{"paper_id":"5ddeec83-d048-4cd9-9f9f-faf132833a48","body_text":"Abstract\nPurpose\nUterine angiomyolipoma (AML) is a rare condition involving benign tumors composed of varying proportions of blood vessels, fat, and epithelioid or spindled smooth muscle cells. We analyzed the clinicopathological features, diagnosis and treatment methods, and prognosis of uterine AML.\nMethods\nWe retrospectively analyzed the clinical-pathological data of eight patients with pathologically diagnosed uterine AML at a single center from January 2008 to July 2020.\nResults\nThe mean age of the patients was 50 years (range, 41–62). One patient was asymptomatic; the main clinical manifestations of the others included vaginal bleeding (3), menorrhagia (2), abdominal pain (1), and dysmenorrhea with adenomyosis (1). In one case, fat components observed via abdominal computed tomography led to a diagnosis of uterine leiomyolipoma; the rest were diagnosed as uterine leiomyoma (4), uterine fibroid degeneration (2), and pelvic mass (1). The lesions were in the body of the uterus (6), the fundus of the uterus (1), and the broad ligament (1). Seven patients had a focal soft tumor texture, and one had a tough texture; the lesions were yellow (3), yellow-white (3), and pinkish white (2). Surgeries included transabdominal myomectomy (2), transabdominal hysterectomy (2), transabdominal hysterectomy/bilateral salpingo-oophorectomy (2), and laparoscopic total hysterectomy/bilateral salpingectomy (2). The median follow-up time was 72 months. No relapses were reported.\nConclusion\nUterine AML has a low incidence rate and is most likely to occur in perimenopausal women. The clinical manifestations are similar to those of uterine leiomyomas, but AML should be suspected if the internal echo of the uterine tumor is uneven and contains adipose tissue.\nSimilar content being viewed by others\nAvailability of data and material\nAll data and material are fully available without restriction.\nReferences\nFolpe AL, Kwiatkowski DJ (2010) Perivascular epithelioid cell neoplasms: pathology and pathogenesis. Hum Pathol 41(1):1–15. https://doi.org/10.1016/j.humpath.2009.05.011\nLam H, Nijmeh J, Henske E (2017) New developments in the genetics and pathogenesis of tumours in tuberous sclerosis complex. J Pathol 241(2):219–225. https://doi.org/10.1002/path.4827\nThway K, Fisher C (2015) PEComa: morphology and genetics of a complex tumor family. Ann Diagn Pathol 19(5):359–368. https://doi.org/10.1016/j.anndiagpath.2015.06.003\nCil A, Haberal A, Hucumenoglu S, Kovalak E, Gunes M (2004) Angiomyolipoma of the uterus associated with tuberous sclerosis: case report and review of the literature. Gynecol Oncol 94(2):593–596. https://doi.org/10.1016/j.ygyno.2004.05.015\nMulchandani NJ, Vimala R (2020) Uterine angiomyolipoma: a case report and review of literature. Indian J Gynecol Oncol. https://doi.org/10.1007/s40944-020-00426-3\nHenske E, Jóźwiak S, Kingswood J, Sampson J, Thiele E (2016) Tuberous sclerosis complex. Nature Rev Dis Prim 2:16035. https://doi.org/10.1038/nrdp.2016.35\nGiannella L, Delli Carpini G, Montik N, Verdecchia V, Puccio F, Di Giuseppe J, Tsiroglou D, Goteri G, Ciavattini A (2020) Ultrasound features of a uterine perivascular epithelioid cell tumor (PEComa): case report and literature review. Diagnostics. https://doi.org/10.3390/diagnostics10080553\nNguyen J, Ghandehari H, Parra-Herran C, Vicus D (2020) Uterine rupture: an unusual presentation of a uterine perivascular epithelioid cell tumor (PEComa). Int J Gynecol Cancer . https://doi.org/10.1136/ijgc-2020-001837\nBraun H, Wheelock J, Amaker B, Seeds J (2002) Sonographic evaluation of a uterine angiolipoleiomyoma. J Clin Ultrasound 30(4):241–244. https://doi.org/10.1002/jcu.10057\nBennett J, Braga A, Pinto A, Van de Vijver K, Cornejo K, Pesci A, Zhang L, Morales-Oyarvide V, Kiyokawa T, Zannoni G, Carlson J, Slavik T, Tornos C, Antonescu C, Oliva E (2018) Uterine PEComas: A morphologic, immunohistochemical, and molecular analysis of 32 tumors. Am J Surg Pathol 42(10):1370–1383. https://doi.org/10.1097/pas.0000000000001119\nConlon N, Soslow R, Murali R (2015) Perivascular epithelioid tumours (PEComas) of the gynaecological tract. J Clin Pathol 68(6):418–426. https://doi.org/10.1136/jclinpath-2015-202945\nParra-Herran C, Howitt B (2019) Uterine mesenchymal tumors: update on classification, staging, and molecular features. Surg Pathol Clin 12(2):363–396. https://doi.org/10.1016/j.path.2019.01.004\nKawauchi S, Nawata H, Yamagata Y, Yaegashi H, Fukunaga M, Moriya T, Furuya T, Sugino N, Sasaki K (2010) Chromosomal imbalances detected by comparative genomic hybridization provide evidence that HMB-45-negative uterine angiomyolipomas belong to the PEComa family. Histopathology 56(7):974–977. https://doi.org/10.1111/j.1365-2559.2010.03567.x\nYaegashi H, Moriya T, Soeda S, Yonemoto Y, Nagura H, Sasano H (2001) Uterine angiomyolipoma: case report and review of the literature. Pathol Int 51(11):896–901. https://doi.org/10.1046/j.1440-1827.2001.01289.x\nAcknowledgements\nThis work was supported by the National Natural Science Foundation of China (No. 81872125), and the local Technology and Development Key Program of Liaoning Province (No. 2019416020).\nFunding\nThis work was supported by the National Natural Science Foundation of China (No. 81872125), and the local Technology and Development Key Program of Liaoning Province (No. 2019416020).\nAuthor information\nAuthors and Affiliations\nContributions\nAll authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Jiao Wang, Qing Yang and Ningning Zhang. The first draft of the manuscript was written by Jiao Wang, Dandan Wang was responsible for critical revision of the manuscript and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\nCorresponding author\nEthics declarations\nConflicts of interest\nThe authors declare no competing interests.\nEthics approval\nThis study was approved by the Institutional Review Board of Shengjing Hospital of China Medical University.\nConsent to participate\nInformed consent was obtained from all the patients.\nConsent for publication\nInformed consent to publish was obtained from all the patients.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nWang, J., Yang, Q., Zhang, N. et al. Uterine angiomyolipoma: a clinical analysis of 8 cases and literature review. Arch Gynecol Obstet 304, 171–177 (2021). https://doi.org/10.1007/s00404-021-05992-1\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-021-05992-1","source_license":"CC0","license_restricted":false}