Cystic Clear Cell Epithelioid Leiomyoma: An Unusual Presentation.

摘要

Epithelioid leiomyoma is a rare variant of leiomyoma.The tumour includes three distinct entities,leiomyoblastoma, clear cell leiomyoma and plexiformleiomyoma. It is histologically characterised byepithelioid cells, clear cells or plexiform pattern invaried proportions. We report a case of a 49-year-oldfemale with complaints of palpable mass per abdomenand spotting per vagina. Radiology revealed a complexcystic mass with obscured right ovary. She underwenttotal abdominal hysterectomy with bilateral salpingooophorectomy.Pathological examination showed aposterior wall lesion with central 9 × 8 cm cyst withmultiple septations and surrounding rim of solid areas.Microscopic examination showed a clear cellepithelioid leiomyoma. No mitosis/tumour cell necrosiswas seen. The clinical course of epithelioid leiomyomais still unclear owing to absence of large studies. Smallsize, clear cell histology, mitosis of 2/10 High PowerField (HPF) and hyalinization are features of a benigncourse, whereas cellular atypia, mitosis of 5/10 HPFare definite indicators of a malignant outcome. Anepithelioid leiomyoma with, size 6 cm moderateatypia, necrosis and mitosis of 2-5/10 HPF are termedas smooth muscle tumours of uncertain malignantpotential and should be under close follow up.