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首页> 外文期刊>The Internet Journal of Urology >A rare case of Periurethral Leiomyoma with unusual expression of estrogen and progesterone receptors
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A rare case of Periurethral Leiomyoma with unusual expression of estrogen and progesterone receptors

机译：罕见的尿道周平滑肌瘤，雌激素和孕激素受体表达异常

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Urethral tumours are rare and can arise from its lining epithelium, glandular epithelium or the smooth and striated muscle fibers. Periurethral leiomyoma, a benign tumour arising from the smooth muscle fibers is extremely rare that can present with varying clinical features. Excision biopsy should be carried out to differentiate it from malignant lesions. Peri-urethral leiomyomas have been shown to express estrogen and progesterone receptors, therefore can increase rapidly in size during pregnancy. Less than 5 cases with such receptor expression mainly in pregnant females have been reported in literature. We present a rare case of peri-urethral leiomyoma with positive estrogen and progesterone receptor expression in non-pregnant lady that was rapidly increasing in size. Introduction Periurethral leiomyoma is a rare benign tumour that has rarely been shown to express the estrogen and progesterone receptors. Prompt diagnosis, differentiation from the malignant tumour and treatment of this unusual tumour is necessary to prevent complications. Case History An Asian woman aged 27 presented with a two-month history of a lump in the vagina, two episodes of blood in the urine and mild obstructive lower urinary tract symptoms. She had been married for two years, had no children and was not on any medication. Clinical examination revealed a 6cm smooth firm swelling situated on the left side of the external urethral meatus. Ultrasound of abdomen and pelvis and intravenous urogram was entirely normal. Flexible cystoscopy and examination under anesthesia showed an engorged vascular lump in the urethral wall. Surgical exploration revealed a totally encapsulated tumour extending towards but not involving the external sphincter. The tumour was completely excised. The histology revealed an encapsulated tumour with smooth muscle fibers suggesting a benign leiomyoma (Fig. 1). Immunohistochemical staining was positive for smooth muscle actin (Fig. 2) and negative for S-100 protein (stains neural tissue). Staining for estrogen receptors (Fig. 3) and progesterone receptors (Fig. 4) was strongly positive. This suggests possibility of a hormone sensitive tumour. At 6 months follow-up, she was continent with no evidence of recurrence.
机译：尿道肿瘤很少见，可能由其衬里上皮，腺上皮或平滑和横纹肌纤维引起。尿道周平滑肌瘤是一种由平滑肌纤维引起的良性肿瘤，极为罕见，可表现出多种临床特征。应进行切除活检以将其与恶性病变区分开。尿道周围平滑肌瘤已显示出雌激素和孕激素受体，因此在怀孕期间大小会迅速增加。文献中报道了少于5例具有这种受体表达的病例，主要是在怀孕的女性中。我们介绍了一种罕见的尿道周平滑肌瘤，在非孕妇中，雌激素和孕激素受体的表达呈阳性，并且大小迅速增加。引言尿道周围平滑肌瘤是一种罕见的良性肿瘤，很少显示出雌激素和孕激素受体。及时诊断，与恶性肿瘤区分开并治疗这种异常肿瘤对于预防并发症是必要的。案例历史一名27岁的亚裔女子表现出两个月的阴道肿块病史，两次尿液和轻度阻塞性下尿路症状。她已经结婚两年，没有孩子，也没有服用任何药物。临床检查显示，位于尿道外口左侧左侧有一个6厘米的光滑牢固肿胀。腹部和骨盆超声检查和静脉内尿路造影完全正常。柔性膀胱镜检查和麻醉检查显示尿道壁血管肿块肿大。手术探查发现肿瘤完全包封，但不累及外部括约肌。肿瘤被完全切除。组织学显示，包囊的肿瘤具有平滑肌纤维，提示良性平滑肌瘤（图1）。免疫组化染色显示平滑肌肌动蛋白阳性（图2），S-100蛋白阴性（染色神经组织）。雌激素受体（图3）和孕激素受体（图4）的染色强烈阳性。这表明可能发生激素敏感性肿瘤。在6个月的随访中，她是大陆患者，没有复发的迹象。

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