Prevalence of cellular leiomyoma and partially cellular leiomyoma in postoperative samples — analysis of 384 cases

Dobrosława L Sikora-Szczęśniak, Dobrosława Sikora-Szczęśniak, Sikora-Szczęśniak DL
Ginekologia polska · 2016 · vol. 87(9) , pp. 609–616 · doi:10.5603/gp.2016.0054 · PMID:27723066 · W2530254756
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This study analyzed 384 postoperative uterine leiomyoma samples, finding a 17.9% prevalence of cellular and partially cellular leiomyomas and a higher incidence of reproductive system malignancy in patients with endometriosis.

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This study assessed the prevalence of cellular and partially cellular leiomyomas in uterine specimens from 2144 postoperative hysterectomy/myomectomy cases, with detailed analysis of 384 cases categorized by the co-occurrence of leiomyomas and/or endometriosis. Researchers compared age, weight, BMI, parity, surgical procedure type, frequencies of atypical/borderline tumor forms, and rates of concomitant reproductive system malignancy, finding cellular/partially cellular leiomyomas in 17.9% of analyzed cases. Nulliparous patients were more common in subgroups without endometriosis, and concomitant reproductive malignancy was more than twofold higher in subgroups with endometriosis. This paper does not explicitly discuss adenomyosis, but it does include endometriosis as a grouping factor when analyzing the prevalence and associated malignancy patterns of cellular leiomyomas.

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Abstract

OBJECTIVES: The aim of the study was to evaluate the prevalence of cellular leiomyomas and partially cellular leiomyomas in postoperative samples. MATERIAL AND METHODS: A total of 2144 cases of uterine leiomyomas were diagnosed in postoperative samples at the Department of Obstetrics and Gynecology, RSzS, Radom, Poland, between 1998 and 2014. We analyzed 384 cases which were subdivided into 4 groups, taking into account the co-occurrence of leiomyomas and/or endometriosis. The following variables were investigated: age, weight, BMI, parity, type of surgical procedure, prevalence of atypical and borderline tumor forms, and concomitant malignancy of the reproductive system. RESULTS: The prevalence of cellular leiomyomas and partially cellular leiomyomas was estimated at 17.9%. Nulliparous patients were significantly more numerous in the subgroups without endometriosis. Concomitant malignancy of the reproductive system was > 2 fold more commonin the subgroups with endometriosis as compared to the other subgroups. CONCLUSIONS: The fact that cellular leiomyomas have a varying degree of cell atypia, together with clinical observations reported in the literature, support the view that cellular leiomyomas and partially cellular leiomyomas can progress to malignant leiomyosarcoma (LMS). Hysterectomy and the subsequent follow-up should be the mainstay of therapy for cellular leiomyoma. Conservative management (myomectomy) should be recommended only tothose patients who wish to preserve their fertility.
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Abstract

Objectives: The aim of the study was to evaluate the prevalence of cellular leiomyomas and partially cellular leiomyomas in postoperative samples.

Material and methods

A total of 2144 cases of uterine leiomyomas were diagnosed in postoperative samples at the Department of Obstetrics and Gynecology, RSzS, Radom, Poland, between 1998 and 2014. We analyzed 384 cases which were subdivided into 4 groups, taking into account the co-occurrence of leiomyomas and/or endometriosis. The following variables were investigated: age, weight, BMI, parity, type of surgical procedure, prevalence of atypical and borderline tumor forms, and concomitant malignancy of the reproductive system.

Results

The prevalence of cellular leiomyomas and partially cellular leiomyomas was estimated at 17.9%. Nulliparous patients were significantly more numerous in the subgroups without endometriosis. Concomitant malignancy of the reproductive system was > 2 fold more commonin the subgroups with endometriosis as compared to the other subgroups.

Conclusions

The fact that cellular leiomyomas have a varying degree of cell atypia, together with clinical observations reported in the literature, support the view that cellular leiomyomas and partially cellular leiomyomas can progress to malignant leiomyosarcoma (LMS). Hysterectomy and the subsequent follow-up should be the mainstay of therapy for cellular leiomyoma. Conservative management (myomectomy) should be recommended only tothose patients who wish to preserve their fertility.

Keywords

cellular leiomyomapartially cellular leiomyoma

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Condition tags

endometriosis

MeSH descriptors

Leiomyoma Uterine Neoplasms Adult Aged Comorbidity Endometriosis Endometriosis Female Humans Leiomyoma Leiomyoma Leiomyoma Middle Aged Poland Poland Prevalence Uterine Neoplasms Uterine Neoplasms Uterine Neoplasms

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