University of East Anglia Medical School, Norwich, UK.
J Gynecol Oncol. 2012 Jan;23(1):69-71. doi: 10.3802/jgo.2012.23.1.69. Epub 2012 Jan 9.
A 48-year-old woman underwent total abdominal hysterectomy with conservation of the ovaries and tubes. Histology showed a well-circumscribed smooth muscle tumor with foci of degeneration (including infarct-type necrosis) but no coagulative tumor cell necrosis and only mild focal cytological atypia. She presented, 24 years later with shortness of breath and abdominal distension and underwent bilateral salpingo-oophorectomy, appendectomy, omental biopsy and para-aortic lymph node sampling. Histology showed bilateral ovarian smooth muscle tumors with no coagulative tumor cell necrosis or significant cellular atypia. The cells were mitotically active. The tumors in both ovaries were most likely secondary to the previous uterine smooth muscle neoplasm. To our knowledge, this case is the first in the literature to describe a benign cellular leiomyoma that subsequently behaved as a smooth muscle tumor of uncertain malignant potential, which recurred 24 years after the initial diagnosis.
一位 48 岁女性接受了全子宫切除术和卵巢及输卵管保留术。组织学显示为边界清楚的平滑肌肿瘤，伴有局灶性变性（包括梗死样坏死），但无凝固性肿瘤细胞坏死，仅有轻度局灶性细胞学异型性。24 年后，她因呼吸急促和腹胀就诊，并接受了双侧输卵管卵巢切除术、阑尾切除术、网膜活检和腹主动脉旁淋巴结取样。组织学显示双侧卵巢平滑肌肿瘤无凝固性肿瘤细胞坏死或明显细胞异型性。细胞有丝分裂活跃。双侧卵巢肿瘤很可能继发于先前的子宫平滑肌肿瘤。据我们所知，该病例是文献中首例描述良性细胞性平滑肌瘤，随后表现为恶性潜能不确定的平滑肌肉瘤，在初始诊断后 24 年复发。
