Gulisa Turashvili, Marosh Manduch and Sonal Varma
Department of Pathology and Molecular Medicine, Queen`s University and Kingston General Hospital, Kingston, Ontario, Canada
Leiomyomas of deep soft tissue have been traditionally divided into gynecologic and somatic leiomyomas. Somatic leiomyoma is exceedingly rare and usually has excellent outcome. We report a case of slow growing lower extremity somatic leiomyoma in a 63-year-old man. It has been predominantly reported to affect younger age group. Our patient is the oldest reported patient in the English language literature. Macroscopically, the specimen consisted of a nodular lesion with focal calcification, measuring 3.1 x 2.2 x 1.5 cm. Microscopically, this was a well-circumscribed, mature smooth muscle tumour with a fibrous pseudocapsule and dense calcification admixed with areas of hydropic and myxoid change, and mild parenchymal and perivascular hyalinization. The smooth muscle cells exhibited focal minimal atypia without increased mitotic activity or necrosis. All margins were clear of tumour. Immunohistochemically, the neoplastic cells were strongly and diffusely positive for smooth muscle markers. The case was reported as “somatic type smooth muscle tumour of soft tissue, probably benign”, and close clinical and radiological follow-up was recommended. The patient remains clinically recurrence-free four months after the diagnosis.