Uterine angioleiomyoma: clinicopathological evaluation of 5 cases

Abstract

Aim: Uterine angioleiomyoma (ALM) is a very rare benign perivascular neoplasm. In this study, clinicopathologic and immunohistochemical features and treatment modalities of the cases were evaluated with a comprehensive literature review. Methods: 5 cases of uterine ALM admitted to the pathology department of our hospital were found in the pathology database. Hematoxylin-Eosin (HE) stained preparations of the cases were removed from the archive and reviewed. Immunohistochemical markers, namely muscle-specific actin, h-caldesmon, desmin, CD10, melan-A, HMB-45 and WT-1, were done. Results: The mean age of the patients was 40 years. Abnormal uterine bleeding and abdominal pain were the cause of admission in all patients. In one case (multiple ALM ), infertility was also present. A single tumour mass was observed in 4 cases, while multiple tumours focus (2 separate tumour focuses) were present in one case. The smallest tumour size was 5.2 cm, and the largest was 10 cm. The tumour was submucosal in one case and intramural in four cases. Macroscopically, all cases were sharp-edged, solid, white-grey, with a vortex nodular appearance. Two cases had solid and venous variants, one had venous and cavernous variants, one had venous variants, and one had all three variants. All cases were stained with desmin, h-caldesmon, smooth muscle actin; Staining with CD10, melan-A, HMB-45 and WT-1 was not observed. Conclusion: Uterine ALM is a rare, benign tumour and preoperative diagnosis is very difficult since there are no specific imaging findings. Therefore, it is crucial for the clinician and pathologist to remember this rare tumour and to distinguish it from similar ones.