Uterine Angioleiomyomas: A Report of 3 Cases of a Distinctive Benign Leiomyoma Variant

Abstract

We report 3 cases of a distinctive uterine leiomyoma containing numerous thick-walled vascular channels, which we term angioleiomyoma. The leiomyomas occurred in women aged 33, 44, and 49 and ranged from 1.5 to 6.0 cm. They were composed of bland, spindle-shaped cells with numerous evenly distributed, arteriole-like vessels with thick muscular walls throughout. The spindle cells often swirled around the vessels. In 1 case, fibrin was present within vessel walls. The spindle cells were positive with smooth-muscle markers and negative with HMB45. We believe angioleiomyoma should be recognized as a distinct entity and included in the World Health Organization classification of tumors of the female genital tract as a benign leiomyoma variant, similar to cellular and atypical leiomyoma. Uterine angioleiomyoma has a close morphological resemblance to the similarly named skin tumor. We review uterine smooth-muscle and other mesenchymal neoplasms in which prominent vascular channels are a feature.

Uterine Angioleiomyoma with Hypofibrinogenemia: A Rare Presentation

“…7 An angioleiomyoma arising from the uterus is very rare with few reported cases worldwide. [1][2][3]8 Abdominal pain is an important clinical symptom that occurs in patients with uterine angioleimyomas apart from menorrhaggia. Ischemia of blood vessels caused by uterine contractions and local dysregulation of blood vessels have been suggested as possible causes for pain and menorrhaggia, respectively.…”

“…Very few cases of uterine angioleiomyomas have been reported worldwide. [1][2][3] Uterine angioleiomyomas are difficult to diagnose preoperatively because of their rarity and are easily misdiagnosed as leiomyomas because of similar clinical presentations between the two types of neoplasms and similar ultrasonography (USG) findings. Most often, the correct diagnosis is made postoperatively, after a histopathologic report on the excised specimen is received.…”

Pelvic retroperitoneal angioleiomyoma mimicking uterine mass: imaging and histopathological findings

“…Retroperitoneal leiomyomas occur almost exclusively in women (6). Most of these tumors resemble uterine leiomyomas by histology and positive hormone receptors.…”

Heterologous and Rare Homologous Sarcomas of the Uterine Corpus

“…1A); variable amounts of a solid components have been reported, typically less than 20% of the lesion, 11 but occasionally comprising the majority of the tumor in a manner reminiscent of leiomyosarcoma. 9 Accordingly, the differential diagnosis for angiosarcoma includes leiomyosarcoma, biphasic neoplasms such as adenosarcoma with angiosarcomatous overgrowth, 30 vascular benign smooth muscle tumors, 31,32 hemangiomas of the uterus, 12 and other conventional malignancies such as high-grade carcinoma and malignant melanoma. Adequate tumor sampling and careful attention to morphologic features supplemented by the judicious application of endothelial immunohistochemical markers should readily facilitate the resolution of these differential diagnostic considerations.…”