AMH and Kisspeptin Receptor Expression in Rare Hydropic Leiomyoma: A Case Study

Area of Science:

• Gynecology
• Pathology
• Oncology

Background:

• Benign uterine tumors (BUMTs), including leiomyomas, are common but can cause significant morbidity.
• Hydropic leiomyomas (HLMs) are rare variants that can present diagnostic challenges, especially in atypical locations like the retroperitoneum.
• This case explores an HLM with unique molecular characteristics, potentially offering new therapeutic insights.

Purpose of the Study:

• To report a rare case of a retroperitoneal hydropic leiomyoma (HLM).
• To investigate the immunohistochemical expression of anti-Müllerian hormone (AMH), AMH receptor 2 (AMHR2), kisspeptin (KISS1), and KISS1 receptor (KISS1R) in HLM.
• To highlight the diagnostic considerations and potential therapeutic implications of these findings for benign uterine tumors (BUMTs).

Main Methods:

• A case report of a 44-year-old woman presenting with acute lower abdominal pain.
• Diagnostic imaging using Magnetic Resonance Imaging (MRI) to characterize the retroperitoneal mass.
• Surgical excision followed by histopathological examination and immunohistochemical analysis for AMH, AMHR2, KISS1, and KISS1R expression.

Main Results:

• A retroperitoneal mass was identified and surgically removed, confirmed as a hydropic leiomyoma (HLM).
• Immunohistochemistry revealed strong expression of AMH, AMHR2, KISS1, and KISS1R in the HLM tumor cells.
• The patient experienced an uneventful recovery with no recurrence observed during a 2-year follow-up period.

Conclusions:

• Retroperitoneal HLMs can be diagnostically challenging, emphasizing the role of MRI in differentiating benign from malignant masses.
• The significant expression of AMH, AMHR2, KISS1, and KISS1R suggests their involvement in HLM pathophysiology.
• Targeted modulation of these pathways may offer novel therapeutic strategies for benign uterine tumors (BUMTs), particularly in challenging cases.