Uterine Leiomyosarcoma

Carmen, Marcela G. del

doi:10.1002/9781118655344.ch15

Cited by 3 publications

(3 citation statements)

References 83 publications

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“…Two rare variants of leiomyosarcomas, epithelioid and myxoid leiomyosarcoma, can be difficult to diagnose, as their pathologic and diagnostic features are different from those of usual spindle cell leiomyosarcomas. [ 7 ] The diagnosis of epithelioid leiomyosarcoma requires the presence of predominantly epithelioid morphology with a round-to-polygonal cell with eosinophilic cytoplasm and round-to-ovoid nuclei comprising most (≥50%) of the tumor cells. In both these subtypes of leiomyosarcomas, nuclear atypia is mild and the mitotic rate is usually <3 mitotic figures/10 HPF.…”

Section: Discussionmentioning

confidence: 99%

Epithelioid Leiomyosarcoma of the Uterus and the Diagnostic Challenge in Diagnosing it on Small Biopsy

Aden

Zaheer²,

Singh³

et al. 2022

Journal of Mid-Life Health

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Epithelioid leiomyosarcoma of the uterus is a rare soft-tissue tumor of the pelvis with <1% cases. It can be asymptomatic or can reach an enormous size, resulting in chronic pelvic pain, postmenopausal bleeding, or may cause bowel and bladder dysfunction. The diagnostic dilemma arises especially when they have epithelioid morphology. This case is being presented because of its rare incidence along with the diagnostic dilemma it presented due to epithelioid morphology which is a very rare presentation, especially challenging on small biopsies. This case also highlights the usefulness of immunohistochemical markers, such as WT1, p53, and p16, which has important diagnostic as well as prognostic values in rare variants of usual tumors. Leiomyosarcoma per se is a highly aggressive tumor, therefore, timely diagnosis and management are advised.

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Section: Discussionmentioning

confidence: 99%

Epithelioid Leiomyosarcoma of the Uterus and the Diagnostic Challenge in Diagnosing it on Small Biopsy

Aden

Zaheer²,

Singh³

et al. 2022

Journal of Mid-Life Health

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“…Uterine sarcomas represent approximately 3–7 percent of uterine cancers (15;16). Leiomyosarcomas are the most common histological variation of these, accounting for a total of 1–2 percent of uterine malignancies (15). Annual incidence is estimated to range from 0.5 to 7 in 100,000 women (15;17–20).…”

mentioning

confidence: 99%

“…Leiomyosarcomas are the most common histological variation of these, accounting for a total of 1–2 percent of uterine malignancies (15). Annual incidence is estimated to range from 0.5 to 7 in 100,000 women (15;17–20). The great majority of leiomyosarcomas are believed to arise de novo from the uterine myometrium or connective tissue surrounding the uterine vasculature, and very rarely, from pre-existing fibroids (18;21–25).…”

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confidence: 99%

Preoperative Magnetic Resonance Imaging Diagnostic Features of Uterine Leiomyosarcomas: A Systematic Review

Kaganov¹,

Ades

Fraser³

2018

Int J Technol Assess Health Care

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Multiparametric MR evaluation of uterine leiomyosarcoma and STUMP versus leiomyoma in symptomatic women planned for high frequency focussed ultrasound: accuracy of imaging parameters and interobserver agreement for identification of malignancy

Aminzadeh

Alibrahim

Dobrotwir

et al. 2021

The British Journal of Radiology

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Objective: To assess accuracy of and interobserver agreement on multiparametric MR findings to distinguish uterine leiomyoma (LM) from uterine leiomyosarcoma (LMS) and soft tissue tumour of unknown malignant potential. Methods: Inclusion criteria: All females over 18 years with least one uterine mass measuring 5 cm or more in at least one of the three standard orthogonal dimensions on MR with histopathological confirmation of LM, LMS, or soft tissue tumour of unknown malignant potential (STUMP) in the 3 months following MR. Patients with LMS were drawn from a larger cohort being assessed for MR-guided focussed ultrasound (MRgFUS) suitability. Image evaluation: Assessed variables were: lesion margin, margin definition, T2 signal homogeneity, >50% of lesion with T2 signal brighter than myometrium, haemorrhage, restricted diffusion, contrast enhancement (CE), CE pattern, local lymphadenopathy and ascites. Results: 32 LM, 10 LMS and 1 STUMP were evaluated. Ill-defined (p-value = 0.0003–0.0004) or irregular (p = 0.003–0.004) lesion margin, T2 hyperintensity >50% (p = 0.001–0.004), and peripheral CE (p = 0.02–0.05) were significantly more common in LMS/STUMP than LM for both radiologists. 10/11 (Reader 2) and 11/11 (Reader 1) LMS/STUMP displayed restricted diffusion but so did 63–80% of LM. Agreement was greatest for margin characteristics (κ = 0.73–0.81). Conclusion: Irregular/ill-defined lesion margin best distinguished LMS/STUMP from LM with good interrater reliability. Advances in knowledge: Assessment of agreement regarding MR parameters distinguishing LM from LMS and STUMP has not previously been undertaken in a cohort including a large number of patients with LMS. This will help inform evaluation of females considering minimally invasive LM treatment.

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Uterine Leiomyosarcoma

Cited by 3 publications

References 83 publications

Epithelioid Leiomyosarcoma of the Uterus and the Diagnostic Challenge in Diagnosing it on Small Biopsy

Epithelioid Leiomyosarcoma of the Uterus and the Diagnostic Challenge in Diagnosing it on Small Biopsy

Preoperative Magnetic Resonance Imaging Diagnostic Features of Uterine Leiomyosarcomas: A Systematic Review

Multiparametric MR evaluation of uterine leiomyosarcoma and STUMP versus leiomyoma in symptomatic women planned for high frequency focussed ultrasound: accuracy of imaging parameters and interobserver agreement for identification of malignancy

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