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| LETTER TO EDITOR |
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| Year : 2013 | Volume
: 61
| Issue : 6 | Page : 686-687 |
Primary leiomyoma of the parietal bone
Qian Wu1, Cong Liu1, Xudong Luo1, Yingzhong Fan1, Liang Zhou1, Qingsong Liu2
1 Department of Neurosurgery, The First People's Hospital of Neijiang, Neijiang 641000, Sichuan, China
2 Department of Pathology, The First People's Hospital of Neijiang, Neijiang 641000, Sichuan, China
| Date of Submission | 23-Oct-2013 |
| Date of Decision | 28-Oct-2013 |
| Date of Acceptance | 04-Dec-2013 |
| Date of Web Publication | 20-Jan-2014 |
Correspondence Address:
Cong Liu
Department of Neurosurgery, The First People's Hospital of Neijiang, Neijiang 641000, Sichuan
China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0028-3886.125384
How to cite this article:
Wu Q, Liu C, Luo X, Fan Y, Zhou L, Liu Q. Primary leiomyoma of the parietal bone. Neurol India 2013;61:686-7 |
Sir,
A 14-year-old boy presented with a 3-month history of progressive enlargement over the right parietal bone. On examination, a 2.0 cm × 1.5 cm sized, hard, fixed mass over the right parietal bone was found. Computerized tomography (CT) revealed a 1.6 cm × 1.0 cm isodense mass with partial erosion of the outer table of the right parietal bone [Figure 1]a. Total resection of the mass was performed under local anesthesia. The mass was hard, hypovascular and capsulated with kind of faint yellow membrane and it eroded the whole of skull while leaving the dura untouched. The specimen mainly contained spindle cells positive for vimentin and smooth muscle actin (SMA) [Figure 1]b while negative for epithelial membrane antigen, S-100, CD34 and Bcl-2 on immunohistochemistry staining, which was consistent with leiomyoma. The post-operative course was uneventful. Three months after the surgery, CT [Figure 1]c showed no evidence of local recurrence. | Figure 1: (a) Computerized tomography (CT) revealed an isodense mass with partial erosion of the outer table of the right parietal bone (b) strong immunoreactivity for smooth muscle actin (×100) (c) follow-up CT showed no evidence of local recurrence
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Leiomyomas are benign well-differential smooth-muscle tumors, and are characterized by positive immunoreactivity of SMA and vimentin. [1],[2] They commonly arise in uterus, gastrointestinal and urinary tracts, skin and mucous membranes. They may develop wherever the smooth muscle is present. However, it rarely occurs in the bone. Several cases of leiomyoma arising in the bone have been reported. [2] To the best of our knowledge, only one case of leiomyoma of skull vault has been reported in recent English language literatures. [1] Leiomyoma of the uterus is the most common, whereas leiomyoma of bone has been very rarely reported, which may be probably due to the paucity of smooth muscle in the bone. Enzinger and Weiss reported that 95% of 7748 leiomyomas occurred in the uterus, 3% in the skin, 0.9% in the gastrointestinal tract and the remainder distributing at other sites. The main clinical manifestation of intraosseous leiomyoma is nonspecific pain. [2] Our patient presented with painless progressive enlargement of the mass. Although leiomyoma is a benign tumor, it can metastasize to many sites of the body such as lung, skull base and spine. [3],[4] On the CT and magnetic resonance imaging images the leiomyoma appears to be well-defined, isodense and homogeneous. [1],[5] Leiomyoma of the skull should be differentiated from Langerhans' cell histiocytosis, fibrous dysplasia and infantile myofibromatosis. [6] Surgery is considered to be the first choice of the treatment for leiomyoma and long-term follow-up is strongly commended.
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