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ABDOMEN / Colon Rectum   53 / F,  Perianal palpable mass
About Author
Authors Heejin Kwon
Institution Dong-A university Hospital
E-mail risual@dau.ac.kr
About Case
Chief complaint
or Title
Perianal palpable mass
Subspecialty ABDOMEN / Colon Rectum
Classification Neoplasm, benign / adenoma
Age 53 Sex F
Difficulty For resident, For specialist
Modality US, CT, MR
Case Figures
Question
Click above Figure for more images.
Questions
What is your diagnosis?
Answer
Diagnosis leiomyoma
Comments

Perianal leiomyoma 

}benign tumor of mesenchymal origin arise from smooth muscle fibers
}Their pathogenesis remains obscure
}Leiomyoma can occur in various organs and may develop in deep soft tissues where smooth muscle is not present.
}
vDeep soft-tissue leiomyomas can be classified into
}Leiomyomas of somatic soft tissue (somatic leiomyoma)
}Usually occur in the extremities (usually in thigh) 
}Affect the sexes equally 
}RetroperitonealR11;abdominal leiomyomas 
}Usually occur in the pelvic retroperitoneum 
}Affect preferentially in women, during perimenopausal period
}Histologically similar and analogous to uterine leiomyomas
}Hormone receptors (+) : estrogen, progesterone
vImmunohistochemistry
}Smooth muscle actin and desmin : (+)
}CD117 (KIT) and S100 : (-) 
}Estrogen and progesterone receptor (+)
}Useful for preoperative staging 
}Define relationship b/w the sphincters and urogenital tract
}Well-defined homogeneous mass
}Transanal US : ovoid hypoechoic mass
}T2WI : heterogeneous iso to mildly high SI compared with that of pelvic muscles, Thin rim with low SI
}Homogeneous enhancement
}A beak sign
}Origin of mass is in internal anal sphincter
External anal sphincter were stretched to allow passage through
References
Keywords Perianal, submucosal mass, tumor
Attachment File -

Number of Applicants : 39
Correct Answer 17
Shiga University of Medical Science Akitoshi Inoue
Dokkyo Medical University Arakawa Hiroaki
Biotypos - Greece Ioannis E. Papachristos
Osaka Metropolitan University hospital Tatsushi Oura
University of Tokyo Toshihiro Furuta
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