Torsion of Angioleiomyoma in the Female Genital Tract: A Rare Report of Two Cases.

Background: Angioleiomyoma (ALM) is a rare, benign tumor involving the peripheral soft tissues. Preoperative diagnosis of ALM is challenging, since there are no characteristic clinical or imaging findings. The objective of this article is to present two rare cases of ALM with torsion involving the female genital tract and review published similar cases. Case Presentation: We report two cases of ALM with torsion originating from the uterus and mesosalpinx, respectively. The two cases presented with abdominal dull pain or a palpable abdominal mass, and imaging findings revealed a large cystic mass, which was suspected to be an ovarian neoplasm. During the surgical procedure, it was found that the mass had undergone torsion. The final histological and immunohistochemical reports of the resected masses validate the diagnosis of ALM. Conclusion: To our knowledge, this is the first report of torsion of ALM originating from the female genital tract. ALM poses a significant diagnostic challenge in cases of a pelvic cystic mass with torsion, as it is frequently misdiagnosed as an ovarian tumor. Surgical excision of the mass while preserving the uterus and adnexa should be strongly recommended for young patients, as ALM has an excellent prognosis.