[Extra-uterine pelvic leiomyoma: diagnosis and practical management].
OBJECTIVE
To analyze the possibilities of setting up a therapy for extra-uterine pelvic leiomyomas.


METHODS
Three cases of leiomyomas of the broad ligament, of the round ligament and of the ovary, and literature review.


RESULTS
Little is known about physiopathology of extra-uterine leiomyoma. The diagnosis of extra-uterine leiomyoma is based on histopathological analysis, using standard histology, and immunohistochemistry with anti-desmin and anti smooth muscle actin antibodies. The main differential diagnoses are fibroma, fibrothecoma, ovarian fibrosarcoma, and gastrointestinal stromal tumors. To define criteria of malignancy, we use Bell's classification without being sure that the uterine and extra-uterine models are comparable. So there is a risk of ignoring a low grade leiomyosarcoma. Providing therapy depends on the clinicopathologic features: the so called "parasitic leiomyoma", a tumor developed at the expense of local smooth muscle cells, metastasis of a benign metastasizing leiomyoma or leiomyomatosis peritonealis disseminata.


CONCLUSIONS
The extra-uterine leiomyoma has no precise nosologic status and no specific criteria of benignity; thus no precise evolution can be predicted. We must be extremely careful, and the issue of the monitoring and long-term therapy of patients must come up.
Roue
A
A
Service de gynécologie obstétrique, HME, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex, France.
Laboisse
C
C
Winer
N
N
Darnis
E
E
Bouquin
R
R
Lopes
P
P
Philippe
H-J
HJ
D000328:Adult; D001956:Broad Ligament; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007889:Leiomyoma / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000628:therapy; D012404:Round Ligament of Uterus; D014057:Tomography, X-Ray Computed