Abstract:

OBJECTIVE: Uterine adenomatoid tumors, in particularly the intramural type, are often accompanied by smooth muscle hypertrophy, which is usually represented by an entrapped myometrium permeated by the adjacent tumor. In some cases, the prominence of smooth muscle component simulates a leiomyoma, thus the lesion is denoted as a ‘leiomyoadenomatoid tumor’. Indeedly, the term “leimyoadenomatoid” is a descriptive name for this lesion and it reflects its histopathological appearance that is composed of prominent stromal smooth muscle proliferation accompanied by glandular structures. It is important that the surgeon and especially the pathologist recognize the existence of this tumor because the histological pattern is sometimes bizarre and the lesion could be misdiagnosed as malignant. METHODS: A mass has been detected in fourth month pregnancy of a 30 year-old woman of uterus. Grossly, the mass had a well circumscribed, smooth surface, hard consistency, white tumor measuring 4,5x4x3 cm in size. The cut surface of specimen showed solid, grey white mass with a whorled appearance RESULTS: In the microscopic examination of the mass, prominent fascicles of smooth muscle were infiltrated by cuboidal to flattened and signet ring-like vacuolated epithelial-like cells as well as tubular-glandular cystically dilated spaces CONCLUSION: The possibility of tumors with a solid growth pattern or cords of cells being mistaken for an infiltrating malignant epithelial or mesothelial neoplasm, or those with small vacuoles being confused with a signet ring cell adenocarcinoma. Thus we herein reported this rare case of leiomyoadenomatoid tumor involving in uterus of 30 years old in pregnancy, and discussed its differential diagnosis and pathophysiology.

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