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Review
. 2019 Oct;98(42):e17423.
doi: 10.1097/MD.0000000000017423.

Vulvar epithelioid leiomyoma with myxoid change: A case report and literature review

Si-Hyong Jang  1 , Hyun Deuk Cho  1 , Ji-Hye Lee  1 , Hyun Ju Lee  1 , Soon Auck Hong  2 , Hyein Ahn  1 , Seong Taek Mun  3 , Mee-Hye Oh  1
Affiliations
Review

Vulvar epithelioid leiomyoma with myxoid change: A case report and literature review

Si-Hyong Jang et al. Medicine (Baltimore). 2019 Oct.

Abstract

Rationale: Smooth muscle tumors of the vulva are infrequent neoplasms with diverse histologic features and unclear biologic behavior. Herein, we report a very rare case of vulvar epithelioid leiomyoma and review of previous reported cases of these tumors. In addition, we have discussed the representative diagnostic criteria of vulvar smooth muscle tumors and prognostic significance of epithelioid morphology.

Patient concerns: We recently met a 45-year-old woman with complaint of painful vulvar mass.

Interventions: Excisional biopsy was performed.

Diagnoses: Pathologic examination revealed a vulvar epithelioid leiomyoma with multinodular growth pattern. Mitotic activity was rare and cellular atypia was not identified. Based on histology and immunohistochemical staining results, the case was diagnosed as vulvar epithelioid leiomyoma.

Outcomes: After mass excision, the patient was discharged with no complication and there was no evidence recurrence for 6 months.

Lessons: After reviewing previous papers and diagnostic criterion, we thought that vulvar smooth muscle tumors with predominant epithelioid morphology may be associated with unfavorable prognosis, Therefore, pathologists should examine the epithelioid component in vulvar smooth muscle tumors carefully.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Microscopic features of vulvar mass. (A) The tumor showed multinodular growth pattern and well circumscription. (B) Tumor cells had epithelioid features with abundant eosinophilic cytoplasm and a round, centrally located nuclei lacking cellular pleomorphism or mitotic activity. (C) Stromal myxoid change was noted in some areas. (D) In some foci, the tumor consisted of typical bland-looking smooth muscle cells.
Figure 2
Figure 2
Immunohistochemical staining results in vulvar mass. Immunohistochemistry for SMA (A) and Smm-hc (B) was positive and immunohistochemistry for desmin (C) was focally positive. ER (D) was diffusely and strongly expressed in tumor cells.
See this image and copyright information in PMC

References

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