Please wait a minute...
European Journal of Gynaecological Oncology  2020, Vol. 41 Issue (2): 167-170    DOI: 10.31083/j.ejgo.2020.02.4950
Original Research Previous articles | Next articles
Re-evaluation of preoperative endometrial smears for the cytodiagnosis of uterine leiomyosarcoma
K. Sonoda1, 2, *(), M. Nogami4, K. Kodama2, Y. Oda3, K. Kato2
1 Gynecologic Service, National Kyushu Cancer Center, Fukuoka, Japan
2 Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
3 Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
4 Division of Diagnostic Pathology, Kyushu University Hospital, Fukuoka, Japan
Download:  PDF(1044KB)  ( 289 ) Full text   ( 7 )
Export:  BibTeX | EndNote (RIS)      
Abstract  
Introduction: Uterine leiomyosarcoma (ULS) is a highly aggressive and lethal tumor. The absence of specific symptoms and diagnostic imaging findings makes the diagnosis of ULS challenging. Endometrial sampling reportedly has a significantly lower predictive value in diagnosing ULS compared with epithelial uterine malignancies. Materials and Methods: The authors retrospectively reviewed the preoperative endometrial cytology findings in seven of the 12 patients with ULS who were treated in this institution between 2008 and 2017. The other five patients did not have preoperative samples obtained for cytology. Results: Only one of the seven patients was originally diagnosed with a malignant tumor, with preoperative cytology showing rounded tumor cells with enlarged, irregular, hyperchromatic, and sometimes multiple nuclei, with conspicuous nucleoli in a necrotic background. After re-evaluation of the preoperative specimens, atypical cells were detected in four of the six patients who were initially deemed to have negative findings. A monomorphic population of spindle cells with slightly hyperchromatic, elongated nuclei was detected in two patients. Another two patients had rounded tumor cells with a moderate amount of basophilic cytoplasm and round or oval nuclei with minimal atypia. Conclusion: Novel diagnostic techniques are needed to accurately identify ULS in the preoperative period. Careful microscopic observation of the entire cytological specimen, together with detailed patient medical information, are essential to making a correct preoperative diagnosis of ULS.
Key words:  Uterine neoplasms      Leiomyosarcoma      Cytodiagnosis     
Published:  15 April 2020     
Fund: 
17K11281/Japan Society for the Promotion of Scienc
*Corresponding Author(s):  K. SONODA     E-mail:  sonoda.k@nk-cc.go.jp

Cite this article: 

K. Sonoda, M. Nogami, K. Kodama, Y. Oda, K. Kato. Re-evaluation of preoperative endometrial smears for the cytodiagnosis of uterine leiomyosarcoma. European Journal of Gynaecological Oncology, 2020, 41(2): 167-170.

URL: 

https://ejgo.imrpress.com/EN/10.31083/j.ejgo.2020.02.4950     OR     https://ejgo.imrpress.com/EN/Y2020/V41/I2/167

[1] Ming Wang, Shi-Hui Meng, Yu-Mei Wu. Ovarian conservation without postoperative radiation improved survival outcomes in patients with stage i uterine leiomyosarcoma[J]. European Journal of Gynaecological Oncology, 2020, 41(3): 422-431.
[2] B. Serdar, K. Meral, S. Ugur, D. Binnaz, D. Namık. Intrapelvic low grade leiomyosarcoma with good prognosis[J]. European Journal of Gynaecological Oncology, 2020, 41(3): 468-470.
[3] J. H. Sang, J. I. Choi, S.-H. Chung. Case series of uterine smooth muscle tumors of uncertain malignant potential (STUMP)[J]. European Journal of Gynaecological Oncology, 2020, 41(3): 492-494.
[4] Z. Zheng, Z.H. Han, Z.T. Li, X.H. Wu. The impact of laparoscopic surgical treatments on oncologic outcome of Stage I uterine leiomyosarcoma[J]. European Journal of Gynaecological Oncology, 2019, 40(6): 977-981.
[5] A.C. da Silva, T. Calapodopulos, T.C. Guaresqui, J. C. Saldanha, E.F.C. Murta, R.S. Nomelini. Uterine smooth muscle tumor of uncertain malignant potential[J]. European Journal of Gynaecological Oncology, 2019, 40(6): 1070-1072.
[6] J. Klat, O. Simetka, C. Povysil. Cervical leiomyosarcoma treated by radical laparoscopic approach: a case report[J]. European Journal of Gynaecological Oncology, 2019, 40(6): 1093-1095.
[7] S. Furukawa, K. Hasegawa, Y. Nozawa, Y. Endo, M. Takata, F. Yoshida-Saito, S. Nakamura, R. Yamauchi. A rare case of primary ovarian leiomyosarcoma[J]. European Journal of Gynaecological Oncology, 2019, 40(5): 870-874.
[8] T. Tomimatsu, S. Mabuchi, T. Tsuboyama, Y. Hori, S. Sekine, T. Kimura. Malignant transformation of uterine leiomyoma: suggested by clinical, imaging, histological, and genetic findings[J]. European Journal of Gynaecological Oncology, 2019, 40(5): 879-882.
[9] Z. Fasoulakis, H. Achouhan, S. Kalagasidou, P. Kadari, A. Pagkalos, P. Simeonidis, E.N. Kontomanolis. A review on uterine sarcomas and a brief report on the role of the notch pathway[J]. European Journal of Gynaecological Oncology, 2019, 40(4): 521-529.
[10] Haiyang Jiang, Luyun Qu, Zenghui Li, Xiaohong Li, Jing Wang, Jianqing Hou. Exploring biomarkers for uterine leiomyosarcoma via combination of iMDM algorithm and pathway enrichment analysis[J]. European Journal of Gynaecological Oncology, 2019, 40(2): 268-274.
[11] Mehmet Tunc, Yusuf Aytac Tohma, Hanifi Sahin, Huseyin Akilli, Latife Atasoy Karakas, Ozden Altundag, Ali Haberal, Ali Ayhan. Fertility sparing in uterine sarcomas: single center experience of 13 patients[J]. European Journal of Gynaecological Oncology, 2019, 40(2): 305-310.
[12] L.M. Langermans, A. Salajan, C. Riera. Retroperitoneal benign leiomyoma is a challenging diagnosis in gynecology: report of two cases[J]. European Journal of Gynaecological Oncology, 2019, 40(2): 318-320.
[13] H. Ishibashi, M. Takano, M. Miyamoto, T. Aoyama, T. Yoshikawa, K. Furuya. Prolonged stable disease using pazopanib in recurrent and refractory uterine leiomyosarcoma: a proposal of “pazopanib beyond progression”[J]. European Journal of Gynaecological Oncology, 2018, 39(5): 821-824.
[14] Ala’ U’wais, Kuan-Gen Huang, Tsung-Hsun Tsa, Yu-Jen Liu. Uterine leiomyosarcoma with skeletal muscle metastasis[J]. European Journal of Gynaecological Oncology, 2018, 39(2): 307-309.
[15] G. Miolo, M. Uccello, D. A. Santeufemia, G. M. Pes, A. Buonadonna, G. Baldino, F. Dessole, G. Capobianco. Rare late mandibular recurrence of uterine leiomyosarcoma: a case report[J]. European Journal of Gynaecological Oncology, 2018, 39(1): 146-148.
No Suggested Reading articles found!