Update on Uterine Mesenchymal Neoplasms

Area of Science:

• Gynecologic pathology
• Surgical pathology
• Molecular pathology

Background:

• Epithelioid and myxoid uterine mesenchymal neoplasms pose diagnostic challenges.
• Diagnostic criteria for these tumors are rapidly evolving.
• Molecular testing has significantly advanced tumor classification.

Purpose of the Study:

• To review recent advances in epithelioid and myxoid uterine mesenchymal neoplasms.
• To highlight clinicopathological and molecular features of key tumor types.
• To provide differential diagnoses for morphologic mimickers.

Main Methods:

• Literature review of recent advances in uterine mesenchymal neoplasms.
• Focus on clinicopathological and molecular features.
• Discussion of differential diagnoses.

Main Results:

• Recent advances in molecular testing are crucial for diagnosing uterine mesenchymal neoplasms.
• Key features of perivascular epithelioid cell tumors, uterine tumors resembling ovarian sex cord tumors, BCOR/BCORL1-altered high-grade endometrial stromal sarcomas, and inflammatory myofibroblastic tumors are detailed.
• Novel developments in epithelioid and myxoid leiomyosarcomas are presented.

Conclusions:

• Accurate diagnosis of uterine mesenchymal neoplasms relies on integrating clinicopathological and molecular data.
• Understanding evolving diagnostic criteria is essential for effective patient management.
• Differential diagnosis of morphologic mimickers aids in precise classification.