Loves to promote social media for education in Pathology, Designed by Elegant Themes | Powered by WordPress, ANTICOAGULANTS in Hematologic Investigations, Understanding AZZOPARDI PHENOMENON / EFFECT. Myxoid degeneration in a huge uterine leiomyoma: an unusual benign pathology mimiking malignancy 117 Fig. Hydropic degeneration of uterine leiomyoma mimicking a huge ovarian cyst Ifeyinwa Mary Asuzu, Emmanuel Ugwa, Kevin Nwabueze Ezike ABSTRACT Introduction: Leiomyomas are very common neoplasms of the female genital tract. Leiomyomas can occur in any age group but more common in 30 to 50 years. 1992 ;16: 26 - 32 . Table 1 summarizes ordinary leiomyomas, including their various forms of degeneration, and their main variants. Am J Surg Pathol. Increased levels of CA 125 often are associated with some types of malignancy. rajuwilk_ngp@sancharnet.in In the growing knowledge of rare interesting tumors, the cotyledonoid leiomyoma is a tumor with an alarming appearance, of … Edematous change, referred to as hydropic degeneration, is a common form of degeneration seen focally in up to 50% of patients with leiomyoma . These are the ones which can manifest with menorrhagia. Red Degeneration: This is due to hemorrhagic infaction of a leiomyoma. We welcome suggestions or questions about using the website. The cut surfaces are well circumscribed, with greywhite and whorled cut surface. Leiomyoma dissects into myometrium (black These are usually asymptomatic if small and are often incidental finding. Ultrasonography (US) showed a heterogeneous abdominopelvic mass. Hydropic degeneration is characterized by accumulation of oedema fluid with associated collagen deposition presenting with various patterns [5], [6]. They can also interfere in fertility. Hydropic change is another form of degeneration with a similar MRI appearance, and is due to an accumulation of oedema fluid in the connective tissue of the leiomyoma. Morphology: Diffuse hydropic degeneration is considered much less common and may result in exceptionally large tumors, depending on the degree of fluid accumulation . Am J Surg Pathol. Leiomyomas can undergo degeneration, which can result in a variety of sonographic appearances. Can cause pressure symptoms due to compression on adjoining structures. Intramural: within the myometrium. Genes involved : HGMA2, ESR2, RAD5 & MED12, Clinical features: 4. Larger tumors result in various pressure symptoms. The individual smooth muscle cells are uniform in size and shape and have characteristic oval to elongated with blunt ends ( CIGAR shaped). It is a close mimicker of malignancy due to rapid growth and atypical imaging appearances. Abstract. This is present in a focal form in up to 50% of otherwise typically appearing leiomyomas [ 1 ]. With minimal discussion in the surgical pathology literature, appropriate evaluation may be challenging because the differential diagnosis includes other uncommon uterine disorders such as intravenous leiomyomatosis, diffuse leiomyomatosis, myxoid … 2b). Hydropic changes lead to formation of cystic cavities. pathology examination confirmed that the mass was a leiomyoma with hydropic and cystic degeneration. The common cause is due to obstruction of venous drainage at the periphery of the lesion. These are usually multiple with sizes ranging from microscopic foci to large bulky tumors. Leiomyomas with hydropic change do not have thick smooth muscle cells fascicles but a delicate filigree pattern with oedema fluid as extracellular material [1]. But can manifest with abnormal uterine bleeding which is more common in submucosal leiomyomas. Increased awareness of this grossly alarming variant of benign uterine leiomyoma can help avoid overtreatment. Microscopy: the pattern is that of interlacing fascicles or whorling of smooth muscle cells. Background: Leiomyomas rarely cause pseudo-Meigs syndrome. Uterine leiomyomas are commonly referred to as Fibroids. If the tumor is very large, the degenerative changes can be seen. 2) and distinguished from the interstitial edema commonly seen in leiomyomata. is present around smooth muscle bundles In the acute test, group 1 showed a sharply demarcated area of coagulative necrosis that did not express estrogen receptor (ER) or progesterone receptor (PR); group 2 showed a severe hydropic degeneration or necrosis; and group 3 showed regular leiomyoma cells. 2. Huge leiomyoma with myxoid degeneration (cystic spaces) on cut section Hyalinization is the commonest type of degeneration. Reports of leiomyoma with marked cystic degeneration have been relatively uncommon (Aydin et al., 2013). 1) was described and distinguished from the interstitial hyaline degeneration that is commonly seen in uterine leiomyomata. Cystic change, an extreme form of hydropic degeneration is a rare clinical presentation. With more than 17 years of experience as an academician, He has developed the art of content generation to make the learning more fun. Earlier age of menarche and nulliparous women have higher risk. Cytogenetic abnormalities: 40 to 50% of uterine leiomyomas show karyotypic abnormalities. Perinodular hydropic degeneration of a uterine leiomyoma is a rare form of the more common hydropic change observed in leiomyomas. They can be single or multiple. Most important risk factor is exposure to environmental estrogens before puberty. Posted by Dr Vijay Shankar S | Jan 11, 2021 | Female Genital System & Breast |. Based on the location of the tumor they are categorized as This is a complication usually occurs in pregnancy. Cotyledonoid dissecting leiomyoma is an extremely rare variant of uterine leiomyoma with an unusual growth pattern characterized by an extrauterine mass that resembles a placenta and histologically shows an intramural dissecting pattern in the uterus [2, 3]. A leiomyoma is a benign smooth muscle tumor that can develop anywhere in the body Hydropic Leiomyoma of Uterine Corpus is an uncommon morphological variant of Uterine Corpus Leiomyoma. Microscopically, the nodules were separated by extensive hydropic degeneration. Obesity, lack of exercise are also risk factors for development of leiomyomas. Multinodular hydropic leiomyoma (MHL) of the uterus is one of the rarest variants of uterine leiomyomas and can create some diagnostic problems. There are no clinical findings that reliably differentiate ordinary leiomyomas from leiomyoma variants and leiomyosarcomas. However, we cannot answer medical or research questions or give advice. Saeed et al. The mass grossly contained serous and hemorrhagic fluids in the cavities, and pathology examination confirmed that the mass was a leiomyoma with hydropic and cystic degeneration. Uncomplicated leiomyomas are of a heterogeneous echo texture and vary from hypoechoic to hyperechoic, sometimes containing calcifications with acoustic shadowing. Ovary tumor - Leiomyoma. Cystic degeneration is an extreme sequel of edema. Only five cases have been reported previously. Geographic areas of hydropic degeneration were identified (Fig. Aims: We present the histopathological findings of a series of six cases of a benign uterine smooth muscle tumour with an unusual growth pattern.. Methods and results: All cases have the appearances of the recently described dissecting (cotyledonoid) leiomyoma.In addition, three of these lesions demonstrate the … Hyaline degeneration consisting of nodular confluent acellular areas (Fig. reviewed 20 cases of cotyledonoid dissecting leiomyoma . 1. They are most common tumors in females. Cotyledonoid leiomyoma apparently results from a combination of several uncommon growth patterns operating together, including subserosal growth, dissecting growth, and perinodular hydropic degeneration. Uterine Leiomyoma: These are the benign tumors of smooth muscle of uterus. They also showed an intravascular luminal growth pattern. Red Degeneration: This is due to hemorrhagic infaction of a leiomyoma. Acoustic shadowing not a reliable predictor of leiomyosarcoma according to Parker et al can cause pressure symptoms due to growth! 2013 ) leiomyoma is a rare form of the uterus can enlarge and may have a lobulated.. 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