A six-year study of leiomyomata with emphasis on lipoleiomyoma

Background: Leiomyoma is the most common benign neoplasm of the uterus. Lipoleiomyoma is a rare variant usually affecting women in the postmenopausal age group. Incidence of lipoleiomyoma varies from 0.59% - 2.1%. This study was undertaken to analyse the different variants, degenerative changes and to determine the incidence, clinical and morphological features of lipoleiomyoma amongst all the leiomyomas studied.Methods: This study was done in the Department of Pathology over a period of 6 years. Authors studied 575 patients with leiomyoma constituting a total of 1122 leiomyomata as some patients presented with multiple leiomyomata. Further clinicopathological correlation was done.Results: In the present study 98.03% of leiomyomata were uterine in location, 1.06% were cervical, 0.62% were in broad ligament and 0.26 % were in ovary. Among the 1122 leiomyomata studied, degenerative changes were noted in 19.6% of which hyaline degeneration was the most common. Leiomyoma variants constituted 5.27% of all leiomyomata. The incidence of lipoleiomyoma was 0.71% with size ranging from 3-10cm.Conclusions: Leiomyoma is a common tumor of the uterus and lipoleiomyoma variant is very uncommon with unknown etiology. They occur in postmenopausal as well as reproductive age group. The site of lipoleiomyoma can be uterine or extrauterine location such as broad ligament. Coexistance of metabolic derangement is an observation that may have a role in development of lipoleiomyoma.

Sertoli cell tumor arising in a cryptorchid testis presenting as a content of inguinal hernial sac.

Sertoli cell tumors (SCTs) are rare tumors accounting for <1% of all testicular tumors. Here, we report a rare case of SCT in a 60‑year‑old man presenting as a painless swelling in the right groin since childhood. Clinically, he presented with right‑sided inguinal hernia with absence of the right testis. He had normal left testis and had no gynecomastia or infertility. The specimen of hernial sac showed testis with a 1.6 cm × 1.5 cm nodular mass having gray tan‑cut surface. Histopathologically, the testis showed atrophy and the nodular portion showed tumor cells arranged in tubular and microcystic pattern, with no solid pattern or necrosis. The diagnosis of SCT was confirmed with immunohistochemical staining for inhibin which showed fine granular cytoplasmic positivity. Cryptorchid testis having SCT and presenting as a content of inguinal hernia is a rare occurrence.

Anaplastic lymphoma kinase positive inflammatory myofibroblastic tumor of the urachus: A rare neoplasm in an unusual location.

Inflammatory myofibroblastic tumors (IMTs) are uncommon benign neoplasms in the abdomen, and urachal involvement is very rare. IMT of the urachus is usually mistaken clinically and radiologically for a malignant tumor. The tumor has spindle cell proliferation with a prominent inflammatory infiltrate and myxoid degeneration favoring other designations such as inflammatory pseudotumor and fibromyxoid pseudotumor. Complete excision is the treatment of choice. The case documented here was in a 50‑year‑old male, with an abdominal mass diagnosed on computed tomography scan as adenocarcinoma of urachus infiltrating the bladder. Histopathology showed a benign spindle cell tumor invading bladder muscle. Immunohistochemistry aided in diagnosing an anaplastic lymphoma kinase (ALK)‑1 positive IMT. Approximately, 50% of the IMTs show ALK positivity, and though when present, it indicates neoplastic nature of the spindle cells, the pathogenesis of IMT is still elusive. The urachal IMTs need documentation in literature for their rarity and diagnostic dilemma posed by them.