Ovary tumor
Other tumors not specific to ovary
Leiomyosarcoma

Author: Nalini Gupta, M.D. (see Authors page)

Revised: 5 July 2016, last major update December 2014

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Leiomyosarcoma [title] ovary

Related topics: Myxoid leiomyosarcoma
Definition / General
  • Rare tumor of teratomatous or nonteratomatous origin
  • "True" leiomyosarcoma if of non-teratomatous origin
Sites
  • Omentum, reteroperitoneum, mesentery
Pathophysiology
  • Arises from: malignant degeneration of ovarian leiomyoma; smooth muscle in blood vessel walls in cortical stroma and corpus luteum, muscular attachments of ovarian ligament, wolfian duct remnants, or totipotential ovarian mesenchyme; or from a teratoma
Clinical Features
Prognostic Factors
Case Reports
Treatment
  • Multimodality treatment: surgical debulking, post-operative radiotherapy or chemotherapy
  • FIGO staging and treatment of ovarian sarcoma is same as for epithelial ovarian carcinoma (Obstet Gynecol Surv 2007;62:480)
Gross Description
  • Solitary, lobular, soft fleshy solid mass with hemorrhage and cystic degeneration
Micro Description
  • Usually 2 of 3: moderate / severe cytologic atypia, 10+ MF/10 HPF, tumor cell necrosis
  • Varies from well differentiated to highly pleomorphic sarcoma
Micro Images

Images hosted on Pathout server:

Epithelioid tumor



Images hosted on other servers:

Pleomorphic tumor cells

Cytologic atypia, necrosis

Tumor cells in intersecting fascicles

H-Caldesmon, desmin and smooth muscle actin

Negative Stains
Differential Diagnosis
  • Cellular fibroma: low mitotic activity <10/10HPF
  • Krukenberg tumors have stromal reaction, history of GI primary, pan CK+
  • Mixed mullerian tumors: pan CK+ areas
  • Sarcomatoid form of sex cord stromal tumors: sex cord elements present
  • Undifferentiated carcinomas: pan CK+, H caldesmon-