Smooth Muscle Tumors of the Visceral Adnexal and Uterine Ligaments and Adnexal Connective Tissue: A Clinicopathologic Study of 67 Cases

The endopelvic fascia is a biomechanical network of supportive tissue that suspends and secures the female reproductive organs to the pelvic sidewall. Several visceral adnexal and uterine ligaments are part of this framework, and we have observed that smooth muscle tumors (SMTs) arising from these structures morphologically resemble gynecologic smooth muscle neoplasms. To determine whether gynecologic smooth muscle tumor criteria for malignancy are valid in these tumors, we evaluated the morphologic features of 67 tumors from 67 patients and correlated our findings with patient outcome. Using current uterine SMT WHO definitions, 57 tumors (85%) were classified as leiomyoma, 2 (3%) as smooth muscle tumor of uncertain malignant potential (STUMP), and 8 (12%) as leiomyosarcoma. Clinical follow-up was available for 88% of patients (range: 1–296 mo, mean: 174 mo, median: 79 mo). Only 1 case of leiomyosarcoma had metastasis at time of presentation, but 6 of 8 (75%) patients eventually died of disease. The other 2 cases of leiomyosarcoma that have not recurred are 11 and 16 mo from initial diagnosis. No cases of STUMP or leiomyoma recurred. On the basis of morphologic features and patient outcome, we believe these tumors distribute into similar categories of leiomyoma, STUMP and leiomyosarcoma, paralleling the biologic potential of uterine SMTs as well as SMTs of other gynecologic sites. We propose use of uterine WHO SMT criteria to classify spindle...
Source: International Journal of Gynecological Pathology - Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

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Uterine smooth muscle tumors are the most common gynecological tumors, with an incidence ranging from 5.4% to 77.0%, depending on the diagnostic method. Histopathology represents the gold standard for diagnosis confirmation. Most of these tumors are benign (leiomyomas) but, rarely, they can be malignant (leiomyosarcomas) leading to adverse clinical outcomes and poor long-term prognosis. Since the majority of women have asymptomatic lesions, the real incidence of leiomyoma is not known. However, based on post-mortem examination, a 50% prevalence has been reported[1].
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Source Type: research
CONCLUSIONS STMN1 and MKI67 were upregulated in uterine leiomyosarcoma and act as potential biomarkers for uterine leiomyosarcoma diagnosis. PMID: 32425177 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
1192Objectives: 1. Highlight the indications of PET imaging in BML. 2. Evaluate the characteristics of MRI in BML. 3. How to analyze and integrate the two imaging methods to make a correct diagnosis of BML. Abstract: Benign metastasizing leiomyoma (BML) is a rare disease entity that usually occurs in females of reproductive age with a prior history of uterine leiomyoma. Patients are usually asymptomatic and the tumors tend to grow gradually. 18FFDG PET/CT is useful for distinguishing malignant leiomyosarcoma from benign leiomyoma. The metabolic behavior of most BML cases in 18FFDG PET/CT is lacking/low uptake, and only a f...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Oncology Poster Session (Educational Exhbits) Source Type: research
Conclusions: The prognosis of STUMP was favorable and tumors with more than 10 mitoses per 10 high power field should be monitored closely. The surgical procedure was not an independent risk factor of recurrence, and myomectomy may be an acceptable option for patients wishing to preserve fertility.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: There are limited data on the effectiveness and safety of in-bag morcellation at the time of laparoscopic myomectomy compared to uncontained power morcellation. We were unable to determine the effects of in-bag morcellation on intraoperative complications as no events were reported in either group. We are uncertain if in-bag morcellation improves total operative time or ease of morcellation compared to control. Regarding morcellation operative time, the quality of the evidence was also very low and we cannot be certain of the effect of in-bag morcellation compared to uncontained morcellation. No cases of posto...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Abstract“Benign” metastatic leiomyomas (BML) are indolently growing metastatic tumors which mostly associate with uterine leiomyomas in women in reproductive ages. The reason to define these lesions as “benign” despite metastasis is their pathological features with low mitotic counts, lack of or min imal nuclear atypia, pseudocyst formation, and coagulative necrosis unlike leiomyosarcomas. Despite lack of pathological malignant features, they may cause significant morbidity and even mortality. Here, we describe a BML case with metastases to vertebrae and skull bones. Vertebral and skull metasta ses ...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research
ConclusionScrotal leiomyoma is a rare benign mesenchymal tumor of the middle-aged men. The current report describes the clinical and histopathological characteristics to help reduce erroneous diagnoses of this rare tumor.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
THE MEDICAL DEVICE APPLIED TO UTERINE FIBROIDS MORCELLATION: ANALYSIS OF CRITICAL BIOLOGICAL ISSUES AND DRAWBACKS FROM A MEDICAL-LEGAL PROSPECTIVE. Curr Pharm Des. 2020 Feb 03;: Authors: Ospan A M, Michael S, Antonio M, Radmila S, Enrico M, Simona Z, Andrea T Abstract Following the FDA safety communication of 2014 increasing attention has been to the treatment of uterine fibroids, due to the suspicion of a potential leiomyosarcoma (ULM). FDA banned the use of power morcellation in US, since this technique is likely to spread malignant cells from an unsuspected ULM. We criticized the medical legal cons...
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
, Zombori T Abstract Pulmonary arterial intimal sarcoma is a rare tumour with high mortality. Due to its localisation, the symptoms can mimic pulmonary thromboembolism and pneumonia, therefore assessing the diagnosis and choosing the adequate therapy is never easy. Its therapy mainly consists of surgery combined with radiochemotherapy. A 46-year-old male patient with testicular seminoma, pulmonary embolism, bronchial asthma and pollen allergy in his history had a follow-up thoracic CT. On the left side of the lung, a pleura-infiltrating 7-8 cm lesion, which occluded the pulmonary artery, was described. The first b...
Source: Orvosi Hetilap - Category: General Medicine Authors: Tags: Orv Hetil Source Type: research
Conditions:   Leiomyoma;   Leiomyosarcoma Intervention:   Procedure: Biopsy and peripheral blood collection Sponsor:   Igenomix Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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