[Clinical and morphologic diagnosis of uterine sarcoma]

The results of a clinico-morphological evaluation of the data on 419 patients suffering from uterine sarcoma are presented. It is recommended that dynamic and ultrasonic surveillance of patients with uterine myoma, particularly those in pre- or postmenopause, be carried out for timely detection of leiomyosarcoma. Premorbid pathogenetic status in patients with mixed mesodermal neoplasms and, especially, carcinosarcomas has much in common with the relevant characteristics of hormone dependent adenocarcinoma of the endometrium. Cytologic examination of the uterus and endocervix in patients with endocrine metabolic disorders and myoma may detect mixed mesodermal tumors and uterine stromal sarcoma at earlier stages. Mitotic index, meta-prophase factor and number of cell mitosis determination is instrumental in differential diagnosis of proliferating myoma and leiomyosarcoma. Among the unfavorable prognostic factors in leiosarcoma are: high anaplasia and mitotic activity (in excess of 10/1000) and marked infiltrative growth, while, in mixed mesodermal tumor (carcinosarcoma included), it is deep invasion (more than 1.0 cm).