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Research Article| Volume 15, ISSUE 3, P545-573, September 1995

Myometrial and Stromal Lesions of the Uterus

  • J. Samuel Smoot
    Affiliations
    From the Department of Pathology, University of California, San Francisco, San Francisco, California
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  • Charles Zaloudek
    Correspondence
    Address reprint requests to Charles Zaloudek, MD Department of Pathology, Box 0102 University of California, San Francisco 505 Parnassus Avenue, M563 San Francisco, CA 94143-0506
    Affiliations
    From the Department of Pathology, University of California, San Francisco, San Francisco, California
    Search for articles by this author
DOI:https://doi.org/10.1016/S0272-2712(18)30318-4
Myometrial and Stromal Lesions of the Uterus
Previous ArticleAdvances in Endometrial Pathology
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      This article is an overview of uterine neoplasms that demonstrate mesenchymal differentiation. Major clinical and pathologic features are described, with a focus on those lesions that cause diagnostic difficulty. Brief discussions on more recent observations made concerning these entities are also included.
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      References

        • Agarwal P.K.
        • Husain N.
        • Chandrawati
        Adenofibroma of uterus and endocervix.
        Histopathology. 1991; 18: 79-80
        • Andrade LALA
        • Derchain SFM
        • Vial J.S.
        • et al.
        Müllerian adenosarcoma of the uterus in adolescents.
        Int J Gynecol Obstet. 1992; 38: 119-123
        • August C.Z.
        • Bauer K.D.
        • Lurain J.
        • et al.
        Neoplasms of endometrial stroma: histopathologic and flow cytometric analysis with clinical correlation.
        Hum Pathol. 1989; 20: 232-237
        • Bell S.W.
        • Kempson R.L.
        • Hendrickson M.R.
        Problematic uterine smooth muscle neoplasms: A clinicopathologic study of 213 cases.
        Am J Surg Pathol. 1994; 18: 535-558
        • Berchuck A.
        • Rubin S.C.
        • Hoskins W.J.
        • et al.
        Treatment of endometrial stromal tumors.
        Gynecol Oncol. 1990; 36: 60-65
        • Bums B.
        • Curry R.H.
        • Bell MEA
        Morphologic features of prognostic significance in uterine smooth muscle tumors: A review of 84 cases.
        Am J Obstet Gynecol. 1979; 135: 109-114
        • Chang K.L.
        • Crabtree G.S.
        • Lim-Tan S.K.
        • et al.
        Primary uterine endometrial stromal neoplasms. A clinicopathologic study of 117 cases.
        Am J Surg Pathol. 1990; 14: 415-438
        • Chang K.L.
        • Crabtree G.S.
        • Lim-Tan S.K.
        • et al.
        Primary extrauterine endometrial stromal neoplasms: A clinicopathologic study of 20 cases and a review of the literature.
        Int J Gynecol Pathol. 1993; 12: 282-296
        • Christopherson W.M.
        • Williamson E.O.
        • Gray L.A.
        Leiomyosarcoma of the uterus.
        Cancer. 1972; 29: 1512-1517
        • Clement P.B.
        • Scully R.E.
        Uterine tumors resembling ovarian sex-cord tumors. A clinicopathologic analysis of 14 cases.
        Am J Clin Pathol. 1976; 66: 512-525
        • Clement P.B.
        • Scully R.E.
        Müllerian adenosarcomas of the uterus with sex cord-like elements. A clinicopathologic analysis of eight cases.
        Am J Clin Pathol. 1989; 91: 664-672
        • Clement P.B.
        • Scully R.E.
        Müllerian adenofibroma of the uterus with invasion of myometrium and pelvic veins.
        Int J Gynecol Pathol. 1990; 9: 363-371
        • Clement P.B.
        • Scully R.E.
        Müllerian adenosarcoma of the uterus: A clinicopathologic analysis of 100 cases with a review of the literature.
        Hum Pathol. 1990; 21: 363-381
        • Clement P.B.
        • Scully R.E.
        Endometrial stromal sarcomas of the uterus with extensive glandular differentiation: A report of three cases that caused problems in differential diagnosis.
        Int J Gynecol Pathol. 1992; 11: 163-173
        • Clement P.B.
        • Young R.H.
        • Scully R.E.
        Intravenous leiomyomatosis of the uterus. A clinicopathological analysis of 16 cases with unusual histologic features.
        Am J Surg Pathol. 1988; 12: 932-945
        • Cohen D.
        • Mazur M.T.
        • Jozefczyk M.A.
        • et al.
        Hyalinization and cellular changes in uterine leiomyomata after gonadotropin releasing hormone agonist therapy.
        J Reprod Med. 1994; 39: 377-380
        • Colgan T.J.
        • Pendergast S.
        • LeBlanc M.
        The histopathology of uterine leiomyomas following treatment with gonadotropin-releasing hormone analogues.
        Hum Pathol. 1993; 24: 1073-1077
        • Colombi R.P.
        Sarcomatoid carcinoma of the female genital tract (malignant mixed müllerian tumors).
        Semin Diagn Pathol. 1993; 10: 169-175
        • Costa M.J.
        • Khan R.
        • Judd R.
        Carcinosarcoma (malignant mixed müllerian [mesodermal] tumor) of the uterus and ovary. Correlation of clinical, pathologic, and immunohistochemical features in 29 cases.
        Arch Pathol Lab Med. 1991; 115: 583-590
        • el-Naggar A.K.
        • Abdul-Karim F.W.
        • Silva E.G.
        • et al.
        Uterine stromal neoplasms: a clinicopathologic and DNA flow cytometric correlation.
        Hum Pathol. 1991; 22: 897-903
        • Evans H.L.
        Endometrial stromal sarcoma and poorly differentiated endometrial sarcoma.
        Cancer. 1982; 50: 2170-2182
        • Evans H.L.
        • Chawla S.P.
        • Simpson C.
        • et al.
        Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases, with emphasis on diagnostic criteria and prognostic factors.
        Cancer. 1988; 62: 2239-2247
        • Fekete P.S.
        • Vellios F.
        The clinical and histologic spectrum of endometrial stromal neoplasms: A report of 41 cases.
        Int J Gynecol Pathol. 1984; 3: 198-212
        • Franquemont D.W.
        • Frierson Jr, H.F.
        • Mills S.E.
        An immunohistochemical study of normal endometrial stroma and endometrial stromal neoplasms. Evidence for smooth muscle differentiation.
        Am J Surg Pathol. 1991; 15: 861-870
        • George E.
        • Manivel J.C.
        • Dehner L.P.
        • et al.
        Malignant mixed miillerian tumors: An immunohistochemical study of 47 cases, with histogenetic considerations and clinical correlation.
        Hum Pathol. 1991; 22: 215-223
        • Gisser S.D.
        • Young I.
        Neurilemoma-like uterine myomas: An ultrastructural reaffirmation of their non-Schwannian nature.
        Am J Obstet Gynecol. 1977; 129: 389-392
        • Gutmann J.N.
        • Thornton K.L.
        • Diamond M.P.
        • et al.
        Evaluation of leuprolide acetate treatment on histopathology of uterine myomata.
        Fertil Steril. 1994; 61: 622-626
        • Hart W.R.
        • Billman Jr, J.K.
        A reassessment of uterine neoplasms originally diagnosed as leiomyosarcomas.
        Cancer. 1978; 41: 1902-1910
        • Kaku T.
        • Silverberg S.G.
        • Major F.J.
        • et al.
        Adenosarcoma of the uterus: A Gynecologic Oncology Group clinicopathologic study of 31 cases.
        Int J Gynecol Pathol. 1992; 11: 75-88
        • Kawaguchi K.
        • Fujii S.
        • Konishi I.
        • et al.
        Mitotic activity in uterine leiomyomas during the menstrual cycle.
        Am J Obstet Gynecol. 1989; 160: 637-641
        • King M.E.
        • Dickersin G.R.
        • Scully R.E.
        Myxoid leiomyosarcoma of the uterus: A report of six cases.
        Am J Surg Pathol. 1982; 6: 589-598
        • Larson B.
        • Silfversward C.
        • Nilsson B.
        • et al.
        Prognostic factors in uterine leiomyosarcoma. A clinical and histopathological study of 143 cases. The Radiumhemmet series 1936-1981.
        Acta Oncol. 1990; 29: 185-191
        • Leibsohn S.
        • d’Ablaing G.
        • Mischell Jr, D.R.
        • et al.
        Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas.
        Am J Obstet Gynecol. 1990; 162: 968-974
        • Lillemoe T.J.
        • Perrone T.
        • Norris H.J.
        • et al.
        Myogenous phenotype of epithelial-like areas in endometrial stromal sarcomas.
        Arch Pathol Lab Med. 1991; 115: 215-219
        • Macasaet M.A.
        • Waxman M.
        • Fruchter R.G.
        • et al.
        Prognostic factors in malignant mesodermal (miillerian) mixed tumors of the uterus.
        Gynecol Oncol. 1985; 20: 32-42
        • Mazur M.T.
        Atypical polypoid adenomyomas of the endometrium.
        Am J Surg Pathol. 1981; 5: 473-482
        • Mulvany N.J.
        • Slavin J.L.
        • Ostor A.G.
        • et al.
        Intravenous leiomyomatosis of the uterus: A clinicopathologic study of 22 cases.
        Int J Gynecol Pathol. 1994; 13: 1-9
        • Myles J.L.
        • Hart W.R.
        Apoplectic leiomyomas of the uterus. A clinicopathologic study of five distinctive hemorrhagic leiomyomas associated with oral contraceptive usage.
        Am J Surg Pathol. 1985; 9: 798-805
        • Nogales F.F.
        • Navarro N.
        • Martinez de Victoria J.M.
        • et al.
        Uterine intravascular leiomyomatosis: An update and report of seven cases.
        Int J Gynecol Pathol. 1987; 6: 331-339
        • Norris H.J.
        • Hilliard G.D.
        • Irey N.S.
        Hemorrhagic cellular leiomyomas (“apoplectic leiomyoma”) of the uterus associated with pregnancy and oral contraceptives.
        Int J Gynecol Pathol. 1988; 7: 212-224
        • Norris H.J.
        • Parmley T.
        Mesenchymal tumors of the uterus. V. Intravenous leiomyomatosis. A clinical and pathologic study of 14 cases.
        Cancer. 1975; 36: 2164-2178
        • Norris H.J.
        • Roth E.
        • Taylor H.B.
        Mesenchymal tumors of the uterus. II. A clinical and pathologic study of 31 mixed mesodermal tumors.
        Obstet Gynecol. 1966; 28: 57-63
        • Norris H.J.
        • Taylor H.B.
        Mesenchymal tumors of the uterus. III. A clinical and pathologic study of 31 carcinosarcomas.
        Cancer. 1966; 19: 1459-1465
        • Norris H.J.
        • Taylor H.B.
        Mesenchymal tumors of the uterus. I. A clinical and pathologic study of 53 endometrial stromal tumors.
        Cancer. 1966; 19: 755-766
        • O’Connor D.M.
        • Norris H.J.
        Mitotically active leiomyomas of the uterus.
        Hum Pathol. 1990; 21: 223-227
        • Ostor A.G.
        • Fortune D.W.
        Benign and low grade variants of mixed müllerian tumour of the uterus.
        Histopathology. 1980; 4: 369-382
        • Parker W.H.
        • Shi Fu Y.
        • Berek J.S.
        Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma.
        Obstet Gynecol. 1994; 83: 414-418
        • Perrone T.
        • Dehner L.P.
        Prognostically favorable “mitotically active” smooth-muscle tumors of the uterus. A clinicopathologic study of ten cases.
        Am J Surg Pathol. 1988; 12: 1-8
        • Piver M.S.
        • Rutledge F.N.
        • Copeland L.
        • et al.
        Uterine endolymphatic stromal myosis: A collaborative study.
        Obstet Gynecol. 1984; 64: 173-178
        • Prayson R.A.
        • Hart W.R.
        Mitotically active leiomyomas of the uterus.
        Am J Clin Pathol. 1992; 97: 14-20
        • Saksela E.
        • Lampinen V.
        • Precope B.J.
        Malignant mesenchymal tumors of the uterine corpus.
        Am J Obstet Gynecol. 1974; 120: 452-460
        • Schweizer W.
        • Demopoulos R.
        • Beller U.
        • et al.
        Prognostic factors for malignant mixed müllerian tumors of the uterus.
        Int J Gynecol Pathol. 1990; 9: 129-136

      53. Silverberg SG, Kurman RJ: Tumors of the Uterine Corpus and Gestational Trophoblastic Disease. Washington DC, Armed Forces Institute of Pathology, 1992

        • Silverberg S.G.
        • Major F.J.
        • Blessing J.A.
        • et al.
        Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus. A Gynecologic Oncology Group pathologic study of 203 cases.
        Int J Gynecol Pathol. 1990; 9: 1-19
        • Taina E.
        • Maenpäa J.
        • Erkkola R.
        • et al.
        Endometrial stromal sarcoma: A report of nine cases.
        Gynecol Oncol. 1989; 32: 156-162
        • Tavassoli F.A.
        • Norris H.J.
        Mesenchymal tumors of the uterus. VII. A clinicopathological study of 60 endometrial stromal nodules.
        Histopathology. 1981; 5: 1-10
        • Taylor H.B.
        • Norris H.J.
        Mesenchymal tumors of the uterus. TV. Diagnosis and prognosis of leiomyosarcoma.
        Arch Pathol. 1966; 82: 40-44
        • Thatcher S.S.
        • Woodruff J.D.
        Uterine stromatosis: A report of 33 cases.
        Obstet Gynecol. 1982; 59: 428-434
        • Tiltman A.J.
        The effect of progestins on the mitotic activity of uterine fibromyomas.
        Int J Gynecol Pathol. 1985; 4: 89-96
        • Upadhyaya N.B.
        • Doody M.C.
        • Googe P.B.
        Histopathological changes in leiomyomata treated with leuprolide acetate.
        Fertil Steril. 1990; 54: 811-814
        • Varela-Duran J.
        • Nochomovitz L.E.
        • Prem K.A.
        • et al.
        Postirradiation mixed müllerian tumors of the uterus: A comparative clinicopathologic study.
        Cancer. 1980; 45: 1625-1631
        • Wheelock J.B.
        • Krebs H.B.
        • Schneider V.
        • et al.
        Uterine sarcoma: analysis of prognostic variables in 71 cases.
        Am J Obstet Gynecol. 1985; 151: 1016-1022
        • Wick M.R.
        • Swanson P.E.
        Carcinosarcomas: Current perspectives and an historical review of nosological concepts.
        Semin Diagn Pathol. 1993; 10: 118-127
        • Young R.H.
        • Treger T.
        • Scully R.E.
        Atypical polypoid adenomyoma of the uterus. A report of 27 cases.
        Am J Clin Pathol. 1986; 86: 139-145
        • Zaloudek C.
        • Norris H.J.
        Mesenchymal tumors of the uterus.
        in: Kurman R.J. Pathology of the Female Genital Tract. Springer-Verlag, New York1994: 487-528
        • Zaloudek C.J.
        • Norris H.J.
        Adenofibroma and adenosarcoma of the uterus: A clinicopathologic study of 35 cases.
        Cancer. 1981; 48: 354-366

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      DOI: https://doi.org/10.1016/S0272-2712(18)30318-4

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      © 1995 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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