Boivin Nicholas, Mannion Ciaran
Hackensack Meridian School of Medicine, Nutley, New Jersey, USA.
Department of Pathology, Hackensack Meridian University Hospital, Hackensack, New Jersey, USA.
Case Rep Pathol. 2025 Sep 8;2025:7026230. doi: 10.1155/crip/7026230. eCollection 2025.
While very commonly encountered in the uterus, in particular in the wall of the uterine corpus, leiomyomas are far less frequently found in extragenital sites in females. Atypical leiomyomas (synonyms: pleomorphic leiomyomas, leiomyomas with bizarre nuclei, bizarre leiomyomas, or symplastic leiomyomas) are a rare subtype of leiomyomas, characterized by cells with bizarre, pleomorphic-appearing nuclei without (or with extremely low) associated mitotic activity. Despite the cytologic appearance, such tumors have a benign clinical course. Although there are cases of leiomyomas appearing outside the uterus in a background of endometriosis, cases specifically of atypical leiomyomas in this setting are exceptionally rare. We present a case of an atypical leiomyoma arising from pararectal endometriosis in a patient presenting with endometriosis-associated primary ovarian clear cell carcinoma, metastasis to the bladder peritoneum, and a peri-intestinal lymph node, in addition to a concurrent ovarian fibroma.
平滑肌瘤在子宫中非常常见，尤其是在子宫体壁，但在女性生殖器外部位则很少见。非典型平滑肌瘤（同义词：多形性平滑肌瘤、核异形平滑肌瘤、奇异性平滑肌瘤或合体细胞性平滑肌瘤）是平滑肌瘤的一种罕见亚型，其特征是细胞具有奇异的、多形性外观的核，且无（或极低）相关的有丝分裂活性。尽管细胞形态如此，但这类肿瘤临床过程呈良性。虽然有平滑肌瘤在子宫内膜异位症背景下出现在子宫外的病例，但在这种情况下具体的非典型平滑肌瘤病例极为罕见。我们报告一例非典型平滑肌瘤，该患者患有与子宫内膜异位症相关的原发性卵巢透明细胞癌，伴有膀胱腹膜转移和肠周淋巴结转移，同时还患有卵巢纤维瘤，此非典型平滑肌瘤起源于直肠旁子宫内膜异位症。
