Leiomyoadenomatoid Tumors of the Uterus: A Case Report and Literature Review

Patient: Female, 35-year-old Final Diagnosis: Leiomyoadenomatoid tumors Symptoms: Lower abdominal pain • recurrent vaginal bleeding Medication: — Clinical Procedure: Myomectomy Specialty: Pathology OBJECTIVE: Rare disease BACKGROUND: An adenomatoid tumor is a benign neoplasm that originates in the mesothelial lining, commonly present in the male and female genital tracts. The lieomyoadenomatoid tumor (LMAT) is rare and considered an adenomatoid variant, characterized microscopically by prominent smooth muscle proliferation within an adenomatoid tumor. Areas of pseudo-glandular infiltration and tubular and slit-like spaces can mimic metastatic carcinoma or malignant tumors. Most cases of LMAT were incidentally discovered microscopically after an impression of leiomyoma. Eighteen cases have been reported in studies published in English. CASE REPORT: We present a case of a 35-year-old woman who experienced recurrent vaginal bleeding and underwent a myomectomy. Microscopically, the mass showed smooth muscle proliferation in fascicles with areas of tubular, slit-like spaces, and gland-like areas, which showed reactivity for Wilms tumor-1 and calretinin by an immunohisto-chemistry study. The final pathology examination showed a 9-cm LMAT, which is the largest size ever reported to the best of our knowledge. There was no recurrence or other symptoms at the 2-year follow-up. CONCLUSIONS: An LMAT should be considered in the differential diagnosis of leiomyomas that present areas of pseudo-infiltrative glands and slit-like spaces, which can lead to misdiagnosis as a malignant tumor.