Deep Leiomyoma



Deep Leiomyoma


Cyril Fisher, MD, DSc, FRCPath









Hematoxylin & eosin shows short fascicles of uniform spindle cells with blunt- or round-ended nuclei and eosinophilic cytoplasm. There is a fibrous stroma with scattered mast cells image.






Hematoxylin & eosin shows nuclear palisading image. This is more common in retroperitoneal leiomyomas in females, which resemble those of the uterus. This should not be misinterpreted as a schwannoma.


TERMINOLOGY


Definitions



  • Benign smooth muscle tumor involving deep soft tissue of limbs or retroperitoneum


CLINICAL ISSUES


Epidemiology



  • Incidence



    • Rare: 4% of benign soft tissue tumors


  • Age



    • 4th-6th decade of life


  • Gender



    • M<F


Site



  • Deep subcutis or subfascial in limbs


  • Retroperitoneum, especially in females



    • Resemble uterine leiomyomas


Presentation



  • Painless mass


  • Slow growing


Treatment



  • Simple excision


Prognosis



  • Benign tumor


  • Correctly diagnosed cases do not recur or metastasize


MACROSCOPIC FEATURES


General Features



  • Well circumscribed


  • Gray-white cut surface


  • Myxoid areas


  • Foci of calcification


  • Rare cystic change


  • Necrosis absent


Size



  • 5-20 cm


  • Retroperitoneal tumors can reach very large size


MICROSCOPIC PATHOLOGY


Predominant Pattern/Injury Type



  • Sheets


Predominant Cell/Compartment Type



  • Smooth muscle


Key Microscopic Features

Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Deep Leiomyoma

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