MVP Immunohistochemistry is a Useful Adjunct in Distinguishing Leiomyosarcoma from Leiomyoma and Leiomyoma with Bizarre Nuclei
Morphologically, distinguishing between leiomyoma (LM) and leiomyosarcoma (LMS) is not always straightforward, especially with benign variants such as bizarre leiomyoma (BLM). To identify potential markers of malignancy in uterine smooth muscle tumors, proteomic studies were performed followed by assessment of protein expression by immunohistochemistry. Archival formalin-fixed paraffin-embedded (FFPE) tissues from tumors (n=23) diagnosed as LM, BLM and LMS (using published criteria) were selected for the study.
AbstractHereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome is a rare autosomal dominant disease caused by germline mutations in the fumarate hydratase (FH) gene. Affected individuals develop cutaneous and uterine leiomyomas and aggressive RCC. To date, only few publications described the frequency and morphology of FH-deficient uterine leiomyomas. We reviewed 22 cases collected over 8 years from routine and consultation files based on distinctive histological features. In addition, we screened 580 consecutive uterine leiomyomas from 484 patients, 23 extra-uterine and 8 uterine leiomyosarcomas, and 6 ...
This study aimed to evaluate the differences between uterine LMS and LM demonstrating intratumoral T1 HIA. METHODS: MR imaging was performed in 509 patients with 1,137 uterine smooth muscle tumors [14 LMSs, five smooth muscle tumors of uncertain malignant potential (STUMPs), and 1,118 LMs] which exceeded 3 cm in diameter. LM with red degeneration and lipoleiomyoma were excluded from the study. We retrospectively reviewed the images and assessed T1 HIA within tumors. RESULTS: T1 HIAs were observed in 11/14 (78.6%) LMSs, 0/5 (0%) STUMPs, and 15/1,118 (1.3%) LMs. T1 HIAs were more homogenous (53% vs 0%, p
(Abstracted from Hum Reprod 2017;32(10):2036–2041) Uterine tumors are a public health issue because of their prevalence in women and their connection to menstrual disorders, anemia, pelvis pain, pregnancy loss, and infertility. Treatment of symptomatic fibroids includes open myomectomy or hysterectomy, which have higher morbidity rates, longer hospital stays, and more disruption of daily life.
In this study we reviewed 119 USMT with a diagnosis of LMS, STUMP (smooth muscle tumor of uncertain malignant potential), ALM/LM-BN (atypical leiomyomas/leiomyoma with bizarre nuclei) and CLM (cellular leiomyoma) as well as 46 ULM and 60 myometrial controls.
CONCLUSIONS: The proportion of malignancy is low after using morcellation in patients who undergo laparoscopic myomectomy. Patients with fast-growing uterine fibroids and abnormal ultrasonic tumor blood flow should be considered for malignant potential, and morcellation should be avoided. PMID: 29133752 [PubMed - in process]
The objective of the present study is to determine the incidence of uterine leiomyosarcomas in our patient population, the rate of preoperative diagnosis of uterine leiomyosarcomas, and to evaluate the risk of unintended morcellation of leiomyosarcomas in our province.
Laparoscopic myomectomy and hysterectomy are standard procedures for myomas. To remove large myomas, power morcellation had been used. But recently, there are concerns upon tissue dissemination leading to complications like disseminated leiomyomatosis and unsuspected leiomyosarcoma. To combat morcellation related complications, there are other methods which include contained in bag power morcellation, in bag manual morcellation, minilaparotomy and tissue extraction with scalpel and vaginal morcellation using scalpel.
In conclusion, recommendations for the current practice of laparoscopic myomectomy and morcellation are reviewed.
Conclusion Surgeons’ thorough knowledge concerning this rare clinical condition is fundamental and crucial in order to establish a correct diagnosis and assert the appropriate treatment and the minimization of the probability of malignant transformation of LPD.
CONCLUSION: The histopathological diagnosis requires careful differentiation from lesions that have smooth muscle proliferation, especially leiomyosarcoma. The most commonly performed treatment is resection of the lesion with free margins. Although breast leiomyoma is rare, it should be considered among the differential diagnoses for breast nodules of benign appearance. Resection with safety margins proved to be the only treatment needed. PMID: 28977094 [PubMed - as supplied by publisher]