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Pathology of Uterine Sarcomas

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Uterine Cancer
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Abstract

Uterine sarcomas are a rare, heterogeneous group of neoplasms, which account for approximately 1 % of all female genital tract malignancies and 3–5 % of malignant uterine tumors [1]. The tumors are derived from the mesenchymal components of the uterus, consisting of endometrial stroma, smooth muscle and blood vessels, or admixtures of these (referred to as homologous elements). Rarely the tumors may contain tissue types not normally seen in the uterus, such as striated muscle, cartilage, or bone (referred to as heterologous elements). Compared with the more common endometrial carcinomas, uterine sarcomas behave more aggressively and are associated with a poorer prognosis with a high rate of local recurrence and/or metastasis. The lack of consensus, on treatment options and risk factors for poor outcome, is largely due to the rarity of these tumors and their histopathological diversity. The classification and staging of these tumors were revised in 2014 and 2009, respectively.

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References

  1. Abeler VM, Royne O, Thoresen S, Danielsen HE, Nesland JM, Kristensen GB. Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients. Histopathology. 2009;54:355–64.

    Article  PubMed  Google Scholar 

  2. D’Angelo E, Prat J. Uterine sarcomas: a review. Gynecol Oncol. 2009. doi:10.1016/j.ygyno.2009.09.023.

  3. Kurman RJ, Carcangiu ML, Herrington S, Young RH, editors. WHO classification of tumours of the female reproductive organs. 4th ed. Lyon: IARC; 2014.

    Google Scholar 

  4. Amant F, Coosemans A, Debiec-Rychter M, Timmerman D, Vercote I. Clinical management of uterine sarcomas. Lancet Oncol. 2009;10:1188–98.

    Article  PubMed  Google Scholar 

  5. FIGO Committee on Gynecologic Oncology. FIGO staging for uterine sarcomas. Int J Gynaecol Obstet. 2009;104:177–8.

    Article  Google Scholar 

  6. Mittal KR, Chen F, Wei JJ, et al. Molecular and immunohistochemical evidence for the origin of uterine leiomyosarcomas from associated leiomyoma and symplastic leiomyoma – like areas. Mod Pathol. 2009;22:1303–11.

    Article  CAS  PubMed  Google Scholar 

  7. Bell SW, Kempson RI, Hendrickson MR. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol. 1994;18:535–58.

    Article  CAS  PubMed  Google Scholar 

  8. Stanley J. Robboy, George L. Mutter, Jaime Prat, Rex C. Bentley, Peter Russell, Malcolm C. Anderson, (eds). Robboy’s pathology of the female reproductive tract. 2nd edition, Churchill Livingstone, Elsevier, 2009, P 475.

    Google Scholar 

  9. O’Neill CJ, McBride HA, Conolly LE, et al. Uterine leiomyosarcomas are characterized by high p16, p53, and MIB1 expression in comparison with usual leiomyomas, leiomyoma variants and smooth muscle tumors of uncertain malignant potential. Histopathology. 2007;50:851–8.

    Article  PubMed  Google Scholar 

  10. Reichert RA. Diagnostic gynecologic and obstetric pathology: an atlas and text. 1st ed. Philadelphia: Lippincott Williams & Wilkins; 2012. p. 278.

    Google Scholar 

  11. Fletcher CDM. Diagnostic histopathology of tumors. 4th ed. Philadelphia: Elsevier Saunders; 2013. p. 804.

    Google Scholar 

  12. Chang KL, Crabtree GS, Lim-Tan SK, et al. Primary endometrial stromal neoplasms. A clinicopathologic study of 117 cases. Am J Surg Pathol. 1990;14:415–38.

    Article  CAS  PubMed  Google Scholar 

  13. Reich O, Regauer S, Urdl W, Lahousen M, Winter R. Expression of oestrogen and progesterone receptors in low- grade endometrial stromal sarcomas. Br J Cancer. 2000;82:1030–4.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Nucci MR, Harburger D, Koontz J, Dal Cin P, Sklar J. Molecular analysis of the JAZF1-JJAZ1 gene fusion by RT-PCR and fluorescence in situ hybridization in endometrial stromal neoplasms. Am J Surg Pathol. 2007;31:65–70.

    Article  PubMed  Google Scholar 

  15. Lee C-H, Marino-Enriquez A, Ou W, et al. The clinicopathologic features of YWHAE-FAM22 endometrial stromal sarcomas: a histologically high-grade and clinically aggressive tumor. Am J Surg Pathol. 2012;36:641–53.

    Article  PubMed  Google Scholar 

  16. Olive E, Clement PB, Young RH. Endometrial stromal tumors: an update on a group of tumors with a protean phenotype. Adv Anat Pathol. 2000;7:257.

    Article  Google Scholar 

  17. Clement PB, Scully RE. Mullerian adenosarcoma of the uterus: a clinicopathologic analysis of 100 cases with a review of the literature. Hum Pathol. 1990;21:363–81.

    Article  CAS  PubMed  Google Scholar 

  18. Soslow RA, Ali A, Oliva E. Mullerian adenosarcomas: an immunophenotypic analysis of 35 cases. Am J Surg Pathol. 2008;32(7):1013–21.

    Article  PubMed  Google Scholar 

  19. McCluggage WG. Uterine carcinosarcomas (malignant mixed Mullerian tumors) are metaplastic carcinomas. Int J Gynecol Cancer. 2002;12:687–90.

    Article  CAS  PubMed  Google Scholar 

  20. Jin Z, Ogata S, Tamura G, et al. Carcinosarcoma (malignant mixed mullerian tumors) of the uterus and ovary: a genetic study with special reference to histogenesis. Int J Gynecol Pathol. 2003;22:368–73.

    Article  PubMed  Google Scholar 

  21. Reichert RA. Diagnostic gynecologic and obstetric pathology: an atlas and text. 1st ed. Philadelphia: Lippincott Williams & Wilkins; 2012. p. 265.

    Google Scholar 

  22. Fadare O. Heterologous and rare homologous sarcomas of the uterine corpus: a clinicopathologic review. Adv Anat Pathol. 2011;18(1):60–74.

    Article  PubMed  Google Scholar 

  23. Moinfar F, Azodi M, Tavassoli FA. Uterine sarcomas. Pathology. 2007;39(1):55–71.

    Article  PubMed  Google Scholar 

  24. Donner LR. Uterine carcinosarcoma with complete sarcomatous overgrowth mimicking pure embryonal rhabdomyosarcoma. Int J Gynecol Pathol. 2003;22(1):89–91.

    Article  PubMed  Google Scholar 

  25. Tropé CG, Abeler VM, Kristensen GB. Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol. 2012;51(6):694–705.

    Article  PubMed  Google Scholar 

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Correspondence to Pushpa Mahadevan .

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Appendix

Appendix

The histological diagnosis of leiomyosarcoma

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Mahadevan, P. (2015). Pathology of Uterine Sarcomas. In: Rajaram, S., K, C., Maheshwari, A. (eds) Uterine Cancer. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1892-0_11

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  • DOI: https://doi.org/10.1007/978-81-322-1892-0_11

  • Publisher Name: Springer, New Delhi

  • Print ISBN: 978-81-322-1891-3

  • Online ISBN: 978-81-322-1892-0

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