Case Report of Dermoscopic Aspects and Reflectance Confocal Microscopy Description of Segmental Leiomyoma and Relative Management
Cutaneous leiomyoma is a benign tumor, mainly composed of smooth muscle cells and arising from the arrector pili muscle of hair follicles. The diagnosis of leiomyomas is of paramount importance, as they can often be associated with underlying malignancies (e.g., renal cell carcinoma, leiomyosarcoma)...
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MDPI AG
2022-12-01
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| Series: | Medicina |
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| author | Giovanni Paolino Riccardo Pampena Nathalie Rizzo Matteo Riccardo Di Nicola Santo Raffaele Mercuri |
| author_facet | Giovanni Paolino Riccardo Pampena Nathalie Rizzo Matteo Riccardo Di Nicola Santo Raffaele Mercuri |
| author_sort | Giovanni Paolino |
| collection | DOAJ |
| description | Cutaneous leiomyoma is a benign tumor, mainly composed of smooth muscle cells and arising from the arrector pili muscle of hair follicles. The diagnosis of leiomyomas is of paramount importance, as they can often be associated with underlying malignancies (e.g., renal cell carcinoma, leiomyosarcoma) and specific genetic mutations. We report the case of a 27-year-old Caucasian male patient that presented to our attention with a rare segmental and Zoosteriform type II leiomyoma. We performed an analysis of the cutaneous lesions using dermoscopy, reflectance confocal microscopy (RCM) and histology. We found that, using dermoscopy, the leiomyomas showed a dermatofibroma-like appearance with a central hypopigmented area, peripheral delicate hyperpigmentation and also erythematous areas and ectatic vessels. RCM, although not specific, showed groups of hypo-reflective areas distributed in the most superficial papillary dermis, which in histology and immunohistochemistry corresponded to the most superficial protrusions in the papillary dermis of the tumoral bundles. Finally, we discuss the management of patients with multiple leiomyomas and stress the fact that, in the cases of multiple leiomyomas, an annual sonography of the kidneys associated with dermatological and (in women) gynecological consultations are needed to ensure the early identification of an underlying tumor. A genetic consultation to detect an eventual FH mutation is recommended, but since in some cases the FH result may be negative, the above recommended controls remain always of paramount importance. |
| first_indexed | 2024-03-09T16:07:37Z |
| format | Article |
| id | doaj.art-e0e88ed993aa4a498901473e72c04fa9 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T16:07:37Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-e0e88ed993aa4a498901473e72c04fa92023-11-24T16:33:44ZengMDPI AGMedicina1010-660X1648-91442022-12-015812184510.3390/medicina58121845Case Report of Dermoscopic Aspects and Reflectance Confocal Microscopy Description of Segmental Leiomyoma and Relative ManagementGiovanni Paolino0Riccardo Pampena1Nathalie Rizzo2Matteo Riccardo Di Nicola3Santo Raffaele Mercuri4Unit of Dermatology, IRCCS Ospedale San Raffaele, 20132 Milan, ItalyUnit of Dermatology, IRCCS Ospedale San Raffaele, 20132 Milan, ItalySurgical Pathology, IRCCS Ospedale San Raffaele, 20132 Milan, ItalyUnit of Dermatology, IRCCS Ospedale San Raffaele, 20132 Milan, ItalyUnit of Dermatology, IRCCS Ospedale San Raffaele, 20132 Milan, ItalyCutaneous leiomyoma is a benign tumor, mainly composed of smooth muscle cells and arising from the arrector pili muscle of hair follicles. The diagnosis of leiomyomas is of paramount importance, as they can often be associated with underlying malignancies (e.g., renal cell carcinoma, leiomyosarcoma) and specific genetic mutations. We report the case of a 27-year-old Caucasian male patient that presented to our attention with a rare segmental and Zoosteriform type II leiomyoma. We performed an analysis of the cutaneous lesions using dermoscopy, reflectance confocal microscopy (RCM) and histology. We found that, using dermoscopy, the leiomyomas showed a dermatofibroma-like appearance with a central hypopigmented area, peripheral delicate hyperpigmentation and also erythematous areas and ectatic vessels. RCM, although not specific, showed groups of hypo-reflective areas distributed in the most superficial papillary dermis, which in histology and immunohistochemistry corresponded to the most superficial protrusions in the papillary dermis of the tumoral bundles. Finally, we discuss the management of patients with multiple leiomyomas and stress the fact that, in the cases of multiple leiomyomas, an annual sonography of the kidneys associated with dermatological and (in women) gynecological consultations are needed to ensure the early identification of an underlying tumor. A genetic consultation to detect an eventual FH mutation is recommended, but since in some cases the FH result may be negative, the above recommended controls remain always of paramount importance.https://www.mdpi.com/1648-9144/58/12/1845dermoscopyreflectance confocal microscopyleiomyoma |
| spellingShingle | Giovanni Paolino Riccardo Pampena Nathalie Rizzo Matteo Riccardo Di Nicola Santo Raffaele Mercuri Case Report of Dermoscopic Aspects and Reflectance Confocal Microscopy Description of Segmental Leiomyoma and Relative Management Medicina dermoscopy reflectance confocal microscopy leiomyoma |
| title | Case Report of Dermoscopic Aspects and Reflectance Confocal Microscopy Description of Segmental Leiomyoma and Relative Management |
| title_full | Case Report of Dermoscopic Aspects and Reflectance Confocal Microscopy Description of Segmental Leiomyoma and Relative Management |
| title_fullStr | Case Report of Dermoscopic Aspects and Reflectance Confocal Microscopy Description of Segmental Leiomyoma and Relative Management |
| title_full_unstemmed | Case Report of Dermoscopic Aspects and Reflectance Confocal Microscopy Description of Segmental Leiomyoma and Relative Management |
| title_short | Case Report of Dermoscopic Aspects and Reflectance Confocal Microscopy Description of Segmental Leiomyoma and Relative Management |
| title_sort | case report of dermoscopic aspects and reflectance confocal microscopy description of segmental leiomyoma and relative management |
| topic | dermoscopy reflectance confocal microscopy leiomyoma |
| url | https://www.mdpi.com/1648-9144/58/12/1845 |
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