Leiomyoma
Template:Short description Template:Infobox medical condition (new)
A leiomyoma, also known as a fibroid, is a benign smooth muscle tumor that very rarely becomes cancer (0.1%). They can occur in any organ, but the most common forms occur in the uterus, small bowel, and the esophagus. Polycythemia may occur due to increased erythropoietin production as part of a paraneoplastic syndrome.
The word is from leio- + myo- + -oma, 'smooth-muscle tumor'. The plural form can be either the English leiomyomas or the classical leiomyomata.
Uterus
Uterine fibroids are leiomyomata of the uterine smooth muscle. As other leiomyomata, they are benign, but may lead to excessive menstrual bleeding (menorrhagia), often cause anemia and may lead to infertility.
A rare form of these tumors is uterine lipoleiomyoma—benign tumors consisting of a mixture of adipocytes and smooth muscle cells. Uterine lipoleiomyomata have been observed together with ovarian and other pathologies and some of them may develop into liposarcoma.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref> These tumors are monoclonal, and non-random chromosomal abnormalities have been seen in 40% of the tumors.
Gallbladder
Mesenchymal neoplasms of the gallbladder are rare and in particular leiomyomas of the gallbladder have been rarely reported, all of them in patients with immune system disorders. However, a case was reported in absence of associated immunodeficiency at Monash Hospital in Melbourne, Australia, in a healthy 39-year-old woman with no symptoms.<ref name=Segura-Sampedro_2012>Template:Cite journal</ref>
Skin
Leiomyomas of the skin are generally (1) acquired, and (2) divided into several categories:<ref name="Fitz2">Template:Cite book</ref><ref name="Andrews">Template:Cite book</ref><ref name=":0">Elenitsas R, & Chu E.Y. (2019). Pathology of skin lesions. Kang S, & Amagai M, & Bruckner A.L., & Enk A.H., & Margolis D.J., & McMichael A.J., & Orringer J.S.(Eds.), Fitzpatrick's Dermatology, 9e. McGraw-Hill Education.</ref>
- Solitary cutaneous leiomyoma
- Multiple cutaneous (or pilar) leiomyomas arising from the arrectores pilorum muscles
- Angioleiomyomas (vascular leiomyomas) that are thought to arise from vascular smooth muscle
- Dartoic (or genital) leiomyomas originating in the dartos muscles of the genitalia, areola, and nipple
- Angiolipoleiomyoma
Esophagus, stomach and small intestines
Leiomyoma is the most common benign mesenchymal tumor of esophagus and second most common benign tumor of the small bowel (with gastrointestinal stromal tumor as most common).<ref>Radiologic Pathology Archives: Esophageal Neoplasms: Radiologic-Pathologic Correlation Rachel B. Lewis, Anupamjit K. Mehrotra, Pablo Rodriguez, and Marc S. Levine. RadioGraphics 2013 33:4, 1083-1108. Accessed 2017-07-08</ref> Although leiomyoma is the most common benign esophageal tumor, malignant carcinoma is still 50 times more likely.<ref>Radiologic Pathology Archives: Esophageal Neoplasms: Radiologic-Pathologic Correlation Rachel B. Lewis, Anupamjit K. Mehrotra, Pablo Rodriguez, and Marc S. Levine. RadioGraphics 2013 33:4, 1083-1108. Accessed 2017-07-08</ref> Approximately 50% of cases are found in the jejunum, followed by the ileum in 31% of cases. Almost one half of all lesions are less than 5 centimeters.<ref name=ARO>Template:Cite web</ref>
Other locations, metastatic leiomyoma
- Metastatic leiomyoma are an extremely rare complication after surgery to remove the uterus for uterine fibroids. The most frequent sites of occurrence are the lungs and pelvis. The lesions are hormonally responsive.<ref name=Patton_2006>Template:Cite journal</ref><ref name=Beck_2012>Template:Cite journal</ref><ref name=Rivera_2004>Template:Cite journal</ref>
- Fibromyoma of the breast is an extremely rare benign breast neoplasm. Most reports in literature mention a history of hysterectomy for uterine fibroids, although the question of whether these fibromyomas are possibly metastases of the uterine fibroids has not been investigated. An alternative hypothesis is an origin from the smooth muscle of the nipple.
- Leiomyoma may spontaneously occur in any muscle. Depending on the location of the tumor, identification may not be timely until overall mass becomes undeniably noticeable. The symptoms for a 30-year-old male with a 10 cm leiomyoma included "dead leg" pains. Tumor was intertwined with quadriceps muscles, making identification and excision difficult. Tumor was successfully excised with only minor rehabilitation required.<ref>Template:Cite journal</ref>
Familial leiomyoma
- Associated with papillary variant of renal cell carcinoma and multiple cutaneous leiomyoma. Defect is in the fumarate hydratase gene in the long arm of chromosome 1.Template:Citation needed
Pathologic findings
Leiomyomas are benign tumors but are sometimes observed to have low (but identifiable) levels of mitotic activity. Leiomyomas of the skin are associated with a form of nuclear atypia typically characterized by cigar-shaped nuclei with tapered ends.<ref name=":0" />
See also
References
External links
Template:Diseases of the skin and appendages by morphology Template:Soft tissue tumors and sarcomas Template:Authority control