Possibilities of differential diagnosis of uterine leiomyosarcoma
Elena A. Sosnova , Arina A. Kordys
V.F.Snegirev Archives of Obstetrics and Gynecology ›› 2023, Vol. 10 ›› Issue (3) : 203 -208.
Possibilities of differential diagnosis of uterine leiomyosarcoma
Uterine leiomyosarcoma is a rare malignant neoplasm consisting of smooth muscle cells, characterized by an aggressive course and poor prognosis.
Differential diagnosis of uterine leiomyosarcoma is challenging due to the nonspecificity and low severity of symptoms, particularly in the early stages. Patients with uterine leiomyosarcoma commonly present with complaints in of pelvic pain, abnormal uterine bleeding, and symptoms of compression of nearby organs. The same clinical symptoms are characteristics of patients with uterine leiomyomas.
Leiomyosarcoma is often detected after histologic examination of material obtained during surgery for uterine myoma. At the same time, preoperative verification of the malignant nature of the neoplasm is crucial in determining the optimal tactics of surgical treatment. For instance, the use of organ-preserving techniques and morcellation in the treatment of presumed uterine leiomyoma may result in the dissemination of tumor cells and significantly worsen the prognosis in patients with undiagnosed leiomyosarcoma.
This review discusses existing methods of preoperative diagnosis of uterine leiomyosarcoma, their efficacy, as well as the possibilities of application in clinical practice.
sarcoma / uterine leiomyosarcoma / uterine leiomyoma / uterine neoplasms
| [1] |
Multinu F, Casarin J, Tortorella L, et al. Incidence of sarcoma in patients undergoing hysterectomy for benign indications: a population-based study. Am J Obstet Gynecol. 2019;220(2):179.e1–179.e10. doi: 10.1016/j.ajog.2018.11.1086 |
| [2] |
Multinu F., Casarin J., Tortorella L., et al. Incidence of sarcoma in patients undergoing hysterectomy for benign indications: a population-based study // Am J Obstet Gynecol. 2019. Vol. 220, N. 2. P. 179.e1–179.e10. doi: 10.1016/j.ajog.2018.11.1086 |
| [3] |
Skorstad M, Kent A, Lieng M. Preoperative evaluation in women with uterine leiomyosarcoma. A nationwide cohort study. Acta Obstet Gynecol Scand. 2016;95(11):1228–1234. doi: 10.1111/aogs.13008 |
| [4] |
Skorstad M., Kent A., Lieng M. Preoperative evaluation in women with uterine leiomyosarcoma. A nationwide cohort study // Acta Obstet Gynecol Scand. 2016. Vol. 95, N. 11. P. 1228–1234. doi: 10.1111/aogs.13008 |
| [5] |
Major FJ, Blessing JA, Silverberg SG, et al. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer. 1993;71(4 Suppl.):1702–1709. doi: 10.1002/cncr.2820710440 |
| [6] |
Major F.J., Blessing J.A., Silverberg S.G., et al. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study // Cancer. 1993. Vol. 71, N. 4 Suppl. P. 1702–1709. doi: 10.1002/cncr.2820710440 |
| [7] |
Ul’rikh EA. Features of the treatment of uterine sarcoma. Practical Oncology. 2013;14(2):127–134. (In Russ). |
| [8] |
Ульрих Е.А. Особенности лечения сарком матки // Практическая онкология. 2013. Т. 14, № 2. С. 127–134. |
| [9] |
Mbatani N, Olawaiye AB, Prat J. Uterine sarcomas. Int J Gynecol Obstet. 2018;143 Suppl. 2:51–58. doi: 10.1002/ijgo.12613 |
| [10] |
Mbatani N., Olawaiye A.B., Prat J. Uterine sarcomas // Int J Gynaecol Obstet. 2018. Vol. 143, Suppl. 2. P. 51–58. doi: 10.1002/ijgo.12613 |
| [11] |
Chantasartrassamee P, Kongsawatvorakul C, Rermluk N, et al. Preoperative clinical characteristics between uterine sarcoma and leiomyoma in patients with uterine mass, a case-control study. Eur J Obstet Gynecol Reprod Biol. 2022;270:176–180. doi: 10.1016/j.ejogrb.2022.01.013 |
| [12] |
Chantasartrassamee P., Kongsawatvorakul C., Rermluk N., et al. Preoperative clinical characteristics between uterine sarcoma and leiomyoma in patients with uterine mass, a case-control study // Eur J Obstet Gynecol Reprod Biol. 2022. Vol. 270. P. 176–180. doi: 10.1016/j.ejogrb.2022.01.013 |
| [13] |
Chen I, Firth B, Hopkins L, et al. Clinical Characteristics Differentiating Uterine Sarcoma and Fibroids. JSLS. 2018;22(1):e2017.00066. doi: 10.4293/JSLS.2017.00066 |
| [14] |
Chen I., Firth B., Hopkins L., et al. Clinical Characteristics Differentiating Uterine Sarcoma and Fibroids // JSLS. 2018. Vol. 22, N. 1. P. e2017.00066. doi: 10.4293/JSLS.2017.00066 |
| [15] |
Zhang G, Yu X, Zhu L, et al. Preoperative clinical characteristics scoring system for differentiating uterine leiomyosarcoma from fibroid. BMC Cancer. 2020;20(1):514. doi: 10.1186/s12885-020-07003-z |
| [16] |
Zhang G., Yu X., Zhu L., et al. Preoperative clinical characteristics scoring system for differentiating uterine leiomyosarcoma from fibroid // BMC Cancer. 2020. Vol. 20, N. 1. P. 514. doi: 10.1186/s12885-020-07003-z |
| [17] |
Nagai T, Takai Y, Akahori T, et al. Highly improved accuracy of the revised PREoperative sarcoma score (rPRESS) in the decision of performing surgery for patients presenting with a uterine mass. Springerplus. 2015;4:520. doi: 10.1186/s40064-015-1318-7 |
| [18] |
Nagai T., Takai Y., Akahori T., et al. Highly improved accuracy of the revised PREoperative sarcoma score (rPRESS) in the decision of performing surgery for patients presenting with a uterine mass // Springerplus. 2015. Vol. 4. P. 520. doi: 10.1186/s40064-015-1318-7 |
| [19] |
Goto A, Takeuchi S, Sugimura K, Maruo T. Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus. Int J Gynecol Cancer. 2002;12(4):354–361. doi: 10.1046/j.1525-1438.2002.01086.x |
| [20] |
Goto A., Takeuchi S., Sugimura K., Maruo T. Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus // Int J Gynecol Cancer. 2002. Vol. 12, N. 4. P. 354–361. doi: 10.1046/j.1525-1438.2002.01086.x |
| [21] |
Cho H-Y, Kim K, Kim Y-B, No JH. Differential diagnosis between uterine sarcoma and leiomyoma using preoperative clinical characteristics. J Obstet Gynaecol Res. 2015;42(3):313–318. doi: 10.1111/jog.12915 |
| [22] |
Cho H.-Y., Kim K., Kim Y.-B., No J.H. Differential diagnosis between uterine sarcoma and leiomyoma using preoperative clinical characteristics // J Obstet Gynaecol Res. 2016. Vol. 42, N. 3. P. 313–318. doi: 10.1111/jog.12915 |
| [23] |
Exacoustos C, Romanini ME, Amadio A, et al. Can gray-scale and color Doppler sonography differentiate between uterine leiomyosarcoma and leiomyoma? J Clin Ultrasound. 2007;35(8):449–457. doi: 10.1002/jcu.20386 |
| [24] |
Exacoustos C., Romanini M.E., Amadio A., et al. Can gray-scale and color Doppler sonography differentiate between uterine leiomyosarcoma and leiomyoma? // J Clin Ultrasound. 2007. Vol. 35, N. 8. P. 449–457. doi: 10.1002/jcu.20386 |
| [25] |
Ludovisi M, Moro F, Pasciuto T, et al. Imaging in gynecological disease (15): Clinical and ultrasound characteristics of uterine sarcoma. Ultrasound Obstet Gynecol. 2019;54(5):676–687. doi: 10.1002/uog.20270 |
| [26] |
Ludovisi M., Moro F., Pasciuto T., et al. Imaging in gynecological disease (15): clinical and ultrasound characteristics of uterine sarcoma // Ultrasound Obstet Gynecol. 2019. Vol. 54, N. 5. P. 676–687. doi: 10.1002/uog.20270 |
| [27] |
Sun S, Bonaffini PA, Nougaret S, et al. How to differentiate uterine leiomyosarcoma from leiomyoma with imaging. Diagn Interv Imaging. 2019;100(10):619–634. doi: 10.1016/j.diii.2019.07.007 |
| [28] |
Sun S., Bonaffini P.A., Nougaret S., et al. How to differentiate uterine leiomyosarcoma from leiomyoma with imaging // Diagn Interv Imaging. 2019. Vol. 100, N. 10. P. 619–634. doi: 10.1016/j.diii.2019.07.007 |
| [29] |
Stolyarova IV, Yakovleva EK, Sharakova VV. Evaluation of diagnostic effectiveness of the method of diffusion-weighted MR-images in diagnosis of pathology of the uterine body. Problems in Oncology. 2015;61(6):986–993. (In Russ). |
| [30] |
Столярова И.В., Яковлева Е.К., Шаракова В.В. Оценка диагностической эффективности методики диффузно-взвешенных МР-изображений в диагностике патологии тела матки // Вопросы онкологии. 2015. Т. 61, № 6. С. 986–993. |
| [31] |
Camponovo C, Neumann S, Zosso L, Mueller MD, Raio L. Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma. Diagnostics (Basel). 2023;13(7):1223. doi: 10.3390/diagnostics13071223 |
| [32] |
Camponovo C., Neumann S., Zosso L., Mueller M.D., Raio L. Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma // Diagnostics (Basel). 2023. Vol. 13, N. 7. P. 1223. doi: 10.3390/diagnostics13071223 |
| [33] |
Namimoto T, Yamashita Y, Awai K, et al. Combined use of T2-weighted and diffusion-weighted 3-T MR imaging for differentiating uterine sarcomas from benign leiomyomas. Eur Radiol. 2009;19(11):2756–2764. doi: 10.1007/s00330-009-1471-x |
| [34] |
Namimoto T., Yamashita Y., Awai K., et al. Combined use of T2-weighted and diffusion-weighted 3-T MR imaging for differentiating uterine sarcomas from benign leiomyomas // Eur Radiol. 2009. Vol. 19, N. 11. P. 2756–2764. doi: 10.1007/s00330-009-1471-x |
| [35] |
Sadeghi R, Zakavi SR, Hasanzadeh M, et al. Diagnostic performance of fluorine-18-fluorodeoxyglucose positron emission tomography imaging in uterine sarcomas: systematic review and meta-analysis of the literature. Int J Gynecol Cancer. 2013;23(8):1349–1356. doi: 10.1097/IGC.0b013e3182a20e18 |
| [36] |
Sadeghi R., Zakavi S.R., Hasanzadeh M., et al. Diagnostic performance of fluorine-18-fluorodeoxyglucose positron emission tomography imaging in uterine sarcomas: systematic review and meta-analysis of the literature // Int J Gynecol Cancer. 2013. Vol. 23, N. 8. P. 1349–1356. doi: 10.1097/IGC.0b013e3182a20e18 |
| [37] |
Bansal N, Herzog TJ, Burke W, Cohen CJ, Wright JD. The utility of preoperative endometrial sampling for the detection of uterine sarcomas. Gynecol Oncol. 2008;110(1):43–48. doi: 10.1016/j.ygyno.2008.02.026 |
| [38] |
Bansal N., Herzog T.J., Burke W., Cohen C.J., Wright J.D. The utility of preoperative endometrial sampling for the detection of uterine sarcomas // Gynecol Oncol. 2008. Vol. 110, N. 1. P. 43–48. doi: 10.1016/j.ygyno.2008.02.026 |
| [39] |
Hinchcliff EM, Esselen KM, Watkins JC, et al. The Role of Endometrial Biopsy in the Preoperative Detection of Uterine Leiomyosarcoma. J Minim Invasive Gynecol. 2016;23(4):567–572. doi: 10.1016/j.jmig.2016.01.022 |
| [40] |
Hinchcliff E.M., Esselen K.M., Watkins J.C., et al. The Role of Endometrial Biopsy in the Preoperative Detection of Uterine Leiomyosarcoma // J Minim Invasive Gynecol. 2016. Vol. 23, N. 4. P. 567–572. doi: 10.1016/j.jmig.2016.01.022 |
| [41] |
Stukan M, Rutkowski P, Smadja J, Bonvalot S. Ultrasound-Guided Trans-Uterine Cavity Core Needle Biopsy of Uterine Myometrial Tumors to Differentiate Sarcoma from a Benign Lesion-Description of the Method and Review of the Literature. Diagnostics (Basel). 2022;12(6):1348. doi: 10.3390/diagnostics12061348 |
| [42] |
Stukan M., Rutkowski P., Smadja J., Bonvalot S. Ultrasound-Guided Trans-Uterine Cavity Core Needle Biopsy of Uterine Myometrial Tumors to Differentiate Sarcoma from a Benign Lesion-Description of the Method and Review of the Literature // Diagnostics (Basel). 2022. Vol. 12, N. 6. P. 1348. doi: 10.3390/diagnostics12061348 |
| [43] |
Yoshida C, Ichimura T, Kawamura N, et al. A scoring system for histopathologic and immunohistochemical evaluations of uterine leiomyosarcomas. Oncol Rep. 2009;22(4):725–731. doi: 10.3892/or_00000493 |
| [44] |
Yoshida C., Ichimura T., Kawamura N., et al. A scoring system for histopathologic and immunohistochemical evaluations of uterine leiomyosarcomas // Oncol Rep. 2009. Vol. 22, N. 4. P. 725–731. doi: 10.3892/or_00000493 |
| [45] |
Bogani G, Cliby WA, Aletti GD. Impact of morcellation on survival outcomes of patients with unexpected uterine leiomyosarcoma: a systematic review and meta-analysis. Gynecol Oncol. 2015;137(1):167–172. doi: 10.1016/j.ygyno.2014.11.011 |
| [46] |
Bogani G., Cliby W.A., Aletti G.D. Impact of morcellation on survival outcomes of patients with unexpected uterine leiomyosarcoma: a systematic review and meta-analysis // Gynecol Oncol. 2015. Vol. 137, N. 1. P. 167–172. doi: 10.1016/j.ygyno.2014.11.011 |
| [47] |
Bretthauer M, Goderstad JM, Løberg M, et al. Uterine morcellation and survival in uterine sarcomas. Eur J Cancer. 2018;101:62–68. doi: 10.1016/j.ejca.2018.06.007 |
| [48] |
Bretthauer M., Goderstad J.M., Løberg M., et al. Uterine morcellation and survival in uterine sarcomas // Eur J Cancer. 2018. Vol. 101. P. 62–68. doi: 10.1016/j.ejca.2018.06.007 |
Eco-Vector
/
| 〈 |
|
〉 |