A Rare Case of Primary Hepatic Leiomyoma
Abstract
Leiomyomas are most commonly encountered in the genitourinary and gastrointestinal systems, with primary hepatic leiomyomas (PHL) being a rare occurrence. We present the case of a 62-year-old man with an incidentally discovered voluminous lesion in the left lobe of the liver, initially suspected to be a hemangioma. The patient was referred for further evaluation, during which advanced imaging modalities were utilized for
accurate diagnosis, and tissue biopsies were obtained. A definitive diagnosis of PHL was established through immunohistochemistry based on pathological findings.
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crj.0000000000000899
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a patient without evidence of immunosuppression. Hepatol Res. 2002 Sep;24(1):80. https://doi.org/10.1016/s1386-
6346(02)00014-1
[9] Perini MV, Fink MA, Yeo DA, Carvalho CA, Morais CF, Jones RM, et al. Primary liver leiomyoma: a review of this unusual tumour. ANZ J Surg. 2013 Apr;83(4):230-3. https://doi. org/10.1111/j.1445-2197.2012.06257.x
[10] Vyas S, Psica A, Watkins J, Yu D, Davidson B. Primary hepatic leiomyoma: unusual cause of an intrahepatic mass. Ann Transl Med. 2015 Apr;3(5):73. https://doi.org/10.3978/j.issn.2305-5839.2015.03.40
[11] Santos I, Valls C, Leiva D, Serrano T, Martinez L, Ruiz S. Primary hepatic leiomyoma: case report. Abdom Imaging. 2011 Jun;36(3):315-7. https://doi.org/10.1007/s00261-010-9648-y
[12] Omiyale AO. Primary leiomyoma of the liver: a review of a rare tumour. HPB Surg. 2014;2014:959202. https://doi.
org/10.1155/2014/959202
[13] M Yanase 1, H Ikeda, I Ogata, A Ohno, A Moriya, N Miura, et al. Primary smooth muscle tumour of the liver encasing
hepatobiliary cystadenoma without mesenchymal stroma. Am J Surg Pathol. 1999;23(7):854–9. https://doi.
org/10.1097/00000478-199907000-00016
[14] Belli G, Ciciliano F, Lannelli A, Marano I. Hepatic resection for primary giant leiomyoma of the liver. HPB (Oxford). 2001;3(1): 11-2. https://doi.org/10.1080/136518201753173692
[15] Tan W., Wu G., Zheng C. Imaging findings of primary hepatic leiomyoma. Chin-Ger J Clin Oncol. 2009;8(3):134–136. https://doi.org/10.1007/s10330-008-0163-3
[16] Urizono Y, Ko S, Kanehiro H, Hisanaga M, Aomatsu Y, Nagao M, et al. Primary leiomyoma of the liver: report of a case. Surg Today. 2006;36(7):629-32. https://doi.org/10.1007/s00595-006-3204-y
[17] Qian XH, Yan YC, Gao BQ, Wang WL. Prevalence, diagnosis, and treatment of primary hepatic gastrointestinal stromal tumors. World J Gastroenterol. 2020 Oct 28;26(40):6195-6206. https://doi.org/10.3748/wjg.v26.i40.6195
[18] Gandhi SN, Brown MA, Wong JG, Aguirre DA, Sirlin CB. MR contrast agents for liver imaging: what, when, how.
Radiographics. 2006 Nov-Dec;26(6):1621-36. https://doi.org/10.1148/rg.266065014
[19] Raber EL, Cheng AL, Dong WF, Sutherland F. Primary hepatic leiomyoma in a transplant patient: characterization with magnetic resonance imaging. Transplantation. 2012 Jan 27;93(2):e4-5.https://doi.org/10.1097/tp.0b013e31823ec0cf
[20] Sadler M, Mays WL, Albert P, Javors B. Hepatic leiomyomas in two adult patients with AIDS: intravenous contrast-enhanced CT and MR imaging. Emerg Radiol. 2002 Sep;9(3):175-7. https://doi.org/10.1007/s10140-002-0214-y
[21] Marin D, Catalano C, Rossi M, Guerrisi A, Di Martino M, Berloco P, Passariello R. Gadobenate dimeglumine-enhanced magnetic resonance imaging of primary leiomyoma of the liver. J Magn Reson Imaging. 2008 Sep;28(3):755-8. https://doi.org/10.1002/jmri.21519
[22] Keramida M, Machairas N, Dorovinis P, Sotiropoulos G, Machairas A. A primary leiomyoma of the liver mimicking a
giant hepatic hemangioma: report of a rare case. HPB (Oxford). 2023;25:S400. http://dx.doi.org/10.1016/j.hpb.2023.07.419
[23] Sousa HT, Portela F, Semedo L, Furtado E, Marinho C, Cipriano MA, Leitão MC. Primary leiomyoma of the liver:
accurate preoperative diagnosis on liver biopsy. BMJ Case Rep. 2009;2009:bcr09.2008.0898. https://doi.org/10.1136/
bcr.09.2008.0898
[24] Hawkins EP, Jordan GL, McGavran MH. Primary leiomyoma of the liver. Successful treatment by lobectomy and presentation of criteria for diagnosis. Am J Surg Pathol. 1980 Jun;4(3):301-4.
[25] Guy CD, Yuan S, Ballo MS. Spindle-cell lesions of the liver: diagnosis by fine-needle aspiration biopsy. Diagn Cytopathol. 2001 Aug;25(2):94-100. https://doi.org/10.1002/dc.2011
[26] Colagrande A, Cazzato G, Fedele S, Andriola V, Ingravallo G, Resta L, Vincenti L. A Unique Case of the ransformation
of a Hepatic Leiomyoma into Leiomyosarcoma with Pancreatic Metastases: Review of the Literature with Case Presentation. Reports. 2022; 5(1):2. https://doi.org/10.3390/reports5010002
of the Hepatobiliary Tract. Springer, Cham. https://doi.org/10.1007/978-3-319-26956-6_63
[2] Jia B, Jin Z, Gao P, Liu Y. Primary hepatic leiomyoma in a Chinese female patient without underlying disease: a case report. BMC Surg. 2019 Oct 7;19(1):140. https://doi.org/10.1186/s12893-019-0598-1
[3] Djokic M, Hadzialjevic B, Luzar B, Trotovsek B. Primary Hepatic Leiomyoma in a Healthy Middle-Aged Woman: Literature Review and Case Report. Front Surg. 2021 Jun 14;8:691674. https://doi.org/10.3389/fsurg.2021.691674
[4] Nwankwo EC Jr, Burton SJ, Brotherton T, Carpenter D, Qureshi K. Asymptomatic Hepatic Leiomyoma in an
Immunocompetent Middle-Aged Woman. ACG Case Rep J. 2022 Nov 24;9(11):e00899. https://doi.org/10.14309/
crj.0000000000000899
[5] Coletta D, Parrino C, Nicosia S, Manzi E, Pattaro G, Oddi A, et al. Primary leiomyoma of the liver in an immunocompetent patient. Intractable Rare Dis Res. 2020 Nov;9(4):251-255. https://doi.org/10.5582/irdr.2020.03075
[6] Miyahara J, Shimazu K, Saito A, Saito M, Fukuda K, Yoshida T, et al. Clinical Course of a Rare Epstein-Barr VirusAssociated Smooth Muscle Tumor and Its Genomic Analysis. Case Rep Oncol. 2023 Aug 4;16(1):577-584. https://doi.org/10.1159/000530383
[7] Cheuk W, Li PC, Chan JK. Epstein-Barr virus-associated smooth muscle tumour: a distinctive mesenchymal tumour
of immunocompromised individuals. Pathology. 2002 Jun;34(3):245-9. https://doi.org/10.1080/00313020220131309
[8] Kanazawa N, Izumi N, Tsuchiya K, Sakurai K, Hamano K, Itakura J, et al. A case of primary leiomyoma of the liver in
a patient without evidence of immunosuppression. Hepatol Res. 2002 Sep;24(1):80. https://doi.org/10.1016/s1386-
6346(02)00014-1
[9] Perini MV, Fink MA, Yeo DA, Carvalho CA, Morais CF, Jones RM, et al. Primary liver leiomyoma: a review of this unusual tumour. ANZ J Surg. 2013 Apr;83(4):230-3. https://doi. org/10.1111/j.1445-2197.2012.06257.x
[10] Vyas S, Psica A, Watkins J, Yu D, Davidson B. Primary hepatic leiomyoma: unusual cause of an intrahepatic mass. Ann Transl Med. 2015 Apr;3(5):73. https://doi.org/10.3978/j.issn.2305-5839.2015.03.40
[11] Santos I, Valls C, Leiva D, Serrano T, Martinez L, Ruiz S. Primary hepatic leiomyoma: case report. Abdom Imaging. 2011 Jun;36(3):315-7. https://doi.org/10.1007/s00261-010-9648-y
[12] Omiyale AO. Primary leiomyoma of the liver: a review of a rare tumour. HPB Surg. 2014;2014:959202. https://doi.
org/10.1155/2014/959202
[13] M Yanase 1, H Ikeda, I Ogata, A Ohno, A Moriya, N Miura, et al. Primary smooth muscle tumour of the liver encasing
hepatobiliary cystadenoma without mesenchymal stroma. Am J Surg Pathol. 1999;23(7):854–9. https://doi.
org/10.1097/00000478-199907000-00016
[14] Belli G, Ciciliano F, Lannelli A, Marano I. Hepatic resection for primary giant leiomyoma of the liver. HPB (Oxford). 2001;3(1): 11-2. https://doi.org/10.1080/136518201753173692
[15] Tan W., Wu G., Zheng C. Imaging findings of primary hepatic leiomyoma. Chin-Ger J Clin Oncol. 2009;8(3):134–136. https://doi.org/10.1007/s10330-008-0163-3
[16] Urizono Y, Ko S, Kanehiro H, Hisanaga M, Aomatsu Y, Nagao M, et al. Primary leiomyoma of the liver: report of a case. Surg Today. 2006;36(7):629-32. https://doi.org/10.1007/s00595-006-3204-y
[17] Qian XH, Yan YC, Gao BQ, Wang WL. Prevalence, diagnosis, and treatment of primary hepatic gastrointestinal stromal tumors. World J Gastroenterol. 2020 Oct 28;26(40):6195-6206. https://doi.org/10.3748/wjg.v26.i40.6195
[18] Gandhi SN, Brown MA, Wong JG, Aguirre DA, Sirlin CB. MR contrast agents for liver imaging: what, when, how.
Radiographics. 2006 Nov-Dec;26(6):1621-36. https://doi.org/10.1148/rg.266065014
[19] Raber EL, Cheng AL, Dong WF, Sutherland F. Primary hepatic leiomyoma in a transplant patient: characterization with magnetic resonance imaging. Transplantation. 2012 Jan 27;93(2):e4-5.https://doi.org/10.1097/tp.0b013e31823ec0cf
[20] Sadler M, Mays WL, Albert P, Javors B. Hepatic leiomyomas in two adult patients with AIDS: intravenous contrast-enhanced CT and MR imaging. Emerg Radiol. 2002 Sep;9(3):175-7. https://doi.org/10.1007/s10140-002-0214-y
[21] Marin D, Catalano C, Rossi M, Guerrisi A, Di Martino M, Berloco P, Passariello R. Gadobenate dimeglumine-enhanced magnetic resonance imaging of primary leiomyoma of the liver. J Magn Reson Imaging. 2008 Sep;28(3):755-8. https://doi.org/10.1002/jmri.21519
[22] Keramida M, Machairas N, Dorovinis P, Sotiropoulos G, Machairas A. A primary leiomyoma of the liver mimicking a
giant hepatic hemangioma: report of a rare case. HPB (Oxford). 2023;25:S400. http://dx.doi.org/10.1016/j.hpb.2023.07.419
[23] Sousa HT, Portela F, Semedo L, Furtado E, Marinho C, Cipriano MA, Leitão MC. Primary leiomyoma of the liver:
accurate preoperative diagnosis on liver biopsy. BMJ Case Rep. 2009;2009:bcr09.2008.0898. https://doi.org/10.1136/
bcr.09.2008.0898
[24] Hawkins EP, Jordan GL, McGavran MH. Primary leiomyoma of the liver. Successful treatment by lobectomy and presentation of criteria for diagnosis. Am J Surg Pathol. 1980 Jun;4(3):301-4.
[25] Guy CD, Yuan S, Ballo MS. Spindle-cell lesions of the liver: diagnosis by fine-needle aspiration biopsy. Diagn Cytopathol. 2001 Aug;25(2):94-100. https://doi.org/10.1002/dc.2011
[26] Colagrande A, Cazzato G, Fedele S, Andriola V, Ingravallo G, Resta L, Vincenti L. A Unique Case of the ransformation
of a Hepatic Leiomyoma into Leiomyosarcoma with Pancreatic Metastases: Review of the Literature with Case Presentation. Reports. 2022; 5(1):2. https://doi.org/10.3390/reports5010002
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| Issue | Vol 9 No 5 (2024): September -October | |
| Section | Case Report(s) | |
| Keywords | ||
| Leiomyoma Liver Gastrointestinal systems | ||
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How to Cite
1.
Zare E, Beheshti Namdar A. A Rare Case of Primary Hepatic Leiomyoma. CRCP. 2025;9(5):203-207.
