Leiomyoma (benign neoplasm of smooth muscles)
LEIOMYOMA (BENIGN NEOPLASM OF SMOOTH MUSCLES)
LEIOMYOMA (BENIGN NEOPLASM OF SMOOTH MUSCLES) DEFINATION
Leiomyoma are benign neoplasm of smooth muscle cells. In the oral cavity they are usually derived from the smooth muscle cells of the blood vessels.
LEIOMYOMA (BENIGN NEOPLASM OF SMOOTH MUSCLES) CLINICAL FEATURES:
Age: Leiomyomas usually occurs among the middle-aged adults.
Sex: Male predilection
Site: Intraorally leiomyomas frequently occurs in relation to the tongue, however other structure s like palates, buccal mucosa and lips are also sometimes affected.
LEIOMYOMA (BENIGN NEOPLASM OF SMOOTH MUSCLES) PRESENTATION:
- Clinically leiomyoma appears as a slow growing, painless, submucosal nodule.
- The surface of the lesion is usually smooth.
- It has a yellowish color and on palpation, it appears firm, encapsulated and well delineated.
- Sometimes the lesion can be multinodular
LEIOMYOMA (BENIGN NEOPLASM OF SMOOTH MUSCLES) HISTOPATHOLOGY:
- Leiomyomas are usually composed of spindle-shaped smooth muscle cells, which resemble fibroblasts.
- The cells usually evolve from blood vessels and are arranged in fascicle or in a stream-like fashion.
- The cell contain elongated, blunt-ended nuclei, which often produce a ‘cigar-shaped’ appearance.
- The spindle-shaped tumor cells also produce perivascular concentric laminations of parallel fascicles.
- The lesions is either encapsulated or well-delineated from the surrounding tissue.
LEIOMYOMA (BENIGN NEOPLASM OF SMOOTH MUSCLES) DIFFERENTIAL DIAGNOSIS:
- Granular cell myoblastoma.
LEIOMYOMA (BENIGN NEOPLASM OF SMOOTH MUSCLES) SPECIAL INVESTIGATION:
- Trichome stain is used to differentiate between these two cells. With this special stain, the smooth muscle cells of leiomyoma appears ‘pink’ while the collagenous structure of fibroblasts appear “Blue or Green”.
- Van-Gieson staining may also be used for this purpose, which stains the collagen fibers “red” and the smooth muscle fibers “yellow’.
- Immunohistochemically analysis using the monoclonal antibodies to muscle-specific “actin” may be useful in confirming the diagnosis of leiomyoma.
LEIOMYOMA (BENIGN NEOPLASM OF SMOOTH MUSCLES) TREATMENT:
Surgical excision including the surrounding normal issue is a treatment of choice. Recurrence is usually rare.