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Topic Completed: 1 December 2014

Minor changes: 22 October 2020

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PubMed Search: Leiomyoma [title] ovary

Nalini Gupta, M.D.
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Cite this page: Gupta N. Leiomyoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumorleiomyoma.html. Accessed October 21st, 2021.
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
  • 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
  • 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
  • Surgical resection
Gross description
  • Solid lobulated mass, median 3 cm (range 0.3 - 20 cm), often in hilar region
  • Cut surface is gray-white, whorled
Gross images

AFIP images

Lobulated sectioned surface

Images hosted on other servers:

Gray-white with whorled pattern

Ovary replaced with creamy mass

Microscopic (histologic) 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
Microscopic (histologic) images

AFIP images

Spindle cells arranged in intersecting fascicles

Images hosted on other servers:

Long fascicle of spindle shaped cells

H&E, desmin, α smooth muscle actin

Positive for SMA

Positive stains
Negative stains
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