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Deep Leiomyoma
Case Detail
| Anatomy: Musculoskeletal |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Neoplasia Benign |
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| Created: over 5 years ago |
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| Updated: over 2 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
CR
MR
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Activities:  PDF  ImageJA |
History
Toddler with longstanding restricted range of motion at the right hip.
Case Images
Diagnosis
Deep Leiomyoma
Findings
DR – “Popcorn” calcifications in the right obturator space
MR – Intramuscular mass with remodeling of the adjacent bones.
Discussion
Leiomyomas of deep soft tissue (usually deep subcutis and skeletal muscle) are extremely rare. The lesions are equally distributed among males and females with an age at presentation in one series from 14 to 62 years. The extremities represented the single most common site. Characteristic morphologic features included well-defined circumscription with a fibrous pseudocapsule, myxohyaline stromal degeneration, and intersecting fascicles of spindle cells with mostly uniform, round-ended, elongated nuclei and tapering, eosinophilic cytoplasm. Dystrophic calcification is present in one-third of cases. Immunohistochemically, all cases showed desmin positivity. Recurrence and metastasis are unusual although careful attention to the presence of significant mitotic activity and suppurative tumor necrosis is essential.
Reference
Kilpatrick SE, Mentzel T, Fletcher CD. Leiomyoma of deep soft tissue. Clinicopathologic analysis of a series. Am J Surg Pathol (1994); 18(6):576-82.