Ovary tumor
Other tumors not specific to ovary

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

Revised: 5 July 2016, last major update December 2014

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PubMed Search: Leiomyosarcoma [title] ovary

Related topics: Myxoid leiomyosarcoma
Cite this page: Leiomyosarcoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarytumorleiomyosarcoma.html. Accessed August 15th, 2018.
Definition / general
  • Rare tumor of teratomatous or nonteratomatous origin
  • "True" leiomyosarcoma if of non-teratomatous origin
  • Omentum, reteroperitoneum, mesentery
  • 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
  • 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
Microscopic (histologic) description
  • Usually 2 of 3: moderate / severe cytologic atypia, 10+ MF/10 HPF, tumor cell necrosis
  • Varies from well differentiated to highly pleomorphic sarcoma
Microscopic (histologic) images

Images hosted on Pathout server:

Epithelioid tumor

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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-