Concurrent uterine and pelvic angiolipoleiomyomas.

Area of Science:

• Gynecologic Oncology
• Surgical Pathology
• Medical Imaging

Background:

• Angiolipoleiomyomas (ALLMs) are rare benign mesenchymal tumors.
• Few cases of ALLMs have been documented in the female reproductive tract.
• Concurrent tumors in distinct pelvic locations are exceptionally uncommon.

Purpose of the Study:

• To present a unique case of concurrent cervical and pararectal angiolipoleiomyomas.
• To describe novel histopathological features of ALLMs, including pseudoinfiltrative margins and prominent nerve bundles.
• To underscore the significance of accurate diagnosis for benign tumors to prevent misdiagnosis and aggressive treatment.

Main Methods:

• Case presentation of a patient with incidentally detected pelvic masses.
• Surgical resection of the cervical and pararectal lesions.
• Histopathological examination including immunohistochemistry for smooth muscle, melanocytic, and stromal markers.

Main Results:

• Histopathology confirmed well-circumscribed, non-encapsulated angiolipoleiomyomas with no atypia or mitotic activity.
• Immunohistochemistry supported the diagnosis of ALLM, showing positivity for smooth muscle markers.
• The patient experienced a successful recovery with no recurrence at 26 months follow-up.

Conclusions:

• This case expands the literature on angiolipoleiomyomas, particularly in the female reproductive system.
• The identified pseudoinfiltrative margins and prominent nerve bundles are important features to recognize in ALLMs.
• Accurate identification of benign ALLMs is crucial to guide appropriate clinical management and avoid unnecessary interventions.