Leiomyosarcoma in the female reproductive system:A clinicopathological analysis of 13 cases
Objective:Leiomyosarcoma(LMS)accounts for approximately 1%of all malignancies in the female reproductive system.Due to the relative rarity of this disease,it is currently not well understood.LMS is difficult to diagnose early,and pathological examination is the"gold standard"for diagnosis.This study aims to investigate the clinicopathological characteristics,diagnosis,and differential diagnosis of LMS in the female reproductive system.Methods:A total of 13 cases of LMS diagnosed between 2019 and 2023 at the Beijing Obstetrics and Gynecology Hospital were collected.The clinicopathological characteristics of these cases were retrospectively analyzed.Results:Patients ranged in age from 40 to 77 years.LMS occurred in the uterus in 10 cases,the mesosalpinx in 1 case,the pelvis in 1 case,and the vagina in 1 case.Gross examination showed tumor sizes ranging from 4 to 18 cm in diameter,with 1 case having fragmented tumor tissues.The remaining tumors appeared as large nodular masses with grayish-white or grayish-yellow,solid,smooth,and soft to medium textures,and some exhibited a typical fish-flesh appearance.Microscopically,3 cases were epithelioid LMS and 10 cases were classic LMS(spindle cell).Most tumors had densely packed cells with active mitotic figures.Immunophenotype analysis showed diffuse positivity for smooth muscle actin(SMA),Desmin,and h-caldesmon,while CD34,CD117,and anaplastic lymphoma kinase(ALK)were negative.The cell multiplication index Ki-67 ranged from 15%to 90%.Postoperative follow-up lasted from 1 to 32 months,with 5 cases experiencing local recurrence.Conclusion:LMS is the most common type of sarcoma in the female reproductive system,with nonspecific clinical manifestations.Imaging examination is important for preoperative diagnosis,and pathological diagnosis requires combining morphological features with immunophenotype.The primary treatment is complete surgical resection.LMS is highly aggressive,with high recurrence and metastasis rates,and has a poor prognosis.
万方数据
维普
