Kita Ayaka, Maeda Tetsuo, Kitajima Kazuhiro, Murakoshi Homare, Watanabe Takahiro, Inagaki Mieko, Yoshida Shigeki
Department of Gynecology and Obstetrics, Chibune General Hospital, 3-2-39 Fukumachi, Nishiyodogawa-ku, Osaka City, Osaka 555-0034, Japan.
Department of Radiology, Chibune General Hospital, 3-2-39 Fukumachi, Nishiyodogawa-ku, Osaka City, Osaka 555-0034, Japan.
Case Rep Womens Health. 2022 Jan 20;34:e00386. doi: 10.1016/j.crwh.2022.e00386. eCollection 2022 Apr.
Epithelioid leiomyoma of the uterus is rare, and its prognostic factors have not been well established. Moreover, radiologic findings of this disease have not been previously documented. This is a case of a 49-year-old woman with epithelioid leiomyoma of the uterus. Magnetic resonance imaging (MRI) revealed a heterogeneous high-intensity mass with multiple ordinary uterine leiomyomas. The mass showed a slightly diffusion-restricted site. Since benign tumors could not be confidently diagnosed using these MRI findings, total abdominal hysterectomy with bilateral salpingectomy was performed, and a pathological diagnosis of epithelioid leiomyoma of the uterus was established. Microscopically, this lesion showed edematous changes and cyst formation, causing a heterogeneous appearance on T2-weighted images. In addition, the diffusion-restricted site is considered to be consistent with areas of solid and dense proliferation of tumor cells. The patient survived and was well 10 months after the surgery. It is important to recognize this benign variant of leiomyoma with an unusual appearance, to provide appropriate therapeutic management.
子宫上皮样平滑肌瘤较为罕见，其预后因素尚未完全明确。此外，此前尚无该疾病的放射学表现记录。本文报告一例49岁患有子宫上皮样平滑肌瘤的女性病例。磁共振成像（MRI）显示一个异质性高强度肿块，伴有多个普通子宫平滑肌瘤。该肿块显示有轻微扩散受限部位。由于仅凭这些MRI表现无法确诊为良性肿瘤，遂行全腹子宫切除术及双侧输卵管切除术，术后病理诊断为子宫上皮样平滑肌瘤。显微镜下，该病变呈现水肿改变及囊肿形成，导致在T2加权图像上表现为异质性外观。此外，扩散受限部位被认为与肿瘤细胞实性密集增殖区域相符。患者术后存活，术后10个月情况良好。认识这种具有不寻常表现的平滑肌瘤良性变体，对于提供恰当的治疗管理很重要。
