Cervical Angiomyolipoma Coexisting with Endometrial Carcinoma in the Absence of Tuberous Sclerosis: A Rare Case Report

Femela Muniraj; C Divyapriya; Vijayashree Raghavan; Rajesh Kanna Nandhagopal Radha; Sailatha Ramanujam; Shery Angel Rajakumar

doi:10.1055/s-0041-1733822

Indian Journal of Medical and Paediatric Oncology, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2021; 42(03): 305-308
DOI: 10.1055/s-0041-1733822

Case Report with Review of Literature

Cervical Angiomyolipoma Coexisting with Endometrial Carcinoma in the Absence of Tuberous Sclerosis: A Rare Case Report

Autor*innen

Femela Muniraj

¹Department of Pathology, Chettinad Hospital and Research Institute, Rajiv Gandhi Road, Kelambakkam, Chengalpattu District, Tamil Nadu, India
C Divyapriya

¹Department of Pathology, Chettinad Hospital and Research Institute, Rajiv Gandhi Road, Kelambakkam, Chengalpattu District, Tamil Nadu, India
Vijayashree Raghavan

¹Department of Pathology, Chettinad Hospital and Research Institute, Rajiv Gandhi Road, Kelambakkam, Chengalpattu District, Tamil Nadu, India
Rajesh Kanna Nandhagopal Radha

¹Department of Pathology, Chettinad Hospital and Research Institute, Rajiv Gandhi Road, Kelambakkam, Chengalpattu District, Tamil Nadu, India
Sailatha Ramanujam

²Department of Obstetrics & Gynecology, Chettinad Hospital and Research Institute, Rajiv Gandhi Road, Kelambakkam, Chengalpattu District, Tamil Nadu, India
Shery Angel Rajakumar

²Department of Obstetrics & Gynecology, Chettinad Hospital and Research Institute, Rajiv Gandhi Road, Kelambakkam, Chengalpattu District, Tamil Nadu, India

Abstract

Angiomyolipoma (AML) is a rare benign mesenchymal neoplasm composed of variable admixture of blood vessels, smooth muscle, and adipose tissue; most commonly located in kidney, and is usually associated with tuberous sclerosis. Extrarenal AML has been reported in various sites, although infrequently in female genital tract (FGT). AML in cervix is extremely rare and only six cases have been reported so far. A 46-year-old postmenopausal female presented with lower abdominal pain, bleeding for 4 days and a polypoidal mass protruding through the cervical os. Endometrial curettings were suggestive of endometrial adenocarcinoma—endometrioid type (World Health Organization [WHO]). The subsequent hysterectomy specimen confirmed the diagnosis and the histologic grade was International Federation of Obstetrics and Gynecology (FIGO) grade I and stage was pT1aN0 (American Joint Committee on Cancer [AJCC], 8th edition). Cervical polyp showed AML. CD34 and smooth muscle actin (SMA) showed diffuse positivity in blood vessels and smooth muscle cells, respectively. HMB-45 was negative. This is the first ever reported case of AML coexisting with endometrial carcinoma in the absence of tuberous sclerosis. CD34 is a good marker for delineating the blood vessels and SMA for both the smooth muscle and vascular components. S100 is generally not needed to prove the adipose tissue component. HMB-45 is not consistently expressed in AML of female genital tract.

Keywords

angiomyolipoma - cervix - endometrial carcinoma - tuberous sclerosis - HMB-45

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Referenzen

References
1 Morgan GS, Straumfjord JV, Hall EJ. Angiomyolipoma of the kidney. J Urol 1951; 65 (04) 525-527
2 Garg M, Duhan A, Bindroo S, Kaur J, Mahajan NC. Isolated angiomyolipoma of vulva: A case report of an uncommon tumor at an uncommon site. J Cancer Res Ther 2015; 11 (03) 645
3 Monteiro R, Sharma S, Gupta S, Choudhary I. Extrarenal angiomyolipoma in uterine cervix: rare presentation in unusual site. Int J Res Med Sci 2020; 8: 367-370
4 Walke V, Gaikwad A, Ratnaparkhi S, Kowe B. Angiomyolipoma of the cervix: a case report. JMSCR 2019; 7 (03) 371-374
5 Tovet TP, Mateva SA, Nikolova MR, Gorchev GA. Uterine angiomyolipoma: a case report, differential diagnosis with PEComa and review of the literature. J Biomed Clin Res 2014; 7 (01) 47-52
6 Yilmaz M, Ingec M, Isaoglu U, Sipal S. Angiomyolipoma of the uterus. Eur J Gen Med 2013; 10 (03) 178-180
7 Peh SC, Sivanesaratnam V. Angiomyolipoma of the vagina–an uncommon tumour. Case report. Br J Obstet Gynaecol 1988; 95 (08) 820-823
8 Anderson AE, Yang X, Young RH. Epithelioid angiomyolipoma of the ovary: a case report and literature review. Int J Gynecol Pathol 2002; 21 (01) 69-73
9 Chen KT. Angiomyolipoma of the vagina. Gynecol Oncol 1990; 37 (02) 302-304
10 Cil AP, Haberal A, Hucumenoglu S, Kovalak EE, Gunes M. Angiomyolipoma of the uterus associated with tuberous sclerosis: case report and review of the literature. Gynecol Oncol 2004; 94 (02) 593-596
11 Katz DA, Thom D, Bogard P, Dermer MS. Angiomyolipoma of the fallopian tube. Am J Obstet Gynecol 1984; 148 (03) 341-343
12 Shakuntala PN, Shilpashree M, Geethanjali S, Sharma SK. Acute abdomen as an unusual presentation of broad ligament angiomyolipoma. A case report and review of literature. Indian J Surg Oncol 2012; 3 (04) 276-278
13 Yaegashi H, Moriya T, Soeda S, Yonemoto Y, Nagura H, Sasano H. Uterine angiomyolipoma: case report and review of the literature. Pathol Int 2001; 51 (11) 896-901
14 Aung T, Goto M, Nomoto M. et al Uterine lipoleiomyoma: a histopathological review of 17 cases. Pathol Int 2004; 54 (10) 751-758
15 Conlon N, Soslow RA, Murali R. Perivascular epithelioid tumours (PEComas) of the gynaecological tract. J Clin Pathol 2015; 68 (06) 418-426
16 An J, Kim HN, Cho HY, Chung DH, Kim NR. Uterine vascular leiomyoma with a fat component mimicking angiomyolipoma: a case report. J Women’s Med 2010; 3 (03) 130-133