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Pongsuvareeyakul T, Maleki S, DeNardo BD, Dizon DS, Phornphutkul C, Singh K. Sporadic uterine Lymphangioleiomyomatosis (LAM): Report of a unique case arising in the lower uterine segment with short review. Gynecol Oncol Rep 2021; 37:100812. [PMID: 34195331 PMCID: PMC8239460 DOI: 10.1016/j.gore.2021.100812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 11/18/2022] Open
Abstract
Extrapulmonary lymphangioleiomyomatosis is rare and can be associated with tuberous sclerosis. Recognition of lymphangioleiomyomatosis is important for early disease screening and genetic testing. Lymphangioleiomyomatosis in lower uterine segment is very rare and can be overlooked.
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Affiliation(s)
- Tip Pongsuvareeyakul
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital of Rhode Island, Brown University, Providence, RI, United States
| | - Sara Maleki
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Bradley D. DeNardo
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Don S. Dizon
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Chanika Phornphutkul
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Kamaljeet Singh
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital of Rhode Island, Brown University, Providence, RI, United States
- Corresponding author at: Department of Pathology, Women & Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, United States.
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Yoshizawa H, Kawai S, Hirota Y, Ueda T, Kuroda M, Fujii T. A case of uterine lymphangioleiomyomatosis in a young woman that was identified via peritonitis. J Obstet Gynaecol Res 2018; 45:482-486. [PMID: 30338891 DOI: 10.1111/jog.13822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 08/29/2018] [Indexed: 11/30/2022]
Abstract
Although lymphangioleiomyomatosis is often observed with tuberous sclerosis, uterine lymphangioleiomyomatosis is rare. Our patient was 36 years old (gravida 0, para 0). She had a history of tuberous sclerosis, and many myometrial cystic lesions were identified during assisted reproductive therapy. Although we administered a gonadotropin-releasing hormone analog, myometrial cystic lesions increased in size. Therefore, simple hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node biopsy were performed. Postoperative histology showed lymphangioleiomyomatosis and myometrial abscess. For uterine lesions in young women with tuberous sclerosis, the possibility of uterine lymphangioleiomyomatosis should also be considered.
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Affiliation(s)
- Hikari Yoshizawa
- Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Satoshi Kawai
- Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yutaka Hirota
- Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Takahiro Ueda
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Makoto Kuroda
- Department of Diagnostic Pathology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Takuma Fujii
- Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Japan
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Suzuki K, Nagasaka K, Oda K, Abe H, Maeda D, Matsumoto Y, Arimoto T, Kawana K, Fukayama M, Osuga Y, Fujii T. A case of lymphangioleiomyomatosis associated with endometrial cancer and severe systemic lupus erythematosus. BMC Cancer 2016; 16:390. [PMID: 27377753 PMCID: PMC4932736 DOI: 10.1186/s12885-016-2413-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 06/24/2016] [Indexed: 01/09/2023] Open
Abstract
Background Lymphangioleiomyomatosis (LAM) is a rare idiopathic disorder that occurs in women of childbearing age, and consists of a diffuse proliferation of abnormal smooth muscle cells along the thoracic and abdominal lymphogenous route. Case presentation We experienced a case of a 47-yo woman with recent history of systemic lupus erythematosus (SLE) diagnosed with endometrial cancer, initially suspected to have metastasized to pelvic and para-aortic lymph nodes based on preoperative diagnostic imaging. Subsequent pathological diagnosis revealed stage IB endometrial cancer without evidence of lymph node involvement. Instead, enlarged pelvic and para-aortic lymph nodes were found to be due to extrapulmonary LAM, from a primary lesion found inside the uterine myometrium. SLE improved after surgery. Conclusion This is the first reported case of comorbid endometrial cancer, SLE, and aggressive LAM metastasizing to regional lymph nodes, and strengthens the clinical evidence for a common role of mTOR pathway hyperactivity and estrogen responsiveness in the pathophysiology of metastasizing lesions of the genital tract.
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Affiliation(s)
- Kensuke Suzuki
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazunori Nagasaka
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Katsutoshi Oda
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Abe
- Department of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daichi Maeda
- Department of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoko Matsumoto
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahide Arimoto
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kei Kawana
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masashi Fukayama
- Department of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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