Cervix
Mesenchymal / mixed epithelial & mesenchymal tumors
Leiomyosarcoma
Author: Branko Perunovic, D.M.
Topic Completed: 1 May 2007
Minor changes: 30 November 2020
Copyright: 2007-2021, PathologyOutlines.com, Inc.
PubMed Search: Leiomyosarcoma cervix
Table of Contents
Definition / general | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Differential diagnosis | Additional referencesCite this page: Perunovic B. Leiomyosarcoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixleiomyosarcoma.html. Accessed June 19th, 2021.
Definition / general
- Rare; < 100 cases reported; but most common primary sarcoma of cervix
- May develop in cervical stump after subtotal hysterectomy (Ginekol Pol 2002;73:613)
- To diagnose cervical primary, must exclude tumors of lower uterine segment
- Peri and postmenopausal women ages 40 to 60 years
- Commonly presents with abnormal vaginal bleeding, abdominopelvic pain and a palpable cervical mass
- Poor prognosis (Cancer 1973;31:1176)
Case reports
- 47 year old woman with 10 kg tumor (Gynecol Oncol 1998;69:169)
- 52 year old woman with xanthomatous tumor (Int J Gynecol Pathol 1998;17:89)
- 53 year old woman with epithelioid tumors (Gynecol Oncol 2005;97:957)
- 59 year old woman with abundant vaginal serosanguinous discharge (Case of the Week #92)
- 72 year old woman with endometrial adenocarcinoma and cervical squamous cell carcinoma (Gynecol Oncol 2001;82:400)
Gross description
- Large (up to 12 cm), polypoid, soft, with irregular outline
- May thicken and expand cervical canal
- Often hemorrhage and necrosis
Gross images
Case #92
Tumor attached by short pedicle
Tumor attached by short pedicle sagittal section
Microscopic (histologic) description
- Interlacing fascicles of smooth muscle cells with large, atypical, hyperchromatic nuclei
- 5+ mitotic figures/10 HPF
- May have osteoclast-like giant cells, epithelioid, myxoid or xanthomatous features
Microscopic (histologic) images
Case #92
Interlacing fascicles
Large pleomorphic nuclei
Muscle specific actin
Cytology description
- Isolated cells or side by side tumor cells with elongated cytoplasm, oval or cigar shaped nuclei with coarse chromocenters
- Nuclear atypia, mitotic figures and necrosis are important features (Tumori 1978;64:205)
Differential diagnosis
- Adenomyoma: spindle cells with wispy cytoplasm, elongated nuclei and nucleoli, but no mitosis or necrosis (Diagn Cytopathol 2005;32:288)
Additional references
