Tumor nasal de músculo liso de comportamiento maligno incierto: informe de un caso / Nasal smooth muscle tumor of uncertain malignant potential: A case report

Los tumores de músculo liso que no pueden ser clasificados según su histología como leiomiomas o leiomiosarcomas se denominan tumores de músculo liso de comportamiento maligno incierto. La localización nasal de estos tumores es muy infrecuente y la extensión adecuada de la cirugía para tratar estas neoplasias no está bien definida. Se describe el caso clínico de una adolescente de 16 años, que consultó por padecer un tumor de aspecto vascular en la cavidad nasal derecha y que fue tratada con éxito mediante cirugía intranasal. El diagnóstico histológico fue tumor de músculo liso de comportamiento maligno incierto. Por la rareza de estas neoplasias, su infrecuente localización nasal y la falta de evidencia que soporte cuál debe ser la extensión de la cirugía, es relevante la descripción y discusión del caso clínico.

Smooth muscle tumors that cannot be histologically classified as leiomyomas or leiomyosarcomas are defined as smooth muscle tumors of uncertain malignant potential. The location of these tumors in the nose is very rare, and the appropriate surgical extent to manage these neoplasms has not been adequately defined. Here we describe the case of a 16-year-old female adolescent who consulted due to a vascular-like tumor in the right nasal cavity who was successfully treated with intranasal surgery. The histological diagnosis was smooth muscle tumor of uncertain malignant potential. Given that these neoplasms are rare, the uncommon location in the nose, and the lack of evidence indicating the extent of surgery, it is relevant to describe and discuss this clinical case.

Angioleiomioma oral mimetizando um granuloma piogênico: relato de caso raro / Oral Angioleiomyoma mimetizing a pyogenic granuloma: A rare case report

Angioleiomioma (AL) é um tumor benigno de origem perivascular que raramente é observado na cavidade oral, principalmente em localizações como a gengiva. Devido sua apresentação clínica inespecífica, os ALs podem mimetizar outras lesões orais, como tumores benignos de glândulas salivares e lesões reacionais, como o granuloma piogênico. O presente artigo objetiva relatar um caso raro de AL localizado em gengiva, em uma paciente de 19 anos. Clinicamente, a lesão apresentava-se como um tumor assintomático, oval, pedunculado, bem definido, com superfície lisa, consistência fibrosa e cor eritematosa, semelhante a um granuloma piogênico, Uma biópsia excisional foi realizada e o fragmento foi encaminhado para análise histopatológica, que revelou uma proliferação vascular de diversos calibres, contendo paredes musculares espessas e proliferação muscular adjacente, além de infiltrado inflamatório, predominantemente crônico, hemácias extravasadas e área de ulceração, consistente com o diagnóstico de AL inflamado. A histopatologia desempenha um papel importante no diagnóstico final de lesões raras e com características clínicas inespecíficas. A excisão cirúrgica da lesão é o tratamento de escolha mais eficaz para os ALs orais. (AU)

Angioleiomyoma (AL) is a benign tumor of smooth muscle of perivascular origin that is rarely seen in the oral cavity, mainly in locations like the gingiva. Due to their nonspecific clinical presentation, ALs can mimic other oral lesions, such as benign salivary gland tumors and reactional lesions, as a pyogenic granuloma. We reported a case of an AL located in the gingiva in a 19-year-old female patient. In clinical terms, the lesion was presented as an asymptomatic, oval, pedunculated, well-defined nodule with a smooth surface, fibrous consistency and erythematous color, similar to a pyogenic granuloma. An excisional biopsy was performed and the fragment was sent for histopathological analysis that revealed a vascular proliferation of different calibers, containing thick muscle walls and adjacent muscle proliferation, in addition to an inflammatory infiltrate, predominantly chronic, extravasated red blood cells and an area of ulceration, consistent with the diagnosis of inflamed AL. The histopathology plays an important role in the final diagnosis of rare lesions and with nonspecific clinical characteristics. The surgical excision of the lesion is the most effective treatment of choice for oral ALs. (AU)

Lipoleiomioma uterino

El lipoleiomioma es una neoplasia uterina benigna poco frecuente cuya incidencia varía entre 0,03% y 0,2%. Este tumor es considerado una variante benigna de los leiomiomas uterinos típicos. Está formado por una proporción variable de adipocitos maduros y células musculares lisas. La etiología puede estar relacionada con la deficiencia de estrógenos que se produce después de la transición menopáusica; generalmente aparece en mujeres obesas perimenopáusicas o menopáusicas. La sintomatología es inespecífica y la mayoría es diagnosticada de forma incidental. Se presenta un caso de lipoleiomioma uterino en paciente de 45 años quien consultó por presentar dolor abdominal. La ecografía mostró tumor en pared anterior de un útero homogéneo y bien definido. Durante la laparotomía se encontró tumor amarillento y de textura blanda. Se realizó histerectomía total más ooforosalpingectomía. El diagnóstico anatomopatológico fue de lipoleiomioma uterino.

Lipoleiomyoma is a rare benign uterine neoplasm whose incidence varies between 0.03%-0.2%. This tumor is considered a benign variant of typical uterine leiomyomas. It consists of a variable proportion of mature adipocytes and smooth muscle cells. The etiology may be related to estrogen deficiency occurring after the menopausal transition; it usually appears in obese perimenopausal or menopausal women. The symptomatology is nonspecific, and most are diagnosed incidentally. We present a case of uterine lipoleiomyoma in a 45-year-old patient who consulted for abdominal pain. Ultrasonography showed a tumor in the anterior wall of a homogeneous and well-defined uterus. During laparotomy, a yellowish tumor with a soft texture was found. Total hysterectomy plus oophorosalpingectomy was performed. The anatomopathologic diagnosis was uterine lipoleiomyoma.

Leiomiomatosis peritoneal diseminada en paciente histerectomizada / Disseminated Peritoneal Leiomyomatosis in a Hysterectomized Patient

La leiomiomatosis peritoneal diseminada es una entidad rara de etiología incierta, caracterizada por la proliferación de múltiples nódulos benignos en la cavidad peritoneal, formados por células musculares lisas, que pueden simular una carcinomatosis peritoneal. Es más frecuente en mujeres en edad fértil, durante el embarazo o por el uso de anticonceptivos orales. Se presenta el caso de una mujer de 40 años diagnosticada de leiomiomatosis peritoneal diseminada, sometida a una histerectomía simple por miomatosis uterina. Después de dos años del diagnóstico presenta una exacerbación de la enfermedad y se sospecha de malignización, por lo que se realiza una laparotomía exploratoria donde se observan múltiples nódulos miomatosos extendidos por epiplón, peritoneo y apéndice. Se le practica la exéresis de todos los nódulos (omentectomía, apendicectomía y anexectomía bilateral(. La biopsia confirma el diagnóstico de leiomiomatosis peritoneal diseminada. Actualmente, la paciente permanece asintomática tras 6 años de seguimiento(AU)

Disseminated peritoneal leiomyomatosis is a rare entity of uncertain etiology, characterized by the proliferation of multiple benign nodules in the peritoneal cavity. These nodules are formed by smooth muscle cells, which can simulate peritoneal carcinomatosis. It manifests predominantly in women of childbearing age, especially during pregnancy or with the use of oral contraceptives. We report here the case of a 40-year-old woman diagnosed with disseminated peritoneal leiomyomatosis, who underwent simple hysterectomy due to uterine myomatosis. Two years after the diagnosis, she presented with an exacerbation of the disease and malignancy was suspected. So exploratory laparotomy was performed. Multiple myomatous nodules were observed, extended by omentum, peritoneum and appendix. All nodules were removed -omentectomy, appendectomy and bilateral adnexectomy. Biopsy confirms the diagnosis of disseminated peritoneal leiomyomatosis. As of today, the patient remains asymptomatic after 6 years of follow-up(AU)

Vaginal leiomyosarcoma in a cow from Uberlândia, Minas Gerais, Brazil / Leiomiossarcoma Vaginal em uma vaca de Uberlândia, Minas Gerais, Brasil

The clinical, pathological, and immunohistochemical findings associated with a vaginal leiomyosarcoma in a 12-year-old, Senepol breed of cow from Uberlândia, Minas Gerais are described. The animal had a large ulcerative neoplastic growth that originated between the base and the left-lateral vaginal wall. Histopathology revealed a tumor formed by muscle-like cells that demonstrated cellular pleomorphism, anisokaryosis, prominent and multiple nucleoli, with rare tumor giant cells. The neoplastic growth invaded adjacent adipose tissue, and contained areas of hemorrhage with discrete accumulations of inflammatory cells. By immunohistochemistry, most neoplastic cells expressed actin, while immunoreactivity to desmin was weakly expressed. These findings support a diagnosis of leiomyosarcoma, and represent the first description of a bovine vaginal leiomyosarcoma from Brazil.

No presente trabalho, foram descritos os achados clínicos, patológicos e imunohistoquímicos de uma vaca da raça Senepol, 12 anos, com leiomiossarcoma vaginal, de Uberlândia, Minas Gerais. O animal apresentou massa ulcerada localizada entre a base e parede lateral-esquerda da vagina. A histopatologia revelou uma neoplasia formada por células fusiformes a arredondadas que demonstraram pleomorfismo celular, anisocariose, nucléolos proeminentes e múltiplos, com raras células gigantes tumorais. O crescimento neoplásico invadiu o tecido adiposo adjacente e continha áreas de hemorragia com discreto acúmulo de células inflamatórias. A maioria das células neoplásicas expressou actina na avaliação imunohistoquímica, enquanto a imunoreatividade para desmina foi fracamente expressa. Os achados suportam o diagnóstico de leiomiossarcoma e representa a primeira descrição de leiomiossarcoma vaginal em bovinos no Brasil.

Leiomioma vascular bucal: reporte de un caso / Vascular leiomioma: case report

Leiomiomas son neoplasias benignas de músculo liso, poço frecuentes en cavidad bucal, que presentan crecimiento lento y se asemejan a otras lesiones de tejido conectivo. Clinicamente de tamaño entre 0,5 y 3 cm de diámetro, los leiomiomas vasculares generalmente tienen base pedunculada y coloración diversa debido a su ubicación y vascularización. El propósito de este artículo es presentar un reporte de caso de leiomioma vascular en lábio inferior y discutir su etiología, diagnóstico diferencial y tratamiento

Leiomyomas are benign smooth muscle neoplasms, rarely seen in oral cavity, that presents slow growth and are similar to others lesions of conjuntive tissue. Clinically with a size between 0,5 and 3 cm in diameter, vascular leiomyomas generally have pedunculated basis and diverse coloration due to location and vascularity. The purpose of this article is to present a case report of oral vascular leiomyoma in the lower lip and discuss their etiology, differential diagnosis and treatment

Case for diagnosis / Caso para diagnóstico

Vascular leiomyoma are uncommon benign smooth muscle tumors which generally present as a single painful nodule in the lower limbs. We report a case of vascular leiomyoma on the second finger of the left hand, an unusual location for this tumor.

Angioleiomiomas são tumores benignos raros derivados da musculatura lisa vascular, que geralmente se apresentam como nódulo doloroso solitário nos membros inferiores. Relata-se um caso de angioleiomioma no segundo quirodátilo esquerdo, localização incomum deste tumor.

Piloleiomioma simulando morfea en un niño / Piloleiomyoma mimicking morphea in a child

Los piloleiomiomas son tumores cutáneos raros que tienen origen en el músculo erector del pelo. Presentamos el caso de un niño de tres años de edad con una placa indurada en el glúteo izquierdo, asintomática, que estuvo presente desde los tres meses de edad. El examen anatomopatológico mostró un piloleiomioma. Este tumor benigno es raro en niños y suele ser confundido con otras dermatosis. En este artículo revisamos los casos pediátricos publicados y los aspectos genéticos actuales de esta enfermedad. Además, llamamos la atención para el diagnóstico diferencial con otras patologías en la edad pediátrica (AU)

Piloleiomyomas are rare benign smooth muscle tumors arising from the aerector pili muscles in the skin.We describe a three year-old boy presenting with an asymptomatic hard plaque on the left gluteus, which was present since 3 months of age.The anatomopathological examination evidenced a piloleiomyoma.There are few previous reports of piloleiomyomas in children and so they are frequently confounded with other disorders. In this paper, we review the literature on the pediatric cases reported and the current genetics aspects of this disease. Moreover, we make the differential diagnosis with other entities in children (AU)