Post on 02-Apr-2021
Uterine sarcomas
Prof. Ben Davidson, MD PhD Department of Pathology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
Uterus tumor course – Oslo, 21-22/1/16
Cases
• 16
• 17
• 18
• 20
• 21
• 22
• 23
• 30
• 35
• 42
Case 16
• 45-years old woman
• Intraluminal leioyoma (“Fødemyom”)
• Tumor (3.5 cm), smooth surface, no necrosis
DIAGNOSIS: LEIOMYOMA WITH BIZARRE NUCLEI
Suggested diagnoses
• Atypical leiomyoma/leiomyoma with bizarre nuclei (17) • Leiomyom (1) • Sarcoma (3) • Atypical leiomyoma vs. sarcoma (1)
Case 17
• 53-years old woman
• Enlarged uterus
• DD leiomyoma vs. LMS
• Curettage
Division of Pathology
DIAGNOSIS: EPITHELIOID LEIOMYOSARCOMA
Suggested diagnoses • Epithelioid LMS (8) • Epithelioid LMS vs. carcinoma (1) • LMS of leiomyoblastoma type (1) • LMS (1) • Sarcoma (3) • HG malignant tumor; sarcoma? • RMS (1) • Undifferentiated carcinoma (2) • Malignant tumor (2) • Poorly differentiated malignant tumor; chorioca.? Undiff. ca.? (1) • Poorly differentiated malignant tumor; sarcoma? CS? (1) • ESS (1) • PSTT (1)
Case 18
• 46-years old woman
• Recurrent menorrhagia
• “Leiomyoma” (7.5 cm) with additional nodules in periphery
• Hysterectomy
DIAGNOSIS: LEIOMYOSARCOMA
Suggested diagnoses
• LMS (17) • Sarcoma – LMS vs. ESS (1) • Sarcoma (4) • HG malignant tumor; sarcoma? (1) • RMS (1)
Case 20
• 62-years old woman
• Tumor in uterine corpus (16 cm) with small necrotic areas
• Frozen section: sarcoma
• Vaginal hysterectomy
DIAGNOSIS: MYXOID LEIOMYOSARCOMA
Suggested diagnoses
• Myxoid LMS (11) • LMS (3) • Sarcoma (2) • Myxoid change in sarcoma (ESS or LMS) (1) • Myxoid leiomyoma (1) • Cellular leiomyoma with atypia (1) • Cellular leiomyoma with atypia vs. ESS (1) • ES nodule vs. myxoid LMS (1) • ES nodule with myxoid change (1) • Embryonal RMS (1) • ESS (1)
Case 21
• 62-years old woman
• Post-menopausal bleeding
• Suspected malignancy
• Abundant curettage, section from this material
DIAGNOSIS: RHABDOMYOSARCOMA
Suggested diagnoses
• RMS (9) • LMS (5) • Sarcoma (5) • UUS (3) • ESS vs. LMS vs. RMS (1) • ESS (1)
Case 22
• 47-years old woman
• Metrorrhagia
• Uterus at 14w pregnancy size
• First curettage: endometrium at secretory phase
• Second curettage: sarcoma, NOS
• Surgery: 10 kg tumor removed in fragments
DIAGNOSIS: UNDIFFERENTIATED UTERINE SARCOMA
Suggested diagnoses • UUS (3) • Sarcoma (7) • LMS (1) • LMS vs. HG-ESS (1) • HG-ESS (1) • LG-ESS (3) • ESS, myxoid variant (1) • ESS (1) • Endometrial stromal tumor; DD sarcoma (1) • PNET (1) • Malignant spindle cell tumor (2) / Malignant tumor (2) • Cellular leiomyoma with mitoses, possibly sarcoma (1)
Case 23
• 45-years old woman
• Clinically cervical myoma, mucoid content
• Uterus removed with additional tissue fragments with diameter up to 6 cm
• Residual tumor in corpus, with sharp delineation from myometrium
DIAGNOSIS: INFLAMMATORY MYOFIBROBLASTIC TUMOR
Suggested diagnoses • IMT (10) • Myxoid LMS (3) • IMT vs. sarcoma (1) • Sarcoma (1) • Sarcoma with lymphoid infiltration (1) • Spindle cell malignant tumor (1) • Malignant tumor (1) • LG-ESS (1) • Myxoid leiomyoma vs. LG sarcoma (1) • Leiomyoma vs. LMS (1) • Spindle cell tumor with inflammation (1) • Epithelioid leiomyoma (1) • ES nodule (1)
Case 30
• 71-years old woman
• Post-menopausal bleeding
• Polyp
• Curettage
DIAGNOSIS: ADENOSARCOMA
Suggested diagnoses
• AS (13) • Sarcoma (2) • ESS (1) • Clear cell leiomyoma (1) • AS vs. adenofibroma vs. CS vs. LG-ESS vs. angiosarcoma (1) • Adenofibroma (2) • RMS (1) • LMS (1) • Angiosarcoma (1) • Mucinous adenocarcinoma (1)