Spindle cell variant of leiomyoma exhibiting myxoid change and calcification: a rare case report

Spindle cell variant of leiomyoma exhibiting myxoid change and calcification: a rare case report DOI: https://doi.org/10.18203/2320-1770.ijrcog20253917Keywords: Leiomyoma, Endometrial cancer, Myxoid degeneration, Spindle cellAbstract Uterine leiomyomas, commonly referred to as fibroids, are the most prevalent benign tumors found in women of reproductive age, characterised by the proliferation of smooth muscle cells within the uterus. While the vast majority of leiomyomas are benign, a small percentage (approximately 1%) can undergo malignant transformation into leiomyosarcoma, complicating management and prognosis. Here we report a case of 51-year-old P1L1 presented to the outpatient department (OPD) with complaints of heavy menstrual bleeding for two years. Patient was examined and investigated. On clinical examination, a palpable pelvic mass of approximately 20×15 cm noted measuring about 24 weeks in size. On radiological examination, revealed a heterogeneously hyperechoic solid-cystic lesion measuring 12.5×10.5×7.6 cm with features suggestive of endometrial carcinoma. Total abdominal hysterectomy with bilateral salpingo - oophorectomy. Histopathological examination (HPE) report revealed endometrial hyperplasia without atypia. The myometrium reveals features of adenomyosis and leiomyoma. The subserosal fibroid consists of spindle cells in interlacing fascicles, with areas of calcification and focal myxoid change. Metrics References Yang Q, Madueke-Laveaux OS, Cun H, Wlodarczyk M, Garcia N, Carvalho KC, et al. Comprehensive review of uterine leiomyosarcoma: pathogenesis, diagnosis, prognosis, and targeted therapy. Cells. 2024;13:1106. DOI: https://doi.org/10.3390/cells13131106 Panda A, Mahoorkar DN, Reddy N, Reddy BM. Myxoid degeneration of leiomyoma-a masquerade. Int J Reprod Contracept Obstet Gynecol. 2022;11:3415-7. DOI: https://doi.org/10.18203/2320-1770.ijrcog20223145 Kawakami S, Togashi K, Konishi I. Red degeneration of uterine leiomyoma: MR appearance. J Comput Assist Tomogr. 1994;18(6):925-8. DOI: https://doi.org/10.1097/00004728-199411000-00014 Cruz M, Murakami T, Suda T. Myxoid leimyoma of the uterus: CT and MRI features. Abdomin Imaging. 2001;26:98-100. DOI: https://doi.org/10.1007/s002610000102 Kaushik C, Prasad A, Singh Y, Baruah BP. Case series- Cystic degeneration in Uterine leiomyomas. Indian J Radiol Imaging. 2008;18(1):69-72. DOI: https://doi.org/10.4103/0971-3026.35820 Rupa P, Meena Thapa. Case Report- A case report on an unusual degeneration of uterine leiomyoma: Myxoid degeneration. J Kathmandu Med Coll. 2018;7. DOI: https://doi.org/10.3126/jkmc.v7i4.23325 Chaouki M, Marouen N, Najet BM. An unusual presentation of uterine leiomyoma: Myxoid leiomyoma. Int J Case Rep Images. 2012;3(3):1-3. DOI: https://doi.org/10.5348/ijcri-2012-03-96-CR-1 Monika A, Kajal S. A perplexing case of Cellular Leiomyoma with excessive Myxoid Degeneration. J Clin Diagnost Res. 2018;12(7):QD03-5. Kamra HT, Dantkale SS, Birla K. Myxoid Leiomyoma of cervix. J Clin Diagnost Res. 2013;7(12):2956-7. DOI: https://doi.org/10.7860/JCDR/2013/6171.3805