Uterus - Postoperative spindle cell tumors

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Uterus

Stromal tumors

Postoperative spindle cell tumors

Reviewer: Mohamed Desouki, M.D. (see Reviewers page)
Revised: 23 October 2011, last major update October 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

General
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● Similar to spindle cell nodule elswhere, e.g. vagina, urinary bladder, endocervix and other sites (Am J Surg Pathol 1984;8:101)

Terminology
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● Postoperative spindle cell nodule

Sites
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● Post procedural, e.g. dilatation and curettage

Etiology
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● Reparative proliferations of fibroblastic cells in response to an inciting factor

Clinical features
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● Vaginal bleeding

Prognostic features
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● No recurrence reported even after incomplete excision

Case reports
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● 75 year old woman post D&C (Arch Pathol Lab Med 1988;112:566)

Micro description
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● Dense cellular proliferation of mitotically active spindle cells which have elongated nuclei with evenly dispersed chromatin and abundant eosinophilic cytoplasm
● Marked vascularity with extravasated RBCs and hemosiderin
● Mitotic rate is often high, but abnormal mitoses or atypia are absent

Micro images
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Bladder tumors

Negative stains
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● Cytokeratin

Differential diagnosis
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● Sarcoma NOS: Marked nuclear anaplasia, variable pleomorphism, 20+ mitotic figures/10 HPF; extensive necrosis is common
● Sarcomatoid carcinoma / MMMT: biphasic with sarcomatoid and carcinomatous elements; angiolymphatic invasion common; keratin+

End of Uterus > Stromal tumors > Postoperative spindle cell tumors

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