Abstract
Objectives
To analyze clinical and pathologic features as well as recurrence patterns of cellular
leiomyomas (CL) in women who underwent surgical therapy for symptomatic disease.
Study design
This retrospective study was conducted at the Department of Obstetrics and Gynecology,
University Women's Clinic, Tuebingen, Germany. We identified all women who had CL
on final diagnosis after surgery between January 1, 2000, and December 31, 2010.
Results
Our study sample comprised 76 women with a diagnosis of CL. A single uterine mass
was present in 51.3% of the cases; in uteri with both CL and uterine leiomyomas (UL),
the CL constituted the largest uterine mass in 20 of 21 (95.2%) cases. Additionally,
in 98% of the uteri, CL were either the largest or the only uterine mass. Five women
(6.6%; 5/76) had reported surgical procedures for symptomatic leiomyoma before the
index surgery in our analysis. Three women underwent hysteroscopic resection of the
leiomyomas and 2 women underwent abdominal myomectomy. Mean time to recurrence was
14.0 months (median 6.0; range, 4.0–52.0). Over the follow-up period, 6 women who
underwent uterus-conserving surgery (12.0%; 6/50) with CL had leiomyoma recurrence.
Five women underwent abdominal myomectomy and one underwent hysteroscopic resection
of the CL. One patient had recurrence of a CL 43 months after abdominal myomectomy
and underwent vaginal hysterectomy; the other five women had recurrences of UL. Mean
time to recurrence was 28.6 months (median 12.5; range, 4.0–83.0).
Conclusions
Recurrence rates of CL in our study group resemble recurrence rates of UL.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of Obstetrics and Gynecology and Reproductive BiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Uterine fibroids: the elephant in the room.Science. 2005; 308: 1589-1592
- The frequency of uterine leiomyomas.Am J Clin Pathol. 1990; 94: 435-438
- Rate, type, and cost of invasive interventions for uterine myomas in Germany, France, and England.J Minim Invasive Gynecol. 2009; 16: 40-46
- Leiomyoma-related hospitalization and surgery: prevalence and predicted growth based on population trends.Am J Obstet Gynecol. 2011; 205: e1-e5
- Recent advances in the pathology of smooth muscle tumours of the uterus.Histopathology. 2001; 39: 331-341
- The pathology of uterine smooth muscle tumors and mixed endometrial stromal-smooth muscle tumors: a selective review with emphasis on recent advances.Int J Gynecol Pathol. 2000; 19: 39-55
- Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases.Am J Surg Pathol. 1994; 18: 535-558
- Diagnostic criteria for uterine smooth muscle tumors: leiomyoma variants associated with malignant behavior.J Reprod Med. 2007; 52: 1001-1010
- Uterine leiomyomata with deletions of Ip represent a distinct cytogenetic subgroup associated with unusual histologic features.Genes Chromosomes Cancer. 2006; 45: 304-312
- Morphologic features of uterine leiomyomas associated with hereditary leiomyomatosis and renal cell carcinoma syndrome: a case report.Am J Surg Pathol. 2011; 35: 1235-1237
- Understanding cellular leiomyomas: a case-control study.Am J Obstet Gynecol. 2010; 203: e1-e6
- Cellular uterine leiomyomata with chromosome 1p deletions represent a distinct entity (Abstract/1145F).in: Presented at the 62nd Annual Meeting of The American Society of Human Genetics, November 7, 2012 in San Francisco, California2012
- Cellular benign mesenchymal tumors of the uterus. A comparative morphologic and immunohistochemical analysis of 33 highly cellular leiomyomas and six endometrial stromal nodules, two frequently confused tumors.Am J Surg Pathol. 1995; 19: 757-768
- Recurrence of leiomyomata after myomectomy.Hum Reprod Update. 2000; 6: 595-602
- Predictors of leiomyoma recurrence after myomectomy.Obstet Gynecol. 2005; 105: 877-881
- Predictors of subsequent surgery for uterine leiomyomata after abdominal myomectomy.Obstet Gynecol. 2002; 99: 426-432
- Benign metastasizing leiomyoma: metastasis to rib and vertebra.Ann Thorac Surg. 2011; 91: 924-926
- Benign metastasizing leiomyoma of the uterus: histologic and immunohistochemical characterization of primary and metastatic lesions.Arch Pathol Lab Med. 1999; 123: 960-962
- Benign metastasizing leiomyoma: clinical, imaging, and pathologic correlation.AJR Am J Roentgenol. 2001; 176: 1409-1413
- Leiomyomatous neoplasms of the lung: a clinical, histologic, and immunohistochemical study.Mod Pathol. 1989; 2: 209-216
- Spontaneous regression of pulmonary leiomyomas during pregnancy.Cancer. 1977; 39: 314-321
- Immunohistological detection of estrogen and progesterone receptors in multiple and well differentiated leiomyomatous lung tumors in women with uterine leiomyomas (so-called benign metastasizing leiomyomas). A report on 5 cases.Pathol Res Pract. 1996; 192: 215-223
- Pulmonary metastases (with admixed epithelial elements) from smooth muscle neoplasms. Report of nine cases, including three males.Am J Surg Pathol. 1979; 3: 325-342
- Late presentation of metastatic smooth muscle neoplasm of the uterus with low malignant potential.J Gynecol Oncol. 2012; 23: 69-71
- Distinctive cytogenetic profile in benign metastasizing leiomyoma: pathogenetic implications.Am J Surg Pathol. 2007; 31: 737-743
Article info
Publication history
Published online: October 16, 2013
Accepted:
October 2,
2013
Received in revised form:
August 8,
2013
Received:
March 5,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
