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Mitotically active leiomyomas of the uterus
1Department of Pathology, Cleveland Clinic Foundation, Ohio 44195-5138.
American Journal of Clinical Pathology
|January 1, 1992
Summary
Mitotically active leiomyomas, uterine smooth muscle tumors with high mitotic counts but no atypia, demonstrate benign behavior. These tumors are best classified as mitotically active leiomyomas, not potentially malignant.
Area of Science:
- Gynecologic pathology
- Surgical pathology
- Uterine neoplasms
Background:
- Uterine smooth muscle tumors require accurate classification to predict clinical behavior.
- High mitotic activity in leiomyomas can be mistaken for malignancy.
Purpose of the Study:
- To evaluate the clinical behavior of uterine smooth muscle tumors with mitotic activity exceeding 4 mitotic figures per 10 high-power fields (HPF).
- To determine appropriate nomenclature for these tumors.
Main Methods:
- Histologic review of 15 uterine smooth muscle tumors with high mitotic counts (>4/10 HPF) but no cytologic atypia.
- Mitotic counts performed using two methods (highest count and average count).
- Clinical follow-up data collected.
Main Results:
- Tumors showed mitotic counts ranging from 4.2 to 15/10 HPF.
- None of the tumors exhibited cytologic atypia.
- Follow-up (mean 2.5 years) revealed no local recurrences or metastases.
Conclusions:
- Uterine smooth muscle tumors with high mitotic activity but no atypia exhibit benign behavior.
- The designation 'mitotically active leiomyoma' is appropriate.
- These tumors should not be classified as smooth muscle tumors of uncertain malignant potential or low-grade leiomyosarcoma.