Angioleiomyoma – a rare variant of genital myomas: report of two cases

Oddział Ginekologiczno-Położniczy, Radomski Szpital Specjalistyczny im. dr. Tytusa Chałubińskiego. Ordynator Oddziału: lek. med. Zenon Michalak, Dobrosława Sikora-Szczęśniak, Grzegorz Szczęśniak, Oddział Chirurgii Ogólnej, Radomski Szpital Specjalistyczny im dr. Tytusa Chałubińskiego. Ordynator Oddziału: dr n. med. Robert Rojewski, Wacław Sikora
In: Current Gynecologic Oncology · 2013 · vol. 11(1) , pp. 74–81 · doi:10.15557/cgo.2013.0007 · W1235953716
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This study describes two cases of angioleiomyoma, a rare genital myoma variant found in the uterine body and broad ligament, occurring in 0.68% of women operated on for myomas.

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This case report examines the incidence of angioleiomyoma, a rare benign mesenchymal tumor, within a cohort of 294 women undergoing surgery for genital myomas. The authors analyzed histological data to determine that angioleiomyoma accounted for 0.68% of all myoma cases, but its prevalence rose to 1.74% in patients who also had intrauterine genital endometriosis. Both reported cases involved obese patients with poor wound healing, and diagnosis was confirmed exclusively through microscopic study of surgical specimens. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Background: Angioleiomyoma (leiomyoma angiogenes) is a benign tumor of mesenchymal origin. Its location in the uterine body is extremely rare and in the broad ligemant is considered exceptional (to date, only isolated cases have been described). The aim of this paper is to present two histologically verified cases of angioleiomyoma – of the uterine body and of the broad ligament. Incidence of this subtype of leiomyoma among patients operated on for genital myomata is discussed. Material and methods: Patients were qualified for surgery based on gynecologic examination, sonographic study and histological assessment of uterine scrapings. Final diagnosis was made in Department of Pathology of the Doctor Tytus Chałubiński Specialized Hospital in Radom based on microscopic study of surgical specimens. Clinical analysis included cases reported in available world literature. Determined were both incidence of leiomyoma angiogenes among patients with a postoperative diagnosis of myoma and those with myoma coexisting with intrauterine genital endometriosis. Results: Among women operated on for myoma (n = 179; 60.9%) and for myoma with intrauterine genital endometriosis (n = 115; 39.1%) – a total of 294 cases – angioleiomyoma was found twice in postoperative histological studies. This accounted for 0.68% of the entire group of women with myoma. On the other hand, among those with myoma and endometriosis, this proportion was twice as high, reaching 1.74%. Discussion: Both patients had BMI value indicating obesity (54.6 kg/m2 and 36.6 kg/m2 – class III and II) and poor healing of their surgical wounds. Conclusions: Diagnosis of genital angioleiomyoma is possible only based on histological studies. The tumor was located in the uterine body and in the broad ligament, respectively. Incidence rate of this tumor among patients operated on for genital myoma is 0.68%.
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Angioleiomyoma – a rare variant of genital myomas: report of two cases Dobrosława L. Sikora-Szczęśniak1, Grzegorz Szczęśniak2, Wacław Sikora1 Background: Angioleiomyoma (leiomyoma angiogenes) is a benign tumor of mesenchymal origin. Its location in the uterine body is extremely rare and in the broad ligemant is considered exceptional (to date, only isolated cases have been described). The aim of this paper is to present two histologically verified cases of angioleiomyoma – of the uterine body and of the broad ligament. Incidence of this subtype of leiomyoma among patients operated on for genital myomata is discussed. Material and methods: Patients were qualified for surgery based on gynecologic examination, sonographic study and histological assessment of uterine scrapings. Final diagnosis was made in Department of Pathology of the Doctor Tytus Chałubiński Specialized Hospital in Radom based on microscopic study of surgical specimens. Clinical analysis included cases reported in available world literature. Determined were both incidence of leiomyoma angiogenes among patients with a postoperative diagnosis of myoma and those with myoma coexisting with intrauterine genital endometriosis. Results: Among women operated on for myoma (n = 179; 60.9%) and for myoma with intrauterine genital endometriosis (n = 115; 39.1%) – a total of 294 cases – angioleiomyoma was found twice in postoperative histological studies. This accounted for 0.68% of the entire group of women with myoma. On the other hand, among those with myoma and endometriosis, this proportion was twice as high, reaching 1.74%. Discussion: Both patients had BMI value indicating obesity (54.6 kg/m2 and 36.6 kg/m2 – class III and II) and poor healing of their surgical wounds. Conclusions: Diagnosis of genital angioleiomyoma is possible only based on histological studies. The tumor was located in the uterine body and in the broad ligament, respectively. Incidence rate of this tumor among patients operated on for genital myoma is 0.68%.

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