Late Recurring Uterine Smooth Muscle Tumors Constitute a Heterogeneous Collection of Leiomyosarcomas and STUMPs
E Veras, O Zivanovic, L Jacks, M Hensley, R Soslow. Memorial Sloan-Kettering Cancer Center, New York, NY
Background: Reliable pathologic predictors of clinical outcome have yet to be determined for uterine leiomyosarcoma (LMS). The literature suggests a correlation between tumor grade and clinical behavior. We studied the pathologic features of uterine smooth muscle tumors with late recurrences, a surrogate for clinically low grade behavior, in an attempt to learn which histologic features correlated with a protracted clinical course.
Design: The Murray Brennan Sarcoma Database and pathology records were reviewed to access STUMPs and LMSs with recurrence and long disease-free intervals, defined as recurrence ≥ 5 years of diagnosis. Stanford diagnostic criteria were used.
Results: 21 cases were retrieved from the database. Slides were available for review in only 9 cases, only 5 of which were LMSs. The cases from the sarcoma database represented approximately 3% of all LMSs.
|Initial Diagnosis||Mitosis / 10 HPFs||Cytologic Atypia / Necrosis||Review Diagnosis (2009)||Size (cm)||Status||Time to Recurrence (Years)|
|Atypical cellular LM of uncertain malignant potential with epithelioid features||5||P (mild/diffuse) / A||Atypical LM||8||AWD||9.188|
|Atypical smooth muscle tumor||2||(moderate/diffuse) / A||ALMLRR||7||AWD||16.229|
|Infarcted smooth muscle tumor of uncertain malignant potential||2||P (mild/diffuse) / A||ALMLRR||15||AWD||13.103|
|LMS, low grade||8||P (mild/diffuse) / A||ALMLRR||10||AWD||9.798|
|LMS, high grade||>20||P (marked/diffuse) / P||LMS||5||AWD||5.486|
|LMS, low grade||12 (including atypical)||P (marked/diffuse) / P||LMS||N/A||AWD||7.978|
|LMS, high grade||11||P (marked/diffuse) / P||LMS with epithelioid features||20||AWD||6.822|
|LMS||7||P (marked/diffuse) / P||LMS||8||DOD||5.092|
|LMS arising in LM||28||P (marked/diffuse) / P||LMS||8||DOD||5.905|