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Breast-nonmalignant
Benign tumors / changes
Leiomyoma
Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)
Revised: 8 October 2012, last major update April 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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● Rare in breast
Sites
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● Usually involves nipple
Etiology
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● Usually contiguous with muscular components of nipple areolar complex (J La State Med Soc 1998;150:367)
Clinical features
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● Superficial or deep (vascular)
● Often painful (Am J Surg Pathol 1979;3:151)
Prognostic factors
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Case reports
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● 23 year old woman with hyperkeratotic subareolar leiomyoma (Ann Dermatol Venereol 2008;135:571)
● 42 year old woman with epithelioid leiomyoma with granular cell change (Hum Pathol 1993;24:1260)
● 47 year old woman with tumor of breast parenchyma (AJR Am J Roentgenol 2005;185:1595)
● Tumor of nipple (Breast J 2006;12:377)
Treatment
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● Complete excision to prevent recurrence
Clinical images
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Gross description (Macroscopy)
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● Often ill-defined
Gross images
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Micro description (Histopathology)
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● Interlacing bundles of spindle cells with eosinophilic cytoplasm and blunt ended, cigar shaped nuclei
● May have epithelioid or granular features
● No atypia, no hypercellularity, no/rare mitotic figures (<3 per 10 HPF), no necrosis
Micro images
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Circumscribed tumor of spindled
cells without atypia
Fascicles of spindle cells with abundant
eosinophilic cytoplasm and blunt ended nuclei
Smooth muscle actin positive
Virtual Slides
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Videos
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Cytology description
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Cytology images
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Positive stains
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● Smooth muscle actin, desmin, vimentin
Negative stains
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● S100, keratin
Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● Hamartoma: also adipose and epithelial elements
● Leiomyosarcoma: infiltrating tumor with pleomorphism, atypia, necrosis (Diagn Pathol 2006;1:13)
Additional references
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End of Breast-nonmalignant > Benign tumors / changes > Leiomyoma
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