose leiomyomas, even uterine leiomyomas. 3 CECT features of uterine leiomyomas are soft-tissue density, exhibit coarse peripheral or central calcification. The enhancement pattern is variable and they also may distort the usually smooth uterine contour.…”

Section: Discussionmentioning

confidence: 99%

“…The enhancement pattern is variable and they also may distort the usually smooth uterine contour. 3 MRI is the most accurate imaging modality for leiomyomas. 9 Uterine leiomyomas can be seen as hypointense/isointence to normal myometrium on T1 images and they might have characteristic high signal intensity on T1-weighted images.…”

Section: Discussionmentioning

confidence: 99%

“…2 Renal leiomyomas are usually detected as single-kidneymasses. 3 There are no reports in literature regarding longterm survival or subsequent recurrence with sarcomatous differantiation.…”

Section: Introductionmentioning

confidence: 99%

“…3 There are no reports in literature regarding longterm survival or subsequent recurrence with sarcomatous differantiation.…”

mentioning

confidence: 99%

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Bilateral renal leiomyoma with 5 year follow-up: Case report

Gören

Erbay

Özer

et al. 2015

CUAJ

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Renal leiomyomas are exceptionally rare benign tumours of the kidney. Although the renal leiomyomas usually do not metastasize, the differential diagnosis between renal leiomyomas and malign lesions (leiomyosarcoma or renal cell carcinoma) cannot be done by radiological examinations, but is possible by histological examination. Surgery is the preferred treatment. After surgery, the prognosis is excellent without recurrence. Although uterine leiomyomas can be multicentric, renal leiomyomas have been single lesions. We report an incidentally detected case of bilateral renal leiomyoma in a 50-year-old woman with a 5-year follow-up. We also review the literature and discuss clinical, radiological and histological features of renal leiomyomas. IntroductionLeiomyomas are benign neoplasms of the smooth muscles, usually occurring in the uterus.1 Renal leiomyomas are exceptionally rare neoplasms that occur at a much lower frequency (0.001%) and show a marked female predominance.1 They rarely present with flank pain and hematuria. 2Renal leiomyomas are usually detected as single-kidneymasses. 3 There are no reports in literature regarding longterm survival or subsequent recurrence with sarcomatous differantiation.We present a 5-year case of bilateral renal leiomyoma detected via contrast-enhanced computed tomography (CECT), magnetic-resonance-imaging (MRI), and histopathologic images. Case reportA 50-year-old female, with migraine, presented with a nonspecific complaint of left flank pain. The hematological, biochemical parameters, and urine analyses were within normal limits. Ultrasonography revealed hypoechoic 30 × 25-mm left mid-pole and 11 × 10-mm right lower-pole renal-masses. CECT of the abdomen revealed a 30 × 35-mm well-circumscribed mid-polar exophytic left renal-mass enhancing less than renal parenchyma on corticomedullary phase with a suspicious renal pelvis invasion and a 10 × 10-mm right lower pole exophytic mass showing a similar enhancing pattern (Fig. 1).Gadolinium-enhanced MRI revealed a 30 × 35-mm well-circumscribed mild exophytic mid-pole renal-mass with renal pelvis invasion; no pathological lymph nodes were detected. On T1-weighted images, both lesions were isointense to muscle tissue and hypointense to renal parenchyma. Enhanced T1-weighted images revealed a peripheral and centrally reticular enhanced left renal mass. Both lesions had no intracellular fat on inphase/outphase images. Malignancy was suggestive due to intense diffusion restriction on diffusion-weighted images (Fig. 1).The left renal mass had renal pelvis invasion on MRI; therefore left radical nephrectomy was performed. Active surveillance was planned for the right renal-mass.A microscopic examination of the left renal mass revealed a leiomyoma. Necrosis, nuclear pleomorphism, and mitotic activity were not detected. Immunohistochemically, the tumour stained strongly with smooth-muscle-actin (SMA) (Fig. 2). HMB45, S100 and desmin were negatively stained.MRI and CECT findings were re-evaluated according to the histopathological fi...

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“…Renal leiomyomas are incidentally detected with ultrasonography. 3 Uterine leiomyomas can be hypoechoic to normal myometrium. 8 However, it can be iso-oechoic or even hyperechoic.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…2 Renal leiomyomas are usually detected as single-kidneymasses. 3 There are no reports in literature regarding longterm survival or subsequent recurrence with sarcomatous differantiation.…”

Section: Introductionmentioning

confidence: 99%

“…3 There are no reports in literature regarding longterm survival or subsequent recurrence with sarcomatous differantiation.…”

mentioning

confidence: 99%

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Bilateral renal leiomyoma with 5 year follow-up: Case report

Gören

Erbay

Özer

et al. 2015

CUAJ

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Renal leiomyoma in pediatric age: a rare case report with review of the literature

Nakib

Mahgoub

Calcaterra

et al. 2017

Journal of Pediatric Surgery Case Reports

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Large renal leiomyoma: A multidisciplinary approach to diagnosis

Chaniotakis¹,

Yang²,

Patel³

et al. 2021

Radiology Case

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We report the case of a 45-year-old woman who presented with a large palpable abdominal mass. Initial sonographic and computed tomographic studies prompted a differential diagnosis of retroperitoneal or renal sarcoma, leiomyoma, and lipid-poor angiomyolipoma. A final diagnosis of renal leiomyoma was reached based on a consensus among radiology, surgery and pathology. In addition to reviewing the features of this entity, this case demonstrates the process of developing a working diagnosis, narrowing the differential as additional testing is performed and establishing a final diagnosis with interdepartmental coordination. Despite the rarity of this condition, the ability to recognize and apply imaging features to differentiate between abdominal masses of unknown origin is important for clinicians and researchers.

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Renal Leiomyoma: Ultrasonography and Computed Tomography Features with Histopathologic Correlation

Cited by 3 publications

References 10 publications

Bilateral renal leiomyoma with 5 year follow-up: Case report

Bilateral renal leiomyoma with 5 year follow-up: Case report

Renal leiomyoma in pediatric age: a rare case report with review of the literature

Large renal leiomyoma: A multidisciplinary approach to diagnosis

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