Malignant Transformation of Leiomyoma of Uterus to Leiomyosarcoma with Metastasis to Ovary

Bharambe, Bhavana M; Deshpande, Kalpana A.; Surase, Sanjay; Ajmera, Alkesh P.

doi:10.1007/s13224-012-0202-4

Cited by 20 publications

(15 citation statements)

References 3 publications

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“…There were significant relationship between estrogen and progesterone in intramural localization group. Rarely, leiomyoma can transform to leiomyosarcoma [16]. In their study, Bükülmez and Doody showed that 27 % of women have problems with fertility and they expressed that this is related with leiomyoma localization [17].…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Estrogen, Progesterone, and GCDFP-15 Expression in Uterine Leiomyomas

Erdem

Başar

Kadıoğlu

et al. 2014

J Obstet Gynecol India

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Approximately, one fourth of women have leiomyomas. Leiomyomas are benign tumors that originated from smooth muscle cells. Estrogen is claimed to relate as a cause but exact mechanism has not fully understood. In this study, 95 leiomyoma cases that have been diagnosed by our department in years between 2010 and 2012 were examined. Age ranges of patients, sizes, locations, and numbers of leiomyomas were identified. Immunohistochemically ER (estrogen), PR (progesterone), and Gross cystic disease fluid protein-15 stains were performed to the paraffin blocks and their percentages of staining were noted. Statistically, submucosal and intramural locations were significantly related to ER and PR (p \ 0,001). There were significant relationship between ER and PR in 30-50 years age group (p \ 0,001). There were significant relationship between ER, PR and locations (p \ 0,001), numbers (p \ 0,001), sizes of leiomyomas (below 5 cm; p \ 0,001), (between 5 and 10 cm; p = 0,037), larger than 10 cm; p = 0,002). Consequently, relationship between leiomyoma and ER, PR were revealed in this study. Also, relationship between leiomyoma locations and patient ages were identified statistically. There was no immunoreactivity with GCDFP-15 in leiomyomas.

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Section: Discussionmentioning

confidence: 98%

Evaluation of Estrogen, Progesterone, and GCDFP-15 Expression in Uterine Leiomyomas

Erdem

Başar

Kadıoğlu

et al. 2014

J Obstet Gynecol India

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“…Smooth muscle tumors can occur in soft tissues throughout the body; for example, benign and malignant Alive (18) uterine smooth muscle tumors, which can be precisely classified by multiple methods [5,12]. Rare cases of malignant uterine leiomyomas have been reported, such as benign metastasizing leiomyoma, malignant transformation to leiomyosarcoma, and malignant transformation of benign metastasizing leiomyoma [12][13][14][15][16][17][18][19]. According to several reports, malignant transformation of fibroids among uterine leiomyoma carriers may occur at an incidence rate of 0.23%, even in relatively small lesions [13,15].…”

Section: Discussionmentioning

confidence: 99%

Leiomyosarcoma of the transverse colon with lymph node metastasis and malignant transformation: a case report

et al. 2020

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Background The concept of GIST was established in 1998, clearly differentiating between gastrointestinal leiomyosarcoma and GISTs among gastrointestinal mesenchymal tumors. Lymph node metastasis is extremely rare in true gastrointestinal leiomyosarcoma, and there are no reports of malignant transformation from leiomyoma. Case presentation The patient was an old woman who had undergone endoscopic mucosal resection for an Is polyp on the left side of the transverse colon at the age of 73. She was diagnosed with leiomyoma with positive surgical margins. Subsequently, she presented to our institution with a sensation of pressure in the upper abdominal region as a chief complaint at the age of 76 years. Abdominal computed tomography and colorectal endoscopy showed a tumor lesion with invagination of the intestines in the transverse colon, the same site as that of the previously resected leiomyoma. A biopsy suggested a smooth muscle tumor, and we performed partial left transverse colectomy and lymph node dissection under a diagnosis of recurrence and enlargement of the previously incompletely resected leiomyoma. Histopathological examination revealed spindle-shaped tumor cells, and the mitotic activity was 30–40/10 high-power field. Tumor cells were immunohistologically positive for α-smooth muscle actin and h-caldesmon; partially positive for desmin; negative for c-kit, CD34, DOG-1, and the S-100 protein; and showed a Ki-67 labeling index of 70–80%. She was diagnosed with leiomyosarcoma malignantly transformed from leiomyoma. Metastasis was found in 1 of the 14 resected lymph nodes. The patient did not undergo adjuvant chemotherapy, but has survived with no recurrence at 2 years after the surgery. Conclusions We have reported a case of leiomyosarcoma of the transverse colon with lymph node metastasis that was malignantly transformed from a leiomyoma.

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“…Unexplained pain and atypical vaginal bleeding in the presence of uterine leiomyoma along with a rapid increase in the leiomyoma's size can serve as warnings with regards to leiomyosarcoma [7,23]. As vaginal bleeding independently can be observed in submucosal myomas of any additional pathology and pain can also occur following a possible degeneration in the myomas, these two symptoms -vaginal bleeding and pain -have rather low value in preoperative differential diagnosis [24,25]. Parker et al have also reported that a rapid increase in the size of the uterus cannot be used in distinguishing leiomyosarcomas from leiomyomas [26].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of occult uterine leiomyosarcomas

et al. 2019

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Objectives:To determine the frequency of occult uterine leiomyosarcomas following hysterectomies and myomectomies performed for benign reasons at our clinic and to draw comparisons with similar studies in the literature. Material and methods:All hysterectomies and myomectomies that have been performed for benign reasons at our clinic between 2010 and 2017 were retrospectively examined via the hospital's information system and the patients that were found to have leiomyosarcomas were analysed. The incidence of occult uterine leiomyosarcoma per 1000 surgeries at our clinic was calculated using the Wilson score interval.Results: A total of 6,173 hysterectomies were performed, and occult uterine leiomyosarcoma was identified in 5 patients. The incidence of occult uterine leiomyosarcoma was calculated to be 0.08% (95% CI 0.03-0.018%). Only 1 of the 771 patients who underwent myomectomy was identified with occult uterine leiomyosarcoma, making its incidence in myomectomy 0.12% (95% CI 0.02-0.073%). When all the patients are considered, occult uterine leiomyosarcoma was identified in 6 of the 6,944 patients, and the general incidence of occult uterine leiomyosarcoma was calculated as 0.08% (95% CI 0.03-0.018%). Conclusions:In our study, the incidence of occult uterine sarcoma following myomectomy and hysterectomy was found to be lower than that reported in the literature. The reason for this lower incidence includes not only genetic causes and racial differences but also preoperative imaging, endometrial and cervical sampling that is performed on every patient.

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Malignant Transformation of Leiomyoma of Uterus to Leiomyosarcoma with Metastasis to Ovary

Cited by 20 publications

References 3 publications

Evaluation of Estrogen, Progesterone, and GCDFP-15 Expression in Uterine Leiomyomas

Evaluation of Estrogen, Progesterone, and GCDFP-15 Expression in Uterine Leiomyomas

Leiomyosarcoma of the transverse colon with lymph node metastasis and malignant transformation: a case report

Evaluation of occult uterine leiomyosarcomas

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