What Is a Leiomyoma?

Leiomyoma is a benign tumor of skin smooth muscle cells. It can occur from vascular smooth muscle, pili, and smooth muscle from the breast or scrotum. The onset may be genetically related. Leiomyoma is divided into simple leiomyoma and vascular leiomyoma. Skin leiomyomas often occur in the limb extension or trunk, multiple, less than 2 cm in diameter, pain; single genital leiomyomas, no pain, intact capsule, diameter up to 15 cm, can be located under the skin, muscle bundle contract Severe pain may occur, and single skin leiomyomas are not easy to relapse. The treatment of leiomyoma is mainly surgical resection.

Basic Information

English name

leiomyoma

Visiting department

Oncology

Multiple groups

Middle-aged

Common locations

Skin leiomyoma: extensor limb or trunk; external genital leiomyoma: subcutaneous

Common causes

Abnormal hyperplasia of smooth muscle

Common symptoms

Skin leiomyoma: multiple, less than 2 cm in diameter, pain; external genital leiomyoma: single, no pain

Causes of leiomyoma

Leiomyoma is caused by abnormal proliferation of smooth muscle.

Clinical manifestations of leiomyoma

Skin leiomyomas are not common and are divided into simple leiomyomas and vascular leiomyomas. Simple leiomyomas have no gender difference and are more common in middle-aged people aged 30 to 40 years. Simple leiomyomas can be divided into leiomyomas of the skin and nipples (dermis) and genital leiomyomas. Dermal leiomyomas come from the pili muscles, and they often occur on the side or trunk of the limb. They are multiple and have a diameter of less than 2 cm. , Pain; Papillary leiomyomas are from areola smooth muscle; External genital leiomyomas are from the sarcolemma or genitalia, single, no pain, the capsule is intact, the diameter can reach 15 cm, and it can be located under the skin. There is more severe pain, and single skin leiomyoma is not easy to relapse.

Multiple skin leiomyomas have recurrences of up to 50%, often with secondary lesions; external genital leiomyomas may have relapses after years of treatment.

Leiomyoma test

Leiomyoma can be used for histopathological examination. Histopathological examination shows that smooth muscle cells are long spindle-shaped or slightly corrugated and are often arranged in parallel.

Angioleiomyoma

Originating from the muscles of the vein wall, it is located under the skin and has a fully encapsulated tumor. There are many venous walls, smooth muscle cells and collagen hyperplasia in the tissue. The lumen is narrow or compressed into a star shape, without inner elastic membrane and adventitia, and more common hyaline-like and mucoid-like changes. Smooth muscle cells and surrounding tumor tissue have no obvious state, mature adipose tissue is atypical, and mitosis and necrosis are rare.

2. Genital leiomyoma and hair leiomyoma

It is composed of a large number of disordered smooth muscle cells and collagen. Hair and appendages are easily affected. The eosinophilic staining of the tumor cells leads to vacuolization of the nucleus. The nucleus is long spindle-shaped. The ends are obtuse. It is relatively clear that both can form false envelopes in the subcutaneous tissue, and local calcification and mucus-like changes occur. If mitosis occurs, vigilance should be watched.

Differential diagnosis of leiomyoma

Leiomyomas should be distinguished from:

Skin fibroma

Collagen fibers proliferate and foam giant cells are visible.

2. Carina cutaneous fibrosarcoma

Spindle-shaped cells, arranged in a wheel-like or vortex shape, with mild atypical changes and CD-34 positive.

3. Neurofibromas

The nucleus is "S" shaped, the fibers are thin and corrugated, and it is positive for S100 and nerve filaments.

Leiomyoma diagnosis

A single or cluster of painful papules or nodules appear clinically. If a small piece of ice is placed on the lesion for a few seconds, the smooth muscle will contract, and the surface of the fibroid may shrink. The diagnosis of leiomyoma should be considered. A biopsy can confirm the diagnosis.

Leiomyoma treatment

The treatment of leiomyoma is mainly surgical resection. Individual tumor patients should be completely removed, otherwise relapse is easy. Multiple tumors are surgically resected and skin grafted. Nifedipine can be taken for pain relief during multiple inconvenience surgery. Others such as cryo-diathermy are also available.