254 International Journal of Scientific Study | May 2015 | Vol 3 | Issue 2 A Unique Case of Appendicular Leiomyoma: Usual Lesion in an Unusual Site M N Gayathri 1 , S Geetha 2 , Prima Shuchita Lakra 2 , M Bharathi 3 , H B Shashidhar 4 1 Assitant Professor, Department of Pathology, Mysore Medical College and Research Institute, Mysore, Karnataka, India, 2 Post-graduate, Department of Pathology, Mysore Medical College and Research Institute, Mysore, Karnataka, India, 3 Professor and Head, Department of Pathology, Mysore Medical College and Research Institute, Mysore, Karnataka, India, 4 Associate Professor, Department of Pathology, Mysore Medical College and Research Institute, Mysore, Karnataka, India or accident. Underwent tubectomy 8 years back, with a menstrual history suggestive of perimenopause. On surgical examination, tender mass in the right iliac fossa was identified. The sonography revealed hemangioma in segment vii of liver measuring 1.7 cm diameter and non-compressible appendix, surrounded by a hypoechoic thickened wall more than 2 mm in diameter the clinical and radiological diagnosis of recurrent appendicitis with hemangioma of liver was made and the patient underwent appendicectomy. The gross pathologic examination revealed a 1.5 cm circumscribed lobulated gray tan mucoid mass arising within the body wall of the appendix, not involving the base or tip (Figure 1). Microscopically, the tumor was composed of fusiform cells with long processes and nuclei with blunted ends, interdigitate with those of the lamina muscularis propria (Figure 2). The mucosa had apparently suffered pressure atrophy to the extent shown in the illustration (Figure 3). On the basis of the characteristic morphologic findings, the diagnosis of appendicular leiomyoma was rendered. At the last follow-up, the patient was well. DISCUSSION Leiomyomas of the uterus are the most common benign tumors of smooth muscle origin, but they arise in any INTRODUCTION Most appendicular neoplasm in adults are carcinoid tumors. 1 Benign tumors including leiomyoma are extremely rare. Ultrasonography is a useful aid in the diagnosis of appendicitis. 2 but the sonographic appearance of appendicular leiomyoma is poorly documented and, therefore, it is impossible to diagnose it preoperatively. This is the reason most of the diagnosis is only established after the surgery. Growth and proliferation of smooth muscle tissue in women coincide with estrogenic stimulation. Children rarely develop these tumors. 3,4 Here, we present a rare case of typical appendicular leiomyoma in a 45-year-old female patient with hemangioma in the liver. CASE REPORT A 45-year-old female with the unremarkable past history presented in the surgery clinic for evaluation of the abdominal pain since 2 months. There was no history of trauma Case Report Abstract Appendicular leiomyoma is a rare entity described in 1977. Herein, we present a case of leiomyoma of the appendix in a 45-year- old female who presented with pain in the lower abdomen of 2 months duration. She was diagnosed as recurrent appendicitis based on the physical examination and ultrasonography. The pathological findings showed uni-lobular proliferation of fusiform cells, arranged in net - like sheets or swirls, in a hyaline background with edematous stroma. To our knowledge, there are only 3 cases of appendicular leiomyomas reported in the literature. Although it is a rare tumor, surgeons and pathologists should be aware of it. Key words: Appendix, Benign appendicular, Leiomyoma Access this article online www.ijss-sn.com Month of Submission : 03-2015 Month of Peer Review : 04-2015 Month of Acceptance : 04-2015 Month of Publishing : 05-2015 Corresponding Author: Dr. Gayathri MN, Department of Pathology, Mysore Medical College and Research Institute, Mysore, Karnataka, India. Phone: +91-9945629613. E-mail: drgayathri1967@gmail.com DOI: 10.17354/ijss/2015/255