BACKGROUND: Primary endobronchial smooth muscle tumors (SMTs), which are extremely rare, include endobronchial leiomyomas and leiomyosarcomas. Clinically, SMTs present with signs and symptoms of bronchial obstruction, and lack specific radiological findings. Thus, histopathological examination is required for accurate diagnosis as well as for tumor grading. We examined the histomorphological and immunohistochemical features of endobronchial SMTs and highlighted pitfalls in diagnosis, particularly when using small biopsies. METHODS: Cases of primary endobronchial SMTs diagnosed at our Institute over the last 6 years (2012–2017) were retrieved from the departmental archives. Histopathological features and immunohistochemistry performed for establishing the diagnosis were reviewed. RESULTS: Five cases of SMTs occurring in endobronchial locations were identified. These included three cases of leiomyoma, and two cases of leiomyosarcoma. The age distribution of patients ranged from 13 to 65 years. Leiomyomas showed more consistent staining with smooth muscle markers (smooth muscle actin, desmin, and smooth muscle myosin heavy chain), while tumors of higher grade showed variable, focal staining, leading to erroneous diagnosis, especially on small biopsies. CONCLUSIONS: The diagnosis of endobronchial SMTs relies on histopathological examination, for both confirmation of smooth muscle lineage and determination of the malignant potential of the lesion. Appropriate immunohistochemical panels including more than one marker of smooth muscle differentiation are extremely valuable for differential diagnosis from morphological mimics, which is necessary for instituting appropriate management.
Actins ; Age Distribution ; Biopsy ; Desmin ; Diagnosis ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Leiomyoma ; Leiomyosarcoma ; Muscle, Smooth ; Myosins ; Neoplasm Grading ; Smooth Muscle Tumor

Uterine smooth muscle tumor is very rare in laboratory rats and, there has been no report in the wild rodents. Among a total of 400 wild rats captured in Gyeonggi, Gangwon, and Chungbuk provinces of Korea in 2007, 2010, and 2011, we found a uterine spindle cell tumor, diagnosed as smooth muscle cell origin based on differential features of histology and immunohistochemistry. Its incidence was very low, like in the laboratory rats, as under 0.5% for female. Considering generally applied histological and cellular criteria, this case was difficult in differential diagnosis between benign and malignant. Ki-67 labeling index was therefore further investigated, and it ranged from 26.4 to 37.6% in the 10 different areas, representing an average of 32.9+/-0.05%. The Ki-67 labeling index of neoplastic cells near the necrotic area was recorded as 83.5%. According to such high Ki-67 labeling index, it was more likely a malignant leiomyosarcoma, assenting to the previous proposal that Ki-67 labeling index is a significant criterion to differentiate between malignant and benign in the smooth muscle tumors.
Animals ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Incidence ; Korea ; Leiomyosarcoma ; Myocytes, Smooth Muscle ; Rats ; Rodentia ; Smooth Muscle Tumor

Leiomyoma is a benign smooth muscle tumor that can be classified into three types: solid, vascular and ephithelioid leiomyoma. This disease occurs most frequently in the uterus, gastrointestinal tract and skin. The oral cavity is an unusual site for a leiomyoma and occurrence in the hard palate is very rare because there is so little smooth muscle tissue present in this region. Clinically, oral leiomyomas usually grow slowly and are asymptomatic firm superficial nodule like lesions, although occasional tumors can be painful. The diagnosis and treatment of oral leiomyoma is possible with complete surgical excision and histological studies by special specific stains. Recently, we experienced a 60-year-old man with 6 month history of soft mass on the hard palate. He underwent surgical resection. Pathological analysis confirmed vascular leiomyoma. Here, we report this case with review of literature.
Angiomyoma ; Coloring Agents ; Diagnosis ; Gastrointestinal Tract ; Humans ; Leiomyoma* ; Middle Aged ; Mouth ; Muscle, Smooth ; Palate, Hard* ; Skin ; Smooth Muscle Tumor ; Uterus

Pseudo-Meigs' syndrome is a rare syndrome associated with struma ovarii, yolk sac tumor, ovarian carcinoma, leiomyoma and tuberculosis, which is combined with ascites and pleural effusion. The cause and pathophysiology of Pseudo-Meigs' syndrome are uncertain. The diagnosis is done by characteristic clinical finding. We have experienced a case of Pseudo-Meigs' syndrome associated with uterine smooth muscle tumor of uncertain malignant potential and elevated CA-125, so report this case.
Ascites ; Diagnosis ; Endodermal Sinus Tumor ; Leiomyoma ; Pleural Effusion ; Smooth Muscle Tumor ; Struma Ovarii ; Tuberculosis

Although the ultrasonography & CT have been regarded as a primary procedure in the differential diagnosis of upper abdominal mass, the CT was more superior in the diagnosis, its extent and relationship to the bowel in the cases of the leiomyosarcoma & leiomyoma of the stomach than those of the ultrasonography. The authors studied CT findings of 9 cases of pathologically proven gastric smooth muscle tumor (leiomyosarcoma 7, leiomyoma 2) during the last two years. The results were as follows: 1. CT findings of gastric leiomyosarcoma were often quite large mass, average 15 cm in diameter; extensive central necrotic or cystic changes were fou nd in all 7 cases, seen more clearly on postcontract scan; calcification and peripheral rim enhancement of the tumor were seen in one case each other. 2. Metastasis to the liver and the spleen was seen only in one case, which revealed centrally necrotic and ascites was found in one case. 3. Two cases of gastric leiomyoma were smaller in size, average 6.3 cm in diameter than those of leiomyosarcomaj central necrotic or cystic changes were less common and less extensive. 4. If there were no evidence of central necrotic or cystic changes in large peri-or juxtagastric tumor, ohe should consider other diagnostic possibilities such as left lobe hepatoma, exophytic stomach cancer, Iymphoma or other mesenchymal tumors than leiomyosarcoma.
Ascites ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential ; Leiomyoma ; Leiomyosarcoma ; Liver ; Muscle, Smooth ; Neoplasm Metastasis ; Smooth Muscle Tumor ; Spleen ; Stomach ; Stomach Neoplasms ; Ultrasonography

OBJECTIVE: In this study, we aimed to evaluate the clinicopathological features, obstetric, and oncological outcomes of patients diagnosed with a uterine smooth muscle tumors of uncertain malignant potential (STUMP). METHODS: A dual-institutional, database review was carried out to screen patients with STUMP who were treated with upfront surgery between January 2006 and December 2017. Data including age at the time of diagnosis, recurrence rate, disease-free survival, overall survival, and fertility outcomes were retrospectively analyzed. RESULTS: Fifty-seven patients with STUMPs were included in the study. The median age at the time of diagnosis was 42 (range, 16 to 75) years. The median follow-up was 57 (range, 16 to 125) months. Eight patients (14%) had recurrence during follow-up. Recurrent STUMPs were seen in seven patients and leiomyosarcoma after 14 months in one patient. Seven patients with a recurrent STUMP survived, while the remaining patient died. Recurrence rates were similar for women who underwent myomectomy and those who underwent hysterectomy. The presence of uterine localization of tumor (subserosal vs intramural-submucosal) statistically significantly affected recurrence rates (odds ratio=5.72; 95% confidence interval=1.349–24.290; p=0.018). Ten of 27 patients who underwent myomectomy for uterine myoma had fertility desire. Seven pregnancies were recorded. CONCLUSIONS: Our study results suggest that fertility-sparing approaches are feasible in patients with STUMP, although recurrence may be seen.
Diagnosis ; Disease-Free Survival ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hysterectomy ; Leiomyoma ; Leiomyosarcoma ; Muscle, Smooth ; Pregnancy ; Recurrence ; Retrospective Studies ; Smooth Muscle Tumor

Glomus tumor shows histologically characteristic three components of glomus cells, vascular structures, and spindle-shaped smooth muscle cells. It is classified into solid glomus tumor, glomangioma and glomangiomyoma according to relative proportions of components. Glomangiomyoma, the least frequent type of glomus tumor, has its overall histopathologic pattern identical to common solid glomus tumor or glomangioma. In contrast to the foregoing types, however, it has an important number of spindle-shaped smooth muscle cells, which blend with the glomus cells. A 49-year-old woman presented with 2-year history of painful bluish red nodule beneath nail plate of right 4th finger. We made a diagnosis of glomangiomyoma by virtue of routine histopathologic examinations and immunohistochemical stains such as vimentin, smooth muscle actin and desmin.
Actins ; Coloring Agents ; Desmin ; Diagnosis ; Female ; Fingers ; Glomus Tumor ; Humans ; Intervertebral Disc ; Middle Aged ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Spine ; Vimentin ; Virtues

Leiomyosarcomas of the stomach are unusual tumors, accounting for 1% to 3% of all malignant tumors and 17% to 20% of all smooth muscle tumors of the stomach. It is difficult to diagnosis these tumors preoperatively because of its vague symptoms and signs or producing symptoms only late. Despite their rarity and difficulty in diagnosis, thier diagnosis is important due to more favorable prognosis aasociated with these tumors than that of gastric carcinoma. Recently, endoscopy is being used with increasing frequency, but because these are submucosal lesions the diagnosis of thease tumors cannot be easily made through the endoscope. We experienced a case of relatively full-brown leiomyosarcoma in gastric fundus. Endoscopy showed 6x6cm sized, definite margined, protruding mass on gastric fundus, with central deep ulceration coated with blood clots. The mucosa overlying the mass was intact, smoothly effaced and the bridging fold was also visible. Postoperative ultrasound showed large protruding mixed echogenic solid mass with contral deep excavation due to ulcer, and intact serosa, so suggestive of endogastric tumor. We believed endoscopy combined with endoscopic ultrasound is probably useful method in early diagnosis of gastric submucosal tumors, especially exogastric type or early small tumors
Camellia ; Diagnosis ; Early Diagnosis ; Endoscopes ; Endoscopy ; Gastric Fundus ; Leiomyosarcoma* ; Mucous Membrane ; Prognosis ; Serous Membrane ; Smooth Muscle Tumor ; Stomach* ; Ulcer ; Ultrasonography

OBJECTIVETo systematically study the clinical diagnosis and treatment of smooth muscle tumor in the male reproductive system.

METHODSWe analyzed the ultrasonographic features, pathological findings, treatment strategies and postoperative follow-up results of 5 male patients with smooth muscle tumor in the reproductive system, and reviewed other relevant literature.

RESULTSCompared with leiomyoma, leiomyosarcoma exhibited stronger mixed echoes than the testis at ultrasonography, typical mitotic phase (> or = 2/10 HP) of tumor cells at HE staining, and significant expressions of HIF-1alpha and Glut-1 at immunohistochemistry. No relapse was observed in the 2 cases of leiomyoma during the 10-year follow-up after simple tumor resection, nor were recurrence and metastasis in another 3 cases of leiomyosarcoma during the first year after radical surgery without combined radio- and chemo-therapy.

CONCLUSIONPrimary smooth muscle tumor of the male reproductive system is difficult to be diagnosed. Ultrasonography can help to preliminarily screen leiomyosarcoma. For those with possible leiomyosarcoma, preoperative MRI and intraoperative frozen sectioning examinations are recommended for the possibility of lymphatic metastasis. Postoperative radiotherapy and chemotherapy should be chosen cautiously for those confirmed with leiomyosarcoma by pathological examination.

Adult ; Genital Neoplasms, Male ; diagnosis ; therapy ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Smooth Muscle Tumor ; diagnosis ; therapy

BACKGROUND: Cutaneous angioleiomyoma is a rare and benign smooth muscle tumor derived from the walls of blood vessels. No studies on this condition have been conducted in Korea since a study of 59 cases of angioleiomyoma was reported in 2000. OBJECTIVE: We sought to analyze the clinical and histopathological types of angioleiomyoma in Korea. METHODS: Data were collected from 27 cases of angioleiomyoma in the dermatology department at Hallym University Medical Center. A clinical analysis was conducted through a chart and photographic review. All cases were histologically classified into four types: solid, cavernous, venous, and mixed. RESULTS: The number of males and females was 12 and 15, respectively. The mean age at diagnosis was 41.1 years, and the mean duration of disease was 4.3 years. Lower extremity (63.0%) was the most common site in both, males and females, and the size of tumors did not exceed 2 cm. About half of the patients (51.9%) had pain or tenderness associated with the tumor. The tumors histopathologically were of the solid (16 cases), mixed (6 cases), cavernous (3 cases), and venous (2 cases) types. CONCLUSION: This study will help to improve our understanding of the characteristics of angioleiomyoma in Korea.
Academic Medical Centers ; Angiomyoma* ; Blood Vessels ; Dermatology ; Diagnosis ; Female ; Humans ; Korea ; Lower Extremity ; Male ; Smooth Muscle Tumor