Intramurally Located Adenomatoid Tumor of the Uterus: A Case Report (original) (raw)
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Adenomatoid Tumour of the Uterus: A Rare Case Report
2020
Adenomatoid tumours are rare benign tumours originating in the mesothelium. Uterine adenomatoid tumours are benign tumours of the uterine serosa and myometrium that originate from the mesothelium. They are mostly under diagnosed as they resemble leiomyoma of the uterus. They may resemble pre-existing vessels and lymphatic ducts as well as metastatic adenocarcinomas. We report a case a of adenomatoid tumour of the uterus in a 50 years old lady that was found accidently during the treatment of adenomyosis. Although adenomatoid tumour may cause a diagnostic problem, in our case histological study has confirmed the diagnosis.
Adenomatoid tumor of the uterus; report of a rare incidentaloma
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2014
Adenomatoid tumor of the uterus is extremely rare and usually an incidental finding in the uteri removed surgically for some other cause as in the present case. The histogenesis of this tumor has been controversial ever since its discovery, although the most favored and proposed is a mesothelial origin. Grossly it is usually mistaken for a leiomyoma. The tumor may have a variety of histomorphologic patterns with rare bizarre appearances, at times leading to an erroneous diagnosis of metastatic adenocarcinoma.
Objective Adenomatoid tumor is a benign neoplasm of mesothelial origin encountered most often in the male and female genital tracts. This tumor has a distinct morphology and is characterized by anastomosing and variably sized tubules lined by epithelioid and flattened cells. Only 4 cases of the extremely rare leiomyoadenomatoid variant are on record. We report 5 cases of adenomatoid tumor including 3 cases of leiomyoadenomatoid tumor of the uterus, which is an extremely rare variant of adenomatoid tumor, difficult to recognize on morphology.
Leiomyoadenomatoid tumor of uterus: two case reports with literature review
Surgical and Experimental Pathology
Background Adenomatoid tumors (AT) are benign neoplasms of mesothelial origin that occur more frequently in the genital tracts. In uterus, AT are usually located in the subserosa of the cornual myometrium. Microscopically, it is characterized by interanastomosing pseudoglands or pseudovascular spaces and striking smooth-muscle hypertrophy is often present. In some cases, the prominence of smooth muscle component simulates a leiomyoma and the lesion is denoted as a leiomyoadenomatoid tumor. The microscopic appearance of the adenomatoid component (AC) may mimic a malignant tumor due to irregular pseudoinfiltration with tubular formations. Just 16 cases with this morphological presentation were found in the literature review. Case presentations The first case, a 38-year-old female, showed lower abdominal pain, menorrhagia, postcoital bleeding and previous history of uterin leiomyoma. The second case, a 26-year-old female, had clinical complaint of metrorrhagia and received diagnostic h...
Multifocal adenomatoid tumor of myometrium: A case report and review of literature
A case of multifocal adenomatoid tumors (mAT) of the myometrium is presented. The patient, a 49-year-old woman underwent vaginal hysterectomy for severe pelvic pain renitent to medical therapy. Diagnosis was made based on histologic examination and immunohistochemistry (IHC). AT should be considered in the differential diagnosis with leiomyoma in patients with severe pelvic pain and an enlarged uterus due to multiple nodules.
Highly Cellular Leiomyoma Mixed With a Focus of Adenomyosis
Cureus
The purpose of this case presentation was to highlight the importance of an adequate evaluation of images when suspicious of atypical leiomyoma and the importance of performing an extemporaneous biopsy during surgery to ensure the lesion is a benign muscular cell tumor. Here, we present a case of a 34-year-old nulliparous woman who presented with a history of infertility and irregular menstrual cycles. A highly vascularized pelvic mass was visualized by Doppler ultrasound and a contrast MRI suggestive of uterine fibroid. Intraoperatively, the lesion was found adjacent to the uterus, with a second lesion deeper into the myometrium. The pathology reported a highly cellular leiomyoma with a focus of adenomyosis. Both lesions were extirpated without complications. The patient recuperated favorably within three months of follow-up. This case shows an example of a variety of the typical histology that can be found in uterine fibroids. Although the management of atypical leiomyomas could vary in different scenarios, conservative treatment is recommended if fertility wishes are present. In all cases, it is mandatory to exclude any possibilities of malignancy, like sarcoma, which would completely change the intraoperative management.
The Significance of Tumor Involved Adenomyosis in Otherwise Low-stage Endometrioid Adenocarcinoma
International Journal of Gynecological Pathology, 2010
Depth of myometrial invasion by endometrioid adenocarcinoma (EMAC) is one of the most important predictive factors of disease recurrence. It is unclear whether myoinvasion arising in carcinomatous involvement of adenomyosis (AM) changes prognosis. The purpose of this study was to evaluate the significance and frequency of the tumor involved AM in otherwise low-stage cancers. Eighty-two hysterectomies with EMAC with less than 50% myoinvasion (T1a, FIGO IA), AM, and at least 2 years of follow-up information were reviewed. The tumors were divided into 4 histologic groups: group 1, no involvement of AM by EMAC (n ¼ 38); group 2, tumor involved AM surrounded by endometrial stroma (n ¼ 31); group 3, tumor involved AM with incomplete peripheral endometrial stroma (n ¼ 10); and group 4, tumor involved AM with invasion into adjacent smooth muscle (n ¼ 3). Tumor involved AM was in the inner half of the myometrium in 35 cases and in the outer half of the myometrium in 9 cases. The only adverse outcome was vaginal recurrence, which was noted in 2 of 82 patients; both the patients were from the control group. None of the patients with deep-seated tumor involved AM had tumor recurrence. In otherwise low-stage tumors, our data support the concept that tumor involvement of the deeply located AM does not affect prognosis. Myometrial-based foci of well-differentiated EMAC, completely or partially surrounded by endometrial stroma, most likely represents tumor colonized AM. Determining invasion out of these foci is subjective, and although limited by rarity in this study, carries no adverse outcome. Therefore, staging should be based on the myoinvasion noted at the native endomyometrial junction.
Histomorphological Spectrum of Uterine Smooth Muscle Tumors
Journal of South Asian Federation of Obstetrics and Gynaecology
Introduction: Uterine smooth muscle tumors are the most common tumors of female genital tract and among these leiomyomas predominate. Leiomyomas most commonly occur during the reproductive years in women with manifestation of abnormal uterine bleeding and abdominal pain. These exhibit wide range of morphological variants and secondary changes. Here, we present a study of 70 cases, which includes rare variants and degenerative changes in leiomyomas. Materials and methods: A retrospective study conducted in a department of pathology for a period of 1 year from January 2019 to December 2019 at a tertiary care hospital. Seventy patients were diagnosed as leiomyoma on histopathological examination of 124 hysterectomy specimens and one myomectomy specimen and included in the study. Detailed microanatomic features were studied and recorded. Result: Uterine leiomyoma was most common among the age-group of 41-50 years of age (64.21%). Most common location was intramural (54.29%). Secondary changes were observed in 48 cases (68.57%). Most common secondary change was hyaline degeneration noted in 38 cases (79.17%). Classical variant of leiomyoma was seen in 66 cases (94.28%) followed by one case (1.43%) each of symplastic, neurilemmoma-like, lymphocyte-rich, and cellular leiomyoma and leiomyomas with rare secondary changes like osseous and chondroid metaplasia. Conclusion: Uterine smooth muscle tumors are commonly seen in perimenopausal females. Leiomyoma is associated with various pathologies comprising of degenerative changes and rare variants which sometimes can be misdiagnosed as malignancy. Hence, a vigilant histopathological examination is necessary to identify the various spectrum of uterine leiomyomas and associated pathologies.
Uterine adenomyosis: a need for uniform terminology and consensus classification
Reproductive Biomedicine Online, 2008
Modern imaging techniques allow non-invasive diagnosis of adenomyosis, a relatively common disorder characterized by the presence of heterotopic endometrial glands and stroma in the myometrium with hyperplasia of the adjacent smooth muscle. The study of adenomyosis is greatly hampered by a lack of clear terminology and the absence of a consensus classification of the lesions. Any classification of adenomyosis must