Perineal leiomyoma

Case contributed by Dr Ammar Haouimi

Presentation

Progressive painless swelling of the perineal region.

Patient Data

Age: 45 years
Gender: Female
mri

There is a large (14 x 11 x 6.5 cm) well-circumscribed ovoid perineal mass of right para-anal location in contact with the puborectalis with a mass effect on the canal anal. It elicits an intermediate signal on T1, low signal on T2 with moderate and relatively homogeneous enhancement on postcontrast sequences. No extension to the adjacent soft tissues is seen.

Normal appearance of the uterus and ovaries.

pathology

Conclusion:

  • gallbladder: chronic calcular cholecystitis with a focal gallbladder wall adenomyomatosis
  • perineal mass: tumoral mesenchymal proliferation leiomyoma type

Case Discussion

MRI features of a perineal mass pathologically proved as a leiomyoma

The patient had at the same time a laparoscopic cholecystectomy for chronic calcular cholecystitis as mentioned on the pathological report.

Perineal leiomyomas are extremely rare benign mesenchymal tumors, usually of superficial location1. The differential diagnosis includes a wide variety of soft tissue tumors such as sarcoma 1. The mobility of the mass and the absence of extension to the adjacent tissues are more in favor of benign origin 1.

 

Additional contributor: Z.E Boudiaf, MD, CHU, Constantine, Algeria

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