Cystic change, an extreme form of hydropic degeneration is a rare clinical presentation. Larger tumors result in various pressure symptoms. The tumor cells were positive for the microphthalmia transcription factor but negative for other melanoma markers. Hyaline degeneration consisting of nodular confluent acellular areas (Fig. Anastomosing thin cord-like arrangements of the leiomyoma cells mimicked the architecture of adenomatoid tumors. A variety of unusual growth patterns can occur in uterine leiomyomas, such as diffuse uterine leiomyomatosis, disseminated peritoneal leiomyomatosis, benign metastasizing leiomyoma, parasitic leiomyoma, intravascular leiomyomatosis, dissecting leiomyoma, and leiomyoma with perinodular hydropic degeneration.1 In 1996, Roth et al2 reported a series of 4 cases of leiomyoma characterized … Polarizing Microscopy Simplified! Based on the location of the tumor they are categorized as If the tumor is very large, the degenerative changes can be seen. Red Degeneration: This is due to hemorrhagic infaction of a leiomyoma. Gross: Uterine leiomyomas are commonly referred to as Fibroids. Marked degrees of hydropic degeneration may have resulted in cystic degeneration, leading to large myometrial cysts. arrow) at the cornu; hydropic change Am J Surg Pathol. Apple Green Birefringence. rajuwilk_ngp@sancharnet.in In the growing knowledge of rare interesting tumors, the cotyledonoid leiomyoma is a tumor with an alarming appearance, of … Cystic degeneration is an extreme sequel of edema. Ultrasonography (US) showed a heterogeneous abdominopelvic mass. Perinodular hydropic degeneration of a uterine leiomyoma is a rare form of the more common hydropic change observed in leiomyomas. Pathology When the leiomyomas increase in size, the vascular supply to it becomes inadequate and leads to different types of degeneration which are hyaline, cystic, myxoid, or red degeneration and dystrophic calcification may also occur. There are many microscopic variants which include cellular, Leiomyoma with bizzare nuclei, Mitotically active, hydropic, apopletic, lipomatous, epithelioid, myxoid, dissecting leiomyomas etc. The cytoplasm s abundant and eosinophilic with elongated bipolar processes. Increased awareness of this grossly alarming variant of benign uterine leiomyoma can help avoid overtreatment. © Copyright PathologyOutlines.com, Inc. Click, Also called dissecting cotyledonoid leiomyoma, Sternberg tumor (, Rare benign tumor characterized by extrauterine bulbous growth continuous with a dissecting myometrial component, Dissecting leiomyomas rarely are due to noncotyledonoid variants (, 55 year old woman whose tumor had alarming gross appearance (, 63 year old woman with epithelioid variant (, Multinodular, exophytic congested bulky tumor resembling placenta extends from uterine wall into broad ligament and pelvic cavity, Reddish brown with multiple bulbous processes protruding over uterine surface, Fascicles and nodules of bland smooth muscle cells, prominent hydropic degeneration, No necrosis, no mitotic figures and no atypia. Geographic areas of hydropic degeneration were identified (Fig. 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. Leiomyoma dissects into myometrium (black Only five cases have been reported previously. Extensive hydropic degeneration in uterine leiomyoma is a rare occurrence and is commonly reported in association with pregnancy. They can be single or multiple. No reported case of pseudo-Meigs syndrome presenting with hydropic degeneration of uterine leiomyoma and an elevated CA 125 level could be found on a MEDLINE search. Occasionally uterine tumors may detach and results in a rare type called PARASITIC leiomyoma. 3. Huge leiomyoma with myxoid degeneration (cystic spaces) on cut section Diffuse, perinodular, and other patterns of hydropic degeneration within and adjacent to uterine leiomyomas: problems in differential diagnosis. Edematous change, referred to as hydropic degeneration, is a common form of degeneration seen focally in up to 50% of patients with leiomyoma . Table 1 summarizes ordinary leiomyomas, including their various forms of degeneration, and their main variants. The most common abnormalities are translocations on chromosome 12; deletion on chromosomes 3q and 7q. 4. 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. A presumed direct relation between the abundance of intratumoral fluid and presence of ascites seemed justified. Anastomosing thin cord-like arrangements of the leiomyoma cells mimicked the architecture of adenomatoid tumors. This is a complication usually occurs in pregnancy. Highly cellular variant and lipoleiomyomas will be yellowish in color. We welcome suggestions or questions about using the website. The individual smooth muscle cells are uniform in size and shape and have characteristic oval to elongated with blunt ends ( CIGAR shaped). Hydropic degeneration is characterized by accumulation of oedema fluid with associated collagen deposition presenting with various patterns [5], [6]. Earlier age of menarche and nulliparous women have higher risk. Cotyledonoid hydropic intravenous leiomyomatosis: a new variant leiomyoma. 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 … 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. 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. Perinodular hydropic degeneration of a uterine leiomyoma is a rare form of the more common hydropic change observed in leiomyomas. 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. This will result in hyper responsivenesness to normal levels of estrogen in adults. 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. We describe a case of a 35-year-old woman with a pedunculated uterine leiomyoma with diffuse hydropic degeneration presenting as a giant abdominal mass. These are usually multiple with sizes ranging from microscopic foci to large bulky tumors. 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]. No striated muscle tissues were noted between the tumor and resection margin, but a thin smooth muscle layer, positive for hormone receptors, was present at the periphery, suggesting the origin of the tumor. These are usually asymptomatic if small and are often incidental finding. Reports of leiomyoma with marked cystic degeneration have been relatively uncommon (Aydin et al., 2013). Pathology confirmed that the mass was a leiomyoma with hydropic and myxoid degeneration. 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