Multicentric infarcted leiomyoadenomatoid tumor: a case report.

Area of Science:

• Gynecologic pathology
• Surgical pathology
• Oncology

Background:

• Adenomatoid tumors are benign lesions typically found in the female reproductive tract.
• Smooth muscle hypertrophy can obscure adenomatoid tumors, complicating diagnosis.
• Infarction can further alter the microscopic appearance of these tumors.

Purpose of the Study:

• To report an unusual case of infarcted leiomyoadenomatoid tumor in the uterus and ovary.
• To highlight diagnostic challenges posed by infarction and atypical cellular features.
• To emphasize the importance of accurate interpretation to guide appropriate patient management.

Main Methods:

• Case report of a 24-year-old woman with severe abdominal pain and pelvic masses.
• Diagnostic imaging including pelvic ultrasonography and computed tomography.
• Laparoscopy-assisted transvaginal mass removal.
• Detailed microscopic examination of resected uterine and ovarian masses.

Main Results:

• Microscopic examination revealed leiomyoadenomatoid tumor with extensive necrosis in both uterine and ovarian masses.
• Tumor exhibited fascicles of smooth muscle with atypical vacuolated cells and tubular formations.
• Extensive infarction and atypical features mimicked malignant neoplasms, including infiltrating carcinoma.
• The presence of epithelial-appearing cells within smooth muscle bundles caused diagnostic confusion.

Conclusions:

• Infarcted leiomyoadenomatoid tumors can present with features mimicking malignancy, leading to potential misdiagnosis.
• The combination of infarction and atypical cellular morphology poses significant diagnostic challenges.
• Correct interpretation is vital to prevent overly aggressive treatment for this benign condition.