Leiomyosarcoma of the Uterus: A Clinicopathologic Multicenter Study of 71 Cases

Mayerhofer, Klaus; Obermair, Andreas; Windbichler, Gudrun; Petru, Edgar; Kaider, Alexandra; Hefler, Lukas; Czerwenka, K.; Leodolter, Sepp; Kainz, Christian

doi:10.1006/gyno.1999.5436

Cited by 161 publications

(117 citation statements)

References 19 publications

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“…20,21 They occur in the fifth and sixth decades of life presenting with symptoms like dysfunctional uterine bleeding and pelvic pain. 22,23 Uterine leiomyosarcomas are aggressive tumors with a tendency to recur locally and metastasize mainly to the lung and liver. The 5-year survival rate varies between 45 and 60%.…”

Section: Introductionmentioning

confidence: 99%

“…The 5-year survival rate varies between 45 and 60%. [22][23][24][25] Despite a number of molecular studies, the pathogenesis of uterine smooth muscle neoplasms needs further exploration, and reliable biomarkers to clearly separate diagnostically challenging cases are missing. Therefore, assessment of malignancy in uterine smooth muscle neoplasms is based on a landmark study by Bell et al 3 using purely morphologic criteria.…”

Section: Introductionmentioning

confidence: 99%

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Exploring chromosomal abnormalities and genetic changes in uterine smooth muscle tumors

et al. 2016

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Smooth muscle tumors of the uterus are a diagnostically challenging group of tumors. Molecular surrogate markers reliably distinguishing between benign and malignant tumors are not available. Therefore, the diagnosis is based on morphologic criteria. The aim was to investigate a well-characterized group of challenging uterine smooth muscle tumors consisting of 20 leiomyomas, 13 leiomyomas with bizarre nuclei, and 14 leiomyosarcomas for copy number alterations, MED12 mutations and FH deletions to search for potential diagnostically useful surrogate markers. MED12 mutations were detected in 47, 15, and 25% of leiomyomas, leiomyomas with bizarre nuclei and leiomyosarcomas, respectively. MED12 mutations in leiomyomas with bizarre nuclei were detected outside the hotspot region. FH-deletions were seen in 27, 30.8, and 25% of leiomyomas, leiomyomas with bizarre nuclei and leiomyosarcomas, respectively. By using copy number alteration profiling a clear separation of leiomyomas, leiomyomas with bizarre nuclei and leiomyosarcomas could not be observed. Copy number alterations revealed clear genetic similarities between leiomyomas with bizarre nuclei and leiomyosarcomas. Leiomyosarcomas showed a similar pattern of gains and losses as leiomyomas with bizarre nuclei, with additional copy number alterations and more homozygous losses and high-level amplifications compared to leiomyomas with bizarre nuclei. In conclusion, this study demonstrates that known FH-deletions, a recurrent molecular change in leiomyomas, occur in morphologically challenging variants of leiomyomas, leiomyomas with bizarre nuclei and leiomyosarcomas. Although MED12 mutations are common in leiomyomas, they infrequently occur in leiomyomas with bizarre nuclei and leiomyosarcomas. The genetic similarities between leiomyomas with bizarre nuclei and leiomyosarcomas raise the intriguing possibility that uterine leiomyomas with bizarre nuclei and leiomyosarcomas are closely related and challenge the traditional concept that leiomyoma with bizarre nuclei is a tumor with just marked 'degenerative' cellular changes. These findings support the hypothesis that tumor progression within uterine smooth muscle tumors might occur.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring chromosomal abnormalities and genetic changes in uterine smooth muscle tumors

et al. 2016

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“…stained sections for diagnosis of a neoplasm has also been discussed (Layfield et al, 2000). In particular, studies dealing with mitosis, atypia and the prognostic parameters of leiomyosarcoma have been done between 1935(Mayerhofer et al,1999. However, the difficulties in determining the mitotic figure at different microscopic magnifications also affect the diagnosis of a tumor.…”

Section: Discussionmentioning

confidence: 99%

“…Necrosis, differentiation degree, vascular invasion, and morphology of adjacent tissues were also included in mitosis and atypia criteria. But all these parameters could not be met each time because of the difficulties in getting all of them in each inspected area (Mayerhofer et al, 1999). In recent years, technological inventions, new image analysis systems and stereological methods offer a new reliable and accurate approach to the subjective criteria for tumor diagnosis.…”

Section: Discussionmentioning

confidence: 99%

A New Approach For Dıagnosıs Of Leıomyoma And Leıomyosarcoma: A Stereologıcal Study

ŞAHİN¹,

Gündoğdu²,

ÜNAL³

et al. 2009

jecm

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Leiomyoma is a common benign tumor of the genital system; diseases and other types of smooth muscle tumors in females is called leiomyosarcoma. The diagnosis of these tumors is based on differentiation of the degree of cellularity and cytological atypia, presence of necrosis and particularly the mitotic index. A treatment procedure is proposed regarding to the diagnosis of leiomyoma and leiomyosarcoma. There is no exact agreement on diagnosis of these tumors and the available methods are biased and dependent on the judgment of the observers. Our aim is to evaluate the leiomyoma and leiomyosarcoma type of tumors using design-based stereological methods. The number of cells showing mitosis within a reference volume was determined to diagnose the type of tumor as leiomyoma or leiomyosarcoma. Numerical density of mitotic figures was 8000-9000/mm³ for leiomyoma, 10.000-11.000/ mm3 for leiomyoma with high mitotic activity, and 30.000-31.000/mm³ for leiomyosarcoma. The difference between leiomyoma and leiomyosarcoma was significant (p<0.001). These results show that the proposed method of providing the numerical density of mitosis for the diagnosis of leiomyosarcoma is unbiased, objective, and reliable. Moreover the method is more effective and easier to use than a morphometric method.

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“…Combining size tumor with the mitotic index, led to the classification of patients into three risk groups: low risk group (tumor size less than 100 mm and less than 10 mitoses / 10 high-resolution fields), medium-risk group (whether the tumor is larger than 100 mm, and no more than 10 mitoses / 10 fields) -risk of death 1.9 times higher, and high-risk group (tumor greater than 100 mm or a high index of mitosis) -risk of death by 5.3 times higher. (3,11,12) …”

Section: Uterine Leiomyosarcomasmentioning

confidence: 99%

Uterine Sarcomas - Current Therapeutic Options

Bacalbaşa¹,

Traistaru²,

Bălescu³

2014

JTMR

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Uterine sarcomas are rare but very aggressive uterine malignancies originating from mesenchymal elements of the uterine wall. They are classified by the "Gynecologic Oncology Group" in nonepithelial neoplasms and mixed epithelial-nonepithelial tumors, each category presenting different features and prognostic factors. In this review we present the main characteristics and the current therapeutic options for each type of primary uterine sarcoma and for their recurrences.

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Leiomyosarcoma of the Uterus: A Clinicopathologic Multicenter Study of 71 Cases

Cited by 161 publications

References 19 publications

Exploring chromosomal abnormalities and genetic changes in uterine smooth muscle tumors

Exploring chromosomal abnormalities and genetic changes in uterine smooth muscle tumors

A New Approach For Dıagnosıs Of Leıomyoma And Leıomyosarcoma: A Stereologıcal Study

Uterine Sarcomas - Current Therapeutic Options

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