Mitotically active haemorrhagic cellular (apoplectic) leiomyoma

Apoplectic leiomyoma is a distinctive smooth muscle tumour usually occurring in women either taking oral contraceptives or who are pregnant or recently postpartum. Most of these tumours show 0-2 mitoses per 10 high power fields, but a mitotic index of up to 8 per 10 high power fields is allowed in such tumours. We describe an apoplectic leiomyoma with a number of atypical features including a high mitotic index (up to 20 per 10 high power fields) in a 47-year-old woman. Follow-up clinically and by computerised tomography (CT) for 3 years demonstrates no recurrence.