Ovary tumor
Other tumors not specific to ovary
Leiomyoma

Author: Nalini Gupta, M.D. (see Authors page)

Revised: 5 July 2016, last major update December 2014

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Leiomyoma [title] ovary
Definition / General
  • Accounts for 0.5-1% of all benign ovarian tumors
  • Associated with synchronous leiomyomas of uterus
  • Do not recur locally or metastasize, even if mitotically active
Epidemiology
Pathophysiology
  • Arises from smooth muscle cells in ovarian hilar blood vessels
  • Other possible origins include cells in ovarian ligament, smooth muscle cells or multipotential cells in ovarian stroma, undifferentiated germ cells, or cortical smooth muscle metaplasia (Am J Surg Pathol 2004;28:1436)
Clinical Features
  • Abdominal pain, mass, vaginal discharge
Laboratory
  • CA125, Ca19-9 and CEA are within normal range
Radiology Description
  • Transvaginal ultrasonography: solid mass
  • MRI T1 and T2 weighted images: well circumscribed low signal intensity mass (Eur Radiol 1998;8:1444)
Case Reports
Treatment
  • Surgical resection
Gross Description
  • Solid lobulated mass, median 3 cm (range 0.3 to 20 cm), often in hilar region
  • Cut surface is grey-white, whorled
Gross Images

Images hosted on Pathout server:

Lobulated sectioned surface



Images hosted on other servers:

Grey-white with whorled pattern

Ovary replaced with creamy mass

Micro Description
  • Irregular bundles and whorling of spindle shaped cells with no atypia or pleomorphism
  • Degenerative changes like hyaline degeneration and myxomatous changes can be seen
  • May be cellular, have prominent mitotic activity or occasionally have bizarre nuclei or myxoid stroma
Micro Images

Images hosted on Pathout server:

Spindle cells arranged in intersecting fascicles



Images hosted on other servers:

Long fascicle of spindle shaped cells

Ovarian leiomyoma

Bundles of smooth muscle fibers

H&E, desmin, α smooth muscle actin

Positive for SMA

Positive Stains
Negative Stains