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Bladder
Bladder tumors - benign
Leiomyoma
Author: Nat Pernick, M.D. (see Authors page)
Revised: 27 February 2010, last major update February 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Benign smooth muscle tumor, similar to counterparts elsewhere
Terminology
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Epidemiology
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● Most common benign neoplasm of bladder, but < 0.5% of bladder tumors
● Mean age 52-61 years, range 22-78 years, no gender preference
Sites
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Etiology
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Clinical features
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● Usually symptomatic
● Can be definitively diagnosed on biopsy or TUR without the risk of unsampled leiomyosarcoma
Prognostic factors
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● Lesions with necrosis or mitotic figures, or not well circumscribed may be well differentiated leiomyosarcoma
Case reports
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● Laparoscopic enucleation (J Minim Invasive Gynecol 2009;16:772)
Treatment
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● Excision if symptoms, enlarging mass or unclear diagnosis
Clinical images
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Gross description (Macroscopy)
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● 0.5 to 4.5 cm, well circumscribed
Gross images
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Micro description (Histopathology)
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● Similar histology to leiomyomas elsewhere
● Low cellularity, may have bizarre or symplastic nuclei, hyalinization, degenerative atypia
● Occasionally has necrosis or myxoid changes (Am J Surg Pathol 2010 Feb 11 [Epub ahead of print])
● Minimal/no mitotic figures, no atypical mitotic figures (Am J Surg Pathol 2002;26:292)
Micro images
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Strong desmin staining
Cytology description
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Cytology images
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Positive stains
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● Actin and desmin (strong)
Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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● Usually diploid
Molecular / cytogenetics images
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Differential Diagnosis
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● Uterine leiomyoma (parasitic): Obstet Gynecol 2009;114:611
● Well differentiated leiomyosarcoma: not well circumscribed; has necrosis, mitotic figures, abnormal mitotic figures
Additional references
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End of Bladder > Benign tumors > Leiomyoma
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