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Musculoskeletal
Diagnosis
Non-Trauma
Soft Tissue Tumors
Smooth Muscle Tumors
Smooth Muscle Tumors, Benign
Leiomyoma: Superficial and Deep
Leiomyoma: Superficial and Deep
Eric Walker, MD, MHA, FACR, FACHE; Catherine C. Roberts, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Benign smooth muscle tumor that occurs in skin, subcutaneous tissues, or deep soft tissues
            • Clinical groups
              • (1) Cutaneous leiomyoma (leiomyoma cutis)
                • Includes genital leiomyomas and piloleiomyomas
              • (2) Angioleiomyomas (angiomyoma or vascular leiomyoma)
                • Typically subcutaneous
                • From tunica media of vein
              • (3) Leiomyoma of deep soft tissues
                • Deep soft tissues of extremity or retroperitoneum (females)
                • Much less common than superficial types
                • Can be confused with leiomyosarcoma, which is more common

          IMAGING

          • General Features

            • Ultrasonographic Findings

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    Selected References

                                    1. Marcoval J et al: Cutaneous leiomyoma: a clinical study of 152 patients. Dermatology. 1-7, 2021
                                    2. Billings SD et al: Leiomyoma. In Fletcher CDM et al: WHO Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 188-9, 2020
                                    3. McCarthy AJ et al: Benign smooth muscle tumors (leiomyomas) of deep somatic soft tissue. Sarcoma. 2018:2071394, 2018
                                    4. Arleo EK et al: Review of leiomyoma variants. AJR Am J Roentgenol. 205(4):912-21, 2015
                                    5. Kransdorf MJ et al: Muscle tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 361-7, 2014
                                    6. Fasih N et al: Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics. 28(7):1931-48, 2008
                                    7. Weiss SW et al: Benign tumors of smooth muscle. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 522-8, 2008
                                    8. Hashimoto H et al: Leiomyoma of deep soft tissue. In Fletcher CDM et al: WHO Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 130, 2002
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Definitions

                                              • Benign smooth muscle tumor that occurs in skin, subcutaneous tissues, or deep soft tissues
                                              • Clinical groups
                                                • (1) Cutaneous leiomyoma (leiomyoma cutis)
                                                  • Includes genital leiomyomas and piloleiomyomas
                                                • (2) Angioleiomyomas (angiomyoma or vascular leiomyoma)
                                                  • Typically subcutaneous
                                                  • From tunica media of vein
                                                • (3) Leiomyoma of deep soft tissues
                                                  • Deep soft tissues of extremity or retroperitoneum (females)
                                                  • Much less common than superficial types
                                                  • Can be confused with leiomyosarcoma, which is more common

                                            IMAGING

                                            • General Features

                                              • Ultrasonographic Findings

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Gross Pathologic & Surgical Features

                                                              • Microscopic Features

                                                                CLINICAL ISSUES

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      Selected References

                                                                      1. Marcoval J et al: Cutaneous leiomyoma: a clinical study of 152 patients. Dermatology. 1-7, 2021
                                                                      2. Billings SD et al: Leiomyoma. In Fletcher CDM et al: WHO Classification of Tumours: Soft Tissue and Bone Tumours. 5th ed. IARC Press. 188-9, 2020
                                                                      3. McCarthy AJ et al: Benign smooth muscle tumors (leiomyomas) of deep somatic soft tissue. Sarcoma. 2018:2071394, 2018
                                                                      4. Arleo EK et al: Review of leiomyoma variants. AJR Am J Roentgenol. 205(4):912-21, 2015
                                                                      5. Kransdorf MJ et al: Muscle tumors. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Lippincott Williams & Wilkins. 361-7, 2014
                                                                      6. Fasih N et al: Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics. 28(7):1931-48, 2008
                                                                      7. Weiss SW et al: Benign tumors of smooth muscle. In Weiss SW et al: Enzinger and Weiss' Soft Tissue Tumors. 5th ed. Elsevier. 522-8, 2008
                                                                      8. Hashimoto H et al: Leiomyoma of deep soft tissue. In Fletcher CDM et al: WHO Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press. 130, 2002