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Objectives To study the histomorphological features of variants of leiomyomas of myometrium in our institution from hysterectomy and myomectomy specimens. Methods In this prospective study, 1,845 hysterectomy and myomectomy specimens collected over a period of two years were studied. A detailed gross and microscopic examination of tumors of myometrium were made after fixing and staining the specimen with routine H&E. Results Neoplastic lesions of the myometrium were diagnosed in 441 (23.90%) of the total 1,845 specimens. Benign tumors were diagnosed in 440 cases, and all the benign tumors were leiomyomas except one case of adenomyoma. Leiomyoma was the most common tumor of the myometrium constituting 99.54%. Usual leiomyoma constituted for 95.45% and variants of leiomyomas were 4.55%. Malignant tumor of the myometrium was diagnosed in one hysterectomy specimen out of 1,845 specimens. Conclusion Variants of leiomyomas were relatively less, but it is important to differentiate them from malignant neoplasms of the myometrium, as they have good prognosis. Tumor size, nature of margin, presence or absence of vascular invasion, coagulative necrosis and cytological atypia are the most important histological features for differentiation.

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