Soft tissue tumors - Genital leiomyoma

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Soft tissue tumors

Smooth muscle

Genital leiomyoma

Reviewer: Vijay Shankar, M.D. (see Reviewers page)
Revised: 23 February 2013, last major update November 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

Leiomyoma: see also classic, bizarre, cutaneous, epithelioid, genital, leiomyoma of deep soft tissue

Definition
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● Solitary tumor, arises from smooth muscle (dartos) bundles in superficial subcutaneous tissue or related structures of genitalia (penis / scrotum, labia, anal skin) or areola / nipple
● Also known as dartotic leiomyoma

Case reports
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● 25 year old woman with large labial tumor (J Med Assoc Thai 2005;88:118)
● 47 year old man with scrotal tumor (The Internet Journal of Dermatology 2009 Volume 7 Number 1)
● 53 year old man with tumor of epididymis (Kaohsiung J Med Sci 2006;22:519)
● 61 year old man with nipple leiomyoma (Dermatol Online J 2005;11:20)
● Tumor of female nipple (Breast J 2006;12:377)

Clinical images
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Nipple tumor

Micro description
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● Classic features of leiomyoma, but may also be cellular, epithelioid or myxoid
● Suggested classification for vulvar tumors is based on number of features below (0-1: leiomyoma, 2: atypical leiomyoma, 3-4: leiomyosarcoma)
(a) 5+ cm in greatest dimension
(b) Infiltrative margins
(c) 5+ mitotic figures per 10 hpf
(d) Moderate to severe cytologic atypia (Am J Surg Pathol 1996;20:779)

Micro images
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Nipple tumor: H&E, desmin

Scrotal biopsy

Positive stains
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● Desmin, smooth muscle actin
● Male genital leiomyomas are AR+ (J Cutan Pathol 2007;34:946)

End of Soft tissue tumors > Smooth muscle > Genital leiomyoma

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