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Surg Pathol Clin 2022 Jun 20;15(2):341-367. Epub 2022 May 20.

Biopathology Department, Anticancer Center, Institut Bergonié, Bordeaux, France; INSERM U 1218, Action Unit, Bordeaux, France; University of Bordeaux, Talence, France.

This article provides an update of the recent developments in mesenchymal tumors of lower genital tract. We focus on the characterization of recurrent molecular events in certain genital stromal tumors, for instance angiomyofibroblastomas and superficial myofibroblastomas. Moreover, fusions involving Tyrosine-kinases receptors (NTRK, FRFR1, RET, COL1A1-PDGFB) have been demonstrated in an emerging group of mesenchymal tumors characterized by a fibrosarcoma-like morphology and a predilection for uterine cervix of premenopausal women. Read More

Rom J Morphol Embryol 2021 Oct-Dec;62(4):883-896

Department of Obstetrics and Gynecology, Emergency County Hospital, University of Medicine and Pharmacy of Craiova, Romania;

Malignant mixed mesodermal sarcomas (myxoid leiomyosarcomas - MLMS) are a rare form of uterine cancer developed from the smooth muscles of the uterus. It usually affects women in the postmenopausal period and has an aggressive character with an unfavorable evolution and prognosis. This paper presents a case where MLMS was postoperatively confirmed with the aid of the histopathological (HP) examination coupled with specific immunolabeling techniques. Read More

Sci Rep 2022 May 26;12(1):8912. Epub 2022 May 26.

Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Ube, 755-8505, Japan.

Somatic mutations in Mediator complex subunit 12 (MED12m) have been reported as a biomarker of uterine fibroids (UFs). However, the role of MED12m is still unclear in the pathogenesis of UFs. Therefore, we investigated the differences in DNA methylome, transcriptome, and histological features between MED12m-positive and -negative UFs. Read More

Cancers (Basel) 2022 May 7;14(9). Epub 2022 May 7.

Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Via Filippo Corridoni, 16, 60123 Ancona, Italy.

: This study aimed to systematically review the existing literature on uterine smooth muscle tumor of uncertain malignant potential (STUMP) to provide information about characteristics and outcomes of patients and the risk factors for recurrence over a period of 60 years (1960-2021). According to PRISMA guidelines, we searched for "uterine smooth muscle tumor of uncertain malignant potential" in PubMed (all fields) and Scopus (Title/Abstract/Keywords) databases (accessed on 1 January 2022). Relevant articles were obtained in full-text format and screened for additional references. Read More

Int J Surg Pathol 2022 Apr 28:10668969221098081. Epub 2022 Apr 28.

O'Neal Comprehensive Cancer Center, 189178The University of Alabama at Birmingham, Birmingham, AL, USA.

sarcomas are a newly recognized group of exceedingly rare low-grade spindle cell sarcomas that often involve the genitourinary and gynecologic tracts. Due to its deceptively low-grade morphology and the non-specific immunoprofile, these neoplasms may pose a diagnostic challenge by histologically mimicking other entities such as endometrial stromal sarcoma, smooth muscle tumor, or uterine perivascular epithelioid cell tumor (PEComa). Histologically, sarcomas typically show spindle cell proliferation with hyperchromatic nuclei and a generalized cytologic uniformity, arranged in short fascicles and exhibiting alternating zones of hypo- and hypercellularity. Read More

Am J Case Rep 2022 Apr 13;23:e935944. Epub 2022 Apr 13.

Department of Pathology, Haeundae Paik Hospital, University of Inje College of Medicine, Busan, South Korea.

BACKGROUND Mixed endometrial stromal and smooth muscle tumors (MESSMT) of the uterus are rare disease entities. The histogenesis is unclear, but its clinical manifestations are similar to those of other mesenchymal tumors. This unique uterine tumor was originally reported as having ultrastructural characteristics of both endometrial stromal and smooth muscle cells. Read More

Pathologe 2022 May 12;43(3):196-201. Epub 2022 Apr 12.

Arbeitsgruppe Mamma‑, Gynäko- & Perinatalpathologie, Institut für Pathologie, Universitätsklinikum Leipzig AöR, Liebigstr. 26, 04103, Leipzig, Deutschland.

The 2020 WHO Classification defines the spindle cell, epithelioid, and myxoid variants as subtypes of uterine leiomyosarcomas (LMS). Presence of cellular atypia (size variation of polymorphic nuclei > 2-3:1), tumor cell necroses, and mitotic count (usually ≥ 10 MF/10 HPF) are still the key features for diagnostic separation from uterine leiomyomas. Preanalytic variables, staining quality, as well as intralesional geographic distribution may affect the mitotic count. Read More

Cureus 2022 Mar 4;14(3):e22838. Epub 2022 Mar 4.

Division of Urology, Department of Surgery, Ministry of National Guard Health Affairs, Riyadh, SAU.

Leiomyosarcoma is an aggressive soft tissue tumor originating from smooth muscle cells typically of the uterus, gastrointestinal, or genitourinary system. The most common site of leiomyosarcoma of soft tissue is the retroperitoneum, accounting for 50% of all cases. The majority of patients are asymptomatic, which may be due to the large retroperitoneal cavity. Read More

Cureus 2022 Feb 27;14(2):e22666. Epub 2022 Feb 27.

Internal Medicine, Beaumont Hospital, Royal Oak, USA.

We present a case of a 46-year-old female presenting with syncope. Echocardiography initially showed a right atrial mass. Further evaluation revealed a mass arising from the fundus of the uterus, with a tumor thrombus in the left gonadal vein, extending into the left renal vein and through the inferior vena cava (IVC) into the right heart across the tricuspid valve. Read More

Int J Surg Case Rep 2022 Apr 19;93:106955. Epub 2022 Mar 19.

Obstetrics and Gynecology Department, University Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco.

Introduction And Importance: Leiomyoma, known as a disease of the uterus, composed of spindle-shaped smooth muscle fibers and collagenous stroma, is rarely encountered in other sites especially in the vagina.

Case Presentation: We report, here, an exceptional case of a vaginal leiomyoma situated in the anterior vaginal wall suggesting in the first place a cystocele. The MRI objectified a rounded formation of the anterior wall of the vagina with regular contours highly suggestive of a vaginal leimyoma. Read More

Gynecol Oncol Rep 2022 Apr 21;40:100962. Epub 2022 Mar 21.

University of South Alabama, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, USA.

Background: Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm that exhibits immunohistochemical evidence of smooth muscle and melanocytic differentiation. We report a case of uterine PEComa in a 21 year-old primigravida, presenting at time of c-section as a small subserosal lesion that expressed soft tan-brown tissue fragments. Microscopically the cells were epithelioid, staining positive for TFE3 and HMB45. Read More

J Cell Mol Med 2022 05 23;26(9):2566-2578. Epub 2022 Mar 23.

Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA.

Preterm birth is a major contributor to neonatal mortality and morbidity. Infection results in elevation of inflammation-related cytokines followed by infiltration of immune cells into gestational tissue. CXCL12 levels are elevated in preterm birth indicating it may have a role in preterm labour (PTL); however, the pathophysiological correlations between CXCL12/CXCR4 signalling and premature labour are poorly understood. Read More

Ann Thorac Surg 2022 Mar 18. Epub 2022 Mar 18.

Division of Thoracic Surgery, Gaffrée e Guinle University Hospital - Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil.

Angiomyolipomas are benign mesenchymal tumors classified as PEComas, consisting of blood vessels, smooth muscle and fat, generally found in renal tissue. Extrarenal cases are uncommon and those of the mediastinum rare with only 23 reports in the literature. We present a successfully managed surgically case of a symptomatic 44-year-old woman with a large heart-shaped mediastinal angiomyolipoma in the right hemithorax associated with chylopericardium. Read More

Radiol Case Rep 2022 May 7;17(5):1536-1539. Epub 2022 Mar 7.

Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, R. Prof. Lima Basto, 1099-023 Lisboa, Portugal.

Diffuse uterine leiomyomatosis is a rare and benign condition which involves the development of innumerable poorly defined, confluent smooth muscle nodules that replace most of the uterine parenchyma. It results in a symmetrically enlarged uterus. The etiology of these benign tumors is not completely understood. Read More

Gynecol Oncol Rep 2022 Apr 26;40:100946. Epub 2022 Feb 26.

Gynecologic Oncology Program, AdventHealth Orlando, Orlando, FL 32804, USA.

Intravenous leiomyomatosis (IVL) is an uncommon variant of leiomyoma characterized by intravascular proliferation of a histologically benign smooth muscle tumor extending beyond the uterus into the distant great vessels. Leiomyomatosis may reach the inferior vena cava, right atrium, and pulmonary arteries. Owing to its rare occurrence, intracardiac leiomyomatosis has been reported as isolated case reports and small case series. Read More

Mol Clin Oncol 2022 Apr 24;16(4):92. Epub 2022 Feb 24.

Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.

Low-grade endometrial stromal sarcoma (LGESS) is a rare uterine tumor, accounting for <1% of all uterine cancer cases. LGESS has several variations and the frequency of tumors exhibiting smooth muscle differentiation is 10-30% of LGESS cases, making such cases even rarer. The present report described the case of a patient with LGESS with smooth muscle differentiation, who was diagnosed as having uterine leiomyoma by preoperative needle biopsy and then underwent laparoscopic surgery. Read More

World J Surg Oncol 2022 Mar 1;20(1):62. Epub 2022 Mar 1.

Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

Background: Perivascular epitheloid cell tumor (PEComas) are characterized by expression of both muscles, most often smooth muscle actin (in ~80% of cases) and melanocytic markers (mainly HMB-45 and Melan A). TFE 3-associated PEComas are new variant which are poorly defined due to their limited reports in literature. These tumors lack response to targeted mTOR inhibitor therapy due to lack of mutation in TSC gene. Read More

Obstet Gynecol Surv 2022 Feb;77(2):101-110

Professor, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Importance: Placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT) are rare forms of gestational trophoblastic neoplasia (GTN). These tumors differ from choriocarcinoma as they are monophasic, have slower growth rates, have lower β-hCG concentrations, and are more chemoresistant. Placental site trophoblastic tumor and ETT can be misdiagnosed, leading to inappropriate management. Read More

Int J Gynecol Pathol 2022 Jan 20. Epub 2022 Jan 20.

CurePath (Chirec Institute-Brussels, CHU Tivoli-La Louvière), Jumet (C.V., X.C.) Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles (J.-C.N., N.D.H., X.C.) Department of Radiology, CHIREC Hospitals, Delta (S.O.), Brussels, Belgium.

Angiolipoleiomyoma is a very rare lesion of the uterus. To the best of our knowledge, only 20 cases have been described in the literature. It is an insufficiently defined entity, which is not included in the WHO classification. Read More

Am J Case Rep 2022 Jan 19;23:e934913. Epub 2022 Jan 19.

Clinical Service of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, Constanţa, Romania.

BACKGROUND Uterine lipoleiomyoma is a rare benign tumor composed of varying proportions of smooth muscle fibers and mature adipocytes, without identification of hemorrhage, necrosis, or cyto-architectural atypia. It is part of the leiomyomas category, with an incidence of 0.03-0. Read More

Ultrasound Obstet Gynecol 2022 Jan 12. Epub 2022 Jan 12.

Department of Surgical Sciences, Obstetrics and Gynecological Unit, University of Rome "Tor Vergata", Italy.

Objectives: Since differential diagnosis in ultrasound (US) imaging of myometrial lesions can be challenging particularly in the highly vascularized ones, we aimed to correlate the ultrasound appearance of highly vascularized uterine myomas with the histopathological diagnosis.

Methods: We recruited patients with a preoperative US-diagnosis of highly vascularized uterine myoma characterized by circumferential and intralesional vascular pattern (color score assessment of 3 or 4, according to the Morphological Uterus Sonographic Assessment), who underwent myomectomy or hysterectomy. Additional US-characteristics including cystic area, echogenicity, borders, shadowing, and size were recorded for each patient at baseline. Read More

Int J Surg Pathol 2022 Jan 7:10668969211070180. Epub 2022 Jan 7.

52993Selcuk University, Konya, Turkey.

The distinction of mesenchymal tumors of the uterus is a frequent diagnostic challenge in gynecologic pathology. Especially, distinguishing low-grade endometrial stromal sarcoma (ESS) from leiomyoma or distinguishing low-grade ESS from high-grade ESS can be difficult. Epithelial-mesenchymal transition (EMT) is a physiological and pathological process in which epithelial cells lose their morphological features, become elongated and acquire mesenchymal traits. Read More

J Reprod Infertil 2021 Jul-Sep;22(3):201-209

Department of Biotechnology, Hyderabad Science Society, Hyderabad, India.

Background: Uterine leiomyomata (UL), commonly known as uterine fibroids, are benign smooth muscle tumors of the myometrium. They cause pelvic pain, abnormal uterine bleeding, and infertility in women of reproductive age. The ovarian hormone estrogen is the main stimulator for the fibroid growth. Read More

Am J Case Rep 2021 Dec 7;22:e934012. Epub 2021 Dec 7.

Department of Laboratory Medicine & Pathology, King Fahad Armed Force Hospital, Jeddah, Saudi Arabia.

BACKGROUND An adenomatoid tumor is a benign neoplasm that originates in the mesothelial lining, commonly present in the male and female genital tracts. The lieomyoadenomatoid tumor (LMAT) is rare and considered an adenomatoid variant, characterized microscopically by prominent smooth muscle proliferation within an adenomatoid tumor. Areas of pseudo-glandular infiltration and tubular and slit-like spaces can mimic metastatic carcinoma or malignant tumors. Read More

J Family Med Prim Care 2021 Sep 30;10(9):3494-3497. Epub 2021 Jun 30.

Department of Pathology, AIIMS, Jodhpur, Rajasthan, India.

Leiomyoma is the commonest benign mesenchymal tumor of the uterus, which can be developed at any site where smooth muscle cells are found. The broad ligament is the most common and ovary is one of the rarest extrauterine sites, accounting for 0.5-1% of all benign ovarian tumors. Read More

J Vasc Surg Cases Innov Tech 2021 Dec 21;7(4):711-717. Epub 2021 Jul 21.

Division of Vascular Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), University of Montreal, Montréal, Canada.

Intravascular leiomyomatosis is a rare entity defined by benign smooth uterine muscle cells that typically originate from the uterus with the potential to spread into veins possibly up to the heart. The diagnosis for patients presenting with cardiac symptoms may be difficult and imaging often interpreted as thrombus or atrial myxoma. Read More

Indian J Pathol Microbiol 2021 Oct-Dec;64(4):837-838

Department of Pathology (Cardiovascular and Thoracic Division), Seth GS Medical College, Mumbai, Maharashtra, India.

Leiomyoma is a benign smooth muscle cell tumor commonly occurring in the uterine myometrium. Extra-uterine tumors are infrequent and those occurring in an intracranial location are extremely rare. We report a primary intracranial leiomyoma as an incidental autopsy finding in a 60-year-old woman, who died of acute myocardial infarction. Read More

Int J Clin Exp Pathol 2021 15;14(9):993-999. Epub 2021 Sep 15.

Department of Cytology and Gynecologic Pathology, Post Graduate Institute of Medical Education and Research Chandigarh, India.

Background: Perivascular epithelioid cell tumors (PEComas) are rare, mesenchymal neoplasms composed of epithelioid cells exhibiting myogenic and melanocytic differentiation. The uterus is an infrequent site of involvement. The most common histopathologic mimics include leiomyosarcoma, endometrial stromal sarcoma, undifferentiated uterine sarcoma, and malignant melanoma. Read More

Nat Commun 2021 09 14;12(1):5448. Epub 2021 Sep 14.

Department of Medical and Clinical Genetics and Applied Tumor Genomics Research Program University of Helsinki, Helsinki, Finland.

Mechanical forces in a constrained cellular environment were recently established as a facilitator of chromosomal damage. Whether this could contribute to tumorigenesis is not known. Uterine leiomyomas are common neoplasms that display relatively few chromosomal aberrations. Read More

Pathol Int 2021 Dec 14;71(12):837-843. Epub 2021 Sep 14.

Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Malignant transformation of gastric leiomyoma has not been reported, and therefore it is considered to have virtually no malignant potential. We report a case of gastric leiomyosarcoma arising from leiomyoma. The patient is a 72-year-old man with a submucosal mass measuring 20 mm in diameter, which was incidentally identified by an endoscopic surveillance. Read More