Department of Pathology, The Affiliated Women's Hospital, School of Medicine, Zhejiang University, Zhejiang Province, PR China.
Int J Gynecol Pathol. 2010 Jan;29(1):39-43. doi: 10.1097/PGP.0b013e3181b1cc46.
The female genital tract is a rare site for angioleiomyoma. Here, we present an unusual case of bilateral large angioleiomyoma in the broad ligaments. A 52-year-old woman underwent total hysterectomy with bilateral salpingo-oophorectomy due to massive tumors in the bilateral adnexal regions. Gross examination revealed a hemangioma-like mass each in the bilateral broad ligaments. The right one extended into the uterine myometrium. Histologically, both tumors had a mixed pattern of prominent thick-walled blood vessels and cellular short spindle myoid cells throughout. The spindle cells often swirled around the vessels, displaying an overlapping feature with angiomyofibroblastoma or myopericytoma. Immunostaining demonstrated that the tumor cells were positive for alpha-smooth muscle actin, desmin, estrogen receptor, and progesterone receptor. We believe that angioleiomyoma should be recognized as a delineated variant of leiomyoma in the female genital tract. This rare benign tumor should be differentiated from other mesenchymal neoplasms with prominent blood vessels.
女性生殖道是血管平滑肌瘤的罕见部位。在此，我们报告一例阔韧带内双侧巨大血管平滑肌瘤的罕见病例。一名 52 岁女性因双侧附件区巨大肿瘤行全子宫切除术加双侧输卵管卵巢切除术。大体检查显示双侧阔韧带各有一个类似于血管瘤的肿块。右侧肿块延伸至子宫肌层。组织学上，两个肿瘤均具有突出的厚壁血管和遍布的细胞短梭形平滑肌细胞的混合模式。梭形细胞常围绕血管盘旋，与血管平滑肌纤维瘤或肌周细胞瘤具有重叠特征。免疫组化显示肿瘤细胞阳性表达α-平滑肌肌动蛋白、结蛋白、雌激素受体和孕激素受体。我们认为血管平滑肌瘤应该被认为是女性生殖道平滑肌瘤的一个明确的变异型。这种罕见的良性肿瘤应与其他具有突出血管的间叶性肿瘤相鉴别。
