Department of Pathology, Sestre Milosrdnice University Hospital, Zagreb, Croatia.
Diagn Pathol. 2009 Jul 30;4:25. doi: 10.1186/1746-1596-4-25.
Ovarian leiomyoma is a rare benign tumor that accounts for 0.5 to 1% of all benign ovarian tumors. It probably arises from smooth muscle cells in the ovarian hilar blood vessels but there are other possible origins including cells in the ovarian ligament, smooth muscle cells or multipotential cells in the ovarian stroma, undifferentiated germ cells, or cortical smooth muscle metaplasia. Additionally, smooth muscle metaplasia of endometriotic stroma, smooth muscle present in mature cystic teratomas, and smooth muscle in the walls of mucinous cystic tumor may explain their occurrence in the ovary in some cases.
A 31-year-old woman was admitted to our surgical emergency service with a one-day history of appendicitis-like symptoms. Upon laparotomy, there was a solid, oval left-sided ovarian tumor located behind the uterus. The tumor was sent to the pathology department. A diagnosis of primary ovarian leiomyoma associated with an endometriotic cyst was established.
The origin of ovarian leiomyoma is still unresolved. In our case, the tumor probably arose from smooth muscle cells derived from myofibroblasts that originate from metaplastic ovarian stromal cells present in the rim of the endometriotic cyst. Despite its rarity, ovarian leiomyoma should be considered in the differential diagnosis of ovarian spindle cell tumors. Appropriate diagnosis may require additional immunohistochemical analysis in some cases.
卵巢平滑肌瘤是一种罕见的良性肿瘤，约占所有良性卵巢肿瘤的 0.5%至 1%。它可能起源于卵巢门血管的平滑肌细胞，但也可能起源于其他部位，包括卵巢韧带中的细胞、卵巢基质中的平滑肌细胞或多能细胞、未分化的生殖细胞或皮质平滑肌化生。此外，子宫内膜异位症基质中的平滑肌化生、成熟囊性畸胎瘤中的平滑肌以及黏液性囊性肿瘤壁中的平滑肌，可能可以解释在某些情况下它们在卵巢中的发生。
一名 31 岁女性因阑尾炎样症状 1 天而被收入我们的外科急诊服务。剖腹术中，发现子宫后面有一个实性、椭圆形的左侧卵巢肿瘤。该肿瘤被送到病理科。诊断为原发性卵巢平滑肌瘤伴子宫内膜异位囊肿。
卵巢平滑肌瘤的起源仍未解决。在我们的病例中，肿瘤可能起源于源自子宫内膜异位症囊肿边缘的化生卵巢基质细胞的肌成纤维细胞中的平滑肌细胞。尽管罕见，但在卵巢梭形细胞肿瘤的鉴别诊断中应考虑卵巢平滑肌瘤。在某些情况下，可能需要额外的免疫组织化学分析来进行适当的诊断。
