Smooth muscle tumours of the uterine corpus: a clinicopathologic study with immunohistochemical aspects.

Department of Obstetrics and Gynaecology, University of Rostock, Germany.
Anticancer research (Impact Factor: 1.83). 01/2005; 25(3A):1559-65.
Source: PubMed


Based on a clinicopathologic study conducted at the University of Rostock, Germany, between 1/1997 and 6/2003, the histological records of 1761 patients who had been hysterectomized were evaluated. 1422 of these patients were suffering from smooth muscle tumours: 1389 were diagnosed as multiple leiomyomas, 26 as leiomyomas of uncertain malignant potential and 7 as leiomyosarcomas.
The data about the microscopic findings were obtained by use of both conventional histology (HE and Giemsa) and immunohistochemistry with markers for leiomyosarcomas (desmin, actin, sm-actin, myoglobin, vimentin, MIB1) and evaluated by statistical methods. Three case reports are also presented: 2 patients with leiomyosarcoma and 1 patient with an UMP tumour.
The statistical evaluation included the frequencies of the different tumours subdivided into age groups, their localizations (with 23 distinctions), the associated microscopic findings (with 12 distinctions and most important combinations) and, finally, the number of tumours per patient and their (grouped) sizes. The case reports showed the presence of nuclear atypia, a heightened mitotic index and tumour cell necrosis. Immunohistochemical methods confirmed the histological diagnosis of a leiomyosarcoma.
In accordance with earlier studies, more than 95% of the smooth muscle tumours were leiomyomas. Leiomyosarcomas were rare (<1% in our study). In 3 out of 7 cases, a leiomyosarcoma had its origin in a leiomyoma.

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    • "Leiomyosarcoma (LMS), the third most common type of soft tissue sarcoma after malignant fibrous histiocytoma (MFH) and liposarcoma, displays phenotypic features of smooth muscle differentiation [1]. Leiomyosarcomas are typically composed of spindle cells with blunt-ended nuclei and eosinophilic cytoplasm, usually expressing a-smooth muscle actin [2], desmin [3], and H-caldesmon [4]. In poorly differentiated cases the expression of these markers can be low or even lacking. "

    Full-text · Article · Jan 2008 · Cancer Genetics and Cytogenetics
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    • "Além dos sintomas descritos, há relatos de metástase benigna em local distinto do trato reprodutivo, como a pleura, após ressecção cirúrgica da lesão com prévia localização uterina (Chan 2005). Segundo Waldmann 2005, mais de 95% das neoplasias de células musculares lisas uterinas são leiomiomas, menos de 1% a 6% são identificadas como leiomiosarcomas. Estima-se que 43% dos casos de malignidade se originam a partir de leiomiomas benignos. "

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    ABSTRACT: Resistance to chemotherapeutic agents and radiotherapy has kept surgery the primary treatment of uterine leiomyosarcoma (ULMS). In search of leads for potential therapeutic targets, array CGH (aCGH) was used to obtain a genomewide pattern of ULMS-specific genetic imbalances and to define the affected biological processes. Fine-resolution genomewide aCGH analysis was performed using customised 16K cDNA microarrays on 18 primary ULMS cases. Furthermore, patterns of DNA copy number changes were assessed for associations with clinical parameters, i.e., tumour grade, tumour size and patient status at last follow-up. Our aCGH results demonstrated extensive DNA copy number changes in all chromosomes. Of the 10,590 gene loci included in the analysis, 4,387 were found to be affected by DNA copy number gains and 4,518 by DNA copy number losses in at least one case. Further analyses revealed that 231 of these were commonly gained, and 265 lost in at least 20% of the cases. The gains affected loci at 1p, 1q, 2p, 3p, 6p, 8q, 10q and 18q, whereas losses were observed at 2q, 4q, 6p, 6q, 7p, 7q, 13q, 14p, 16q, 19p, Xp and Xq. Enrichment analysis of biological processes revealed the gained genes to be involved in the G1/S transition of mitotic cell cycle, co-translational protein targeting to membrane, actin filament polymerisation, and positive regulation of cytokine biosynthesis, whereas the genes affected by losses were associated with DNA replication, chromatin modification, telomere maintenance, meiosis, mitosis and angiogenesis. These biological processes featured prominently two well-established tumour suppressors (BRCA2, EREG) and one proto-oncogene (GFI1). No statistically significant associations were found between the aberration patterns and clinical variables. Analysis of gene pathways using aCGH uncovered the biological networks involved in malignant progression of ULMS.
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