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| Leiomyosarcoma |
| Etiology •unknown •unassociated with unopposed estrogen |
| Pathogenesis •unknown, |
| Epidemiology •perimenopausal women (40-60 yrs) •1-2% of uterine corpus malignancies •may arise in preexisting leiomyoma or de novo |
| General Gross Description •neoplasms may massively involve myometrium of uterus or may fungate into the lumen •more fleshy, pink, and without the whorled appearance of the leiomyoma |
| General Microscopic Description •composed of spindle cells with blunt ended elongate nuclei and thin elongated cytoplasm •may exhibit minimal to extreme cytologic atypia with large, pleomorphic hyperchromatic nuclei •mitotic rate may be relatively low to extremely high •areas of necrosis may be present in high grade neoplasms •care must be taken in terming malignant a cytologically benign neoplasm with high mitotic rate |
| Clinical Correlation •may be asymptomatic or present with post-menopausal bleeding, abdominal enlargement or evidence of metastatic disease •prognosis related to extent of disease •metastasizes to lung via blood stream •treated by surgery +/- radiation •5 yr survival up to 40% |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1062-3 |
| Leiomyosarcoma |
| Synopsis by: Melinda Sanders M.D. (T85000M88903)[23] |
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