Korean J Obstet Gynecol.
2006 Feb;49(2):431-435.
Clinical Analysis of Uterine Leiomyoma with Increased Mitotic Activity
- Affiliations
-
- 1Department of Obstetrics and Gynecology, Our Lady of Mercy Hospital, College of Medicine, Catholic University of Korea. duckyeong20@yahoo.co.kr
- 2Department of Pathology, Our Lady of Mercy Hospital, College of Medicine, Catholic University of Korea.
- 3Department of Obstetrics and Gynecology, Cheong Ju St. Mary's Hospital, Korea.
Abstract
OBJECTIVE
To evaluate clinical-pathological aspects of uterine smooth-muscle tumors with a pathological diagnosis of uncertain malignant potential or leiomyomas with increased mitotic activity.
METHODS
We reviewed the charts and pathological records of twenty seven patients with smooth muscle tumors of the uterus, with 5-9 mitotic figures per 10HPF (High power fields) and without cytological atypia or necrosis retrospectively.
RESULTS
The patients were 29-60 (mean 41.8+/-6.8) years old and mean parity was 1.7+/-0.9. None of the patients had used any hormones preoperatively. The size of the myomatous tumors ranged from 2 to 23 cm (mean 7.1+/-4.6 cm). On gross examination all tumors appeared as typical leiomyomas. Twenty were intramural and 7 were submucous leiomyomas. The mitotic counts ranged 5-9/10 HPF (mean 6.0+/-1.2/10 HPF). Cytological atypia or necrosis were absent. The histological phase of the endometrium could be evaluated in 18 patients. Of these, ten had secretory-phase endometrium and proliferative endometrium was present in eight patients. Hysterectomy was performed in 20 patients with intramural leiomyoma, and myomectomy was in 7 patients under diagnosis of submucosal type. Postoperative follow-up periods ranged 5-94 months (mean 37.0+/-22.6 months). All patients were alive without evidence of recurrence or metastasis.
CONCLUSION
Leiomyomas containing from five to nine mitotic figures per 10 HPF, without cellular atypia or necrosis, should be regarded as benign. Hysterectomy need not autonomically be done, as follow-up is a viable alternative. Myomectomy is an appropriate treatment, particularly in young patients interested in reproduction.
