DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205814

A case of atypical leiomyoma mimicking as endometrial cancer

Priyanka Bhadana, Abha Kiran, Kriti Bhakuni, Veena G. Malla

Abstract


Atypical leiomyoma or leiomyoma with bizarre nucleus is diagnosed on histopathological examination characterized by severe cytological atypia in the form of nuclear enlargement, multi nucleation, hyperchromasia, coarse chromatin and prominent nuclei. These tumours do not have typical features of necrosis or mitotic figures to characterize them as leiomyosarcoma. There are 2% risk of these tumours to convert to leiomyosarcoma. 50-year P3L3A1 postmenopausal for past 6 years presented to gynaecology outpatient department (GOPD) with complains of pain in lower abdomen for past 1 year. Patient was examined and investigated. On clinical examination there was no apparent finding. On radiological examination a well-defined hypoechoic lesion of 6.4×5.7 cm2 was found arising from uterus. Contrast enhanced computed tomography (CECT) abdomen showed heterogenous mass involving endometrium and myometrium likely neoplastic. Total abdominal hysterectomy with bilateral salpingoophrectomy was done. Histopathological examination (HPE) report revealed features of atypical leiomyoma. Patient is under follow up in GOPD.


Keywords


Atypical leiomyoma, Endometrial cancer

Full Text:

PDF

References


Stewart EA. Uterine fibroids. Lancet. 2001;375(9252):293-8.

Mill AM, Ly A, Balzer BL. Cell cycle regulatory markers in uterine leiomyoma with leiomyosarcoma: immunohistochemistry study of 68 cases with clinical follow up. Am J Surg Pathol. 2013;37:634-42.

WHO histological classification of tumor of uterine corpus. IARC publication:218.

Makienen N, Kampjarvi K, Frizell N, Butzow R, Vahteristo P. Charecterization of MED12 HMGA2 FH alteration reveals molecular variability in uterine smooth muscle tumors. Molecular cancer. 2017;16:101.

Ersoz S, Turgutalp H, Mungan S, Guvendi G, Guven S. Cotyledonoid leiomyoma of uterus a case report. Turk Patoloji Derg. 2011;27(3):257-60.

Atkins KA, Arronte N, Darus CJ. The use of p16 in enhancing the histologic classification of uterus smooth muscle tumors. Am J Surg Pathol. 2008;32(1):98-102.

Arleo E, Schwartz P, Hui P, Mccarthy S. Review of Leiomyoma variant. Am J Roentgenol. 2015;205(4):912-21.

Ly A, Amy MD, McKenny M, Balzer JK. Atypical Leiomyoma of the uterus A clinicopathologic study of 51 cases. Am J Surg Pathol. 2013;37(5):643-9.