Senga Kazunori, Ikegami Masachika, Koiwa Sora, Takamiya Akihiro, Motoi Toru
Department of Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
SAGE Open Med Case Rep. 2023 Sep 9;11:2050313X231197529. doi: 10.1177/2050313X231197529. eCollection 2023.
Deep somatic soft tissue leiomyoma is a rare benign smooth muscle tumor, with around 60 cases reported thus far in the literature. Herein, we report a huge leiomyoma in deep somatic soft tissue with massive calcification in the peroneus longus muscle. A 29-year-old male patient presented with a hard, spindle-shaped, 15-cm-diameter mass of the left lower leg. Plain radiography showed marked calcification within the lesion, and magnetic resonance imaging revealed a well-circumscribed lesion with strong contrast enhancement within the peroneus longus. A core needle biopsy was performed to rule out a soft tissue sarcoma, and deep somatic soft tissue leiomyoma was preoperatively diagnosed. A marginal excision was performed, and the patient recovered without event and has been recurrence-free for 16 months. As far as we know, the present soft tissue leiomyoma was one of the largest to be documented, the previously reported cases being up to 14 cm in maximum diameter. Leiomyomas of deep somatic soft tissue should be included in the differential diagnosis of a huge, deep-seated tumor with marked calcification as well as sarcomas, especially in younger patients.
深部躯体软组织平滑肌瘤是一种罕见的良性平滑肌肿瘤，迄今为止文献报道约60例。在此，我们报告1例位于深部躯体软组织的巨大平滑肌瘤，伴腓骨长肌大量钙化。1例29岁男性患者，左小腿出现一个坚硬的纺锤形肿块，直径15 cm。X线平片显示病变内有明显钙化，磁共振成像显示腓骨长肌内有一个边界清晰的病变，增强扫描强化明显。为排除软组织肉瘤，进行了粗针穿刺活检，术前诊断为深部躯体软组织平滑肌瘤。行边缘切除术，患者恢复顺利，术后16个月无复发。据我们所知，目前的软组织平滑肌瘤是有记录以来最大的之一，之前报道的病例最大直径达14 cm。深部躯体软组织平滑肌瘤应纳入巨大、深部且有明显钙化的肿瘤以及肉瘤的鉴别诊断中，尤其是在年轻患者中。
