Letter to Editor: Extensive cystic degeneration of leiomyoma mimicking ovarian cystic neoplasm

Dear Editor, We have received a case of pelvic leiomyoma with extensive cystic degeneration simulating, on gross inspection, an ovarian cystic mucinous neoplasm. A left paraovarian mass, without connection to the uterus or the ovary, was excised form a 45-year-old lady. The mass was 15cm in largest diameter, had a smooth outer surface and firm to soft consistency. On dissection, the mass was a multiloccular cyst with thin walls and thick viscid yellowish contents (Fig. 1a). Solid whitish areas, some with haemorrhagic tinge, were present within the mass. Careful inspection of the some solid areas showed whorled appearance (Fig. 1b). Microscopical examination revealed a typical leiomyoma in the solid parts (Fig. 1c,d). The cystic component was the degenerated parts of the leiomyoma. This resulted in amorphous material that fills spaces delineated by thin strands of the tumour cells (Fig. 1e). The smooth muscle nature of the lesion was proven by diffuse cytoplasmic immunoreactivity to smooth muscle actin (SMA) (Dako, Glostrup, Denmark) (Fig.1f).