Primary leiomyoma of the liver: a review of a rare tumour

Abstract

Context. Primary leiomyoma of the liver is a rare tumour with uncertain pathogenesis with similar presentation with other tumours of the liver. Little is known about its clinical course. Objectives. To review the literature for case reports of primary leiomyoma of the liver. Methods. Extensive literature search was carried out for case reports of primary leiomyoma of the liver. Results. A total of 36 cases of primary leiomyoma of the liver were reviewed. The mean age of presentation is 43 years with slight female sex affectation; females accounted for 55.6% of the cases reported in the literature. The average size of the tumour is 8.7 cm. 34.4% of the cases reviewed were incidental finding with the mean follow-up time of 33 months with most cases reporting no evidence of disease. Conclusions. Primary leiomyoma of the liver is very rare tumour with complex pathogenesis which remains largely unknown. Imaging of the tumour does not allow for a tissue specific diagnosis; hence histological review of the tissue specimen and immunohistochemical stains are imperative for diagnosis. Surgical resection is both diagnostic and curative. The diagnosis of primary leiomyoma of the liver should be considered as a differential in the management of liver tumours.

Figure 1

Tumour cells stained positive by in situ hybridization with Epstein-Barr virus-encoded small RNA. (a) Positive control staining ×200, ×1000; (b) tumour cell staining ×200, ×1000. Arrows indicate positive staining of the nuclei. Reprinted from [2] with the permission of the Director, Editorial Office of the World Journal of Gastroenterology.

Figure 2

CT Abdomen with a mass in segment III of the liver in the hepatic equilibrium (a), portal venous (b), and hepatic arterial phase (c). Reprinted from [2] with the permission of the Director, Editorial Office of the World Journal of Gastroenterology.

Figure 3

Pathologic features. (a) Intraoperative feature of primary leiomyoma of the liver. (b) Tumour (arrow) and normal liver tissue, H&E staining, ×200; (c) α-smooth muscle actin staining (arrow) of tumour tissues, immunohistochemical staining, ×200; (d) Desmin staining (arrow) of tumour tissues, immunohistochemical staining, ×200. Reprinted from [2] with the permission of the Director, Editorial Office of the World Journal of Gastroenterology.