A critical review of “uterine leiomyoma” with subsequent recurrence or metastasis: A multicenter study of 62 cases

Sakiko Sanada, Kimio Ushijima, Hiroyuki Yanai, Yoshiki Mikami, Yoshihiro Ohishi, Hiroaki Kobayashi, Hironori Tashiro, Mikio Mikami, Shingo Miyamoto, Hidetaka Katabuchi

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: Histopathologic diagnosis of a subset of uterine smooth muscle tumors is challenging. We report a critical review regarding the clinicopathological point of view of 62 cases of subsequently recurred or metastasized leiomyoma. Methods: Medical records and glass slides of 62 cases of uterine smooth muscle tumor diagnosed as leiomyoma, which subsequently recurred or metastasized, were critically reviewed by pathologists specializing in gynecologic pathology and oncology. Results: In 47 (75.8%) of 62 cases, the diagnosis of leiomyoma was confirmed, including 11 intravascular leiomyomatosis (IVL) and benign metastasizing leiomyoma (BML). In 29 cases (46.8%) laparoscopic surgery was performed, of which morcellator without a bag was employed in 23 cases. Fifteen cases (24.2%) appeared to be underestimated and were re-classified as smooth muscle tumor of uncertain malignant potential (STUMP), leiomyosarcoma, or other malignant mesenchymal tumors. Recurrences in seven cases (11.3%) were interpreted to be a malignant transformation, and one STUMP recurred as STUMP. Conclusion: The recurrence or metastasis in cases of “leiomyoma” is attributed to iatrogenic or under-evaluation of primary tumors, although a subset of cases is a rare example of biological progression.

Original languageEnglish
JournalJournal of Obstetrics and Gynaecology Research
DOIs
Publication statusAccepted/In press - 2022

Keywords

  • leiomyoma of the uterus/adenomyosis
  • sarcoma/mesenchymal tumors of the uterus
  • surgery in GYN cancers

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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