Mesenchymal / mixed epithelial & mesenchymal tumors


Topic Completed: 1 May 2007

Minor changes: 30 November 2020

Copyright: 2007-2021, PathologyOutlines.com, Inc.

PubMed Search: Leiomyosarcoma cervix

Branko Perunovic, D.M.
Page views in 2020: 885
Page views in 2021 to date: 727
Cite this page: Perunovic B. Leiomyosarcoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixleiomyosarcoma.html. Accessed December 3rd, 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
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)
Positive stains
Differential diagnosis
Additional references
Back to top
Image 01 Image 02