Re-thinking uterine fibroids in immunocompromised patients: adenomatoid tumors

Abstract

Abstract Background Adenomatoid tumor (AT) is an ambiguous term used to describe benign mesothelial neoplasms, most often reported in organs of the reproductive system. Their neoplastic nature has been proven through the confirmation of pathogenic mutations in TRAF7. Several studies have proven an association between AToU and immunosuppression. Several groups have hypothesized immunosuppression causes an abnormal inflammatory state within mesothelial cells, increasing the likelihood of a selective activating mutations in TRAF7. Case presentation A 34 year old female patient with a history of systemic lupus erythematosus was seen in the Emergency Department due to abdominal pain. A diagnosis of uterine leiomyomatosis was made and she was surgically intervened. Macroscopically, several intramural and subserosal uterine nodules were identified. On microscopic examination, all of them except one corresponded to adenomatoid tumours. A somatic mutation in TRAF7 was identified. Conclusions Adenomatoid tumors have been associated with immunosuppression. A decrease in immunosurveillance may explain the association between adenomatoid tumours and immunosuppression. Confirming their neoplastic nature is crucial. Further studies are required to characterize the biological significance TRAF7 has in adenomatoid tumours and their association to immunocompromised states.

Keywords

• Adenomatoid tumor
• Uterus
• TRAF7
• Immunosuppression