Q3. This is a 41 year old lady who presents with heavy menses (menorrhagia).  The picture shows a hysterectomy specimen.

a. Based on the gross morphology, is this a benign or malignant tumour? Why? (Try to practice describing the gross features of the specimen as well).

b. What is the likely diagnosis (i.e. nomenclature of the tumour) ? Take into account the location of the tumour and likely histology.

Answer:

Click above for a video description of the virtual specimen.  Click on the gross picture above to enlarge it.

a. This is a sagittal section of the uterus and cervix, showing a well-circumscribed, rounded nodule in the uterine wall (intramural location). It has a tan whorled cut surface. The mass has a pseudocapsule surrounding it. It does not infiltrate into the endometrium or serosa. No hemorrhage or necrosis is seen. Therefore, this is a benign tumour.

b. This tumour arises from the smooth muscle tissue of the uterine wall (myometrium), and it is benign, hence it is a uterine leiomyoma.

Click on the pictures below to see the MICROSCOPIC features of a benign mesenchymal tumour.

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