Leiomyosarcoma of the uterus

Abstract

Histologic material from 153 cases of uterine tumors with prior diagnosis or suspicion of sarcoma was reviewed. On the basis of cellularity, pleomorphism, and mitotic counts, 81 smooth muscle tumors were divided into 32 leiomyosarcomas, 31 cellular leiomyomas, 17 bizarre leiomyomas, and one intravascular leiomyoma. Only one case among the 153 was lost to follow‐up. The average yearly instance rate for leiomyosarcoma was 0.67 per 100,000 women 20 years old and older. The incidence was significantly higher in Negroes than in Caucasians. The 5‐year survival rate was 20.7%; however, three of the six 5‐year survivors subsequently died of disease, and one is living with disease. Mitotic counts accurately separate leiomyosarcoma from cellular leiomyoma. No patient with fewer than five mitoses per 10 high‐power field died of disease. The average length of follow‐up was 12 years. In spite of the alarming histologic and cytologic features of bizarre leiomyomas no patient died of disease. Follow‐up averaged 11.2 years.

The Prognostic Significance of ‘Stage, Tumor Size, Cellular Atypia and DNA Ploidy in Uterine Leiomyosarcoma

“…Among the cellular parameters only the cellular atypia gave significant independent prognostic information. The mitotic count is by many authors reported to give the best prediction of outcome in patients with uterine leiomyosarcoma (7,(9)(10)(11)(12). In our study, patients with tumors with a mitotic count above 10 per 10 HPF had a relative hazard of about 2.5 in univariate analysis, but this difference was not statistically significant, probably due to the small number of patients with less than 10 mitoses.…”

Pedunculated Sub-Serous Leiomyosarcoma Mimicking Ovarian Cancer: Case Report and Review of Literature

“…It represents 1.3% of all uterine malignancies and about 25% of uterine sarcomas [7][8][9]. Distinguishing between a uterine leiomyoma and a leiomyosarcoma continues to be difficult because the presenting symptoms of a benign leiomyoma closely resemble those of leiomyosarcoma.…”

Sarcomes utérins: à propos de 5 cas et revue de la littérature

“…Notre étude retrouve ces données habituelles avec une moyenne d'âge de 47 ans (37,60 ans). Il s'agit d'une tumeur rare : -incidence annuelle 0,67/100 000 [2], -1,3 % des cancers utérins dans leur ensemble, -le léiomyosarcome du col est plus fréquent que les atteintes du corps de l'utérus.…”

“…Des antécédents d'irradiation préalable sont parfois retrouvés [2,9,10], ils représentent 4,7 % des cas de la littérature ancienne [19].…”