Chulalongkorn Medical Journal


Background : The frequency of uterine leiomyoma variants and smooth muscletumor of uncertain malignant potential (STUMP) are low. Nopreviously study about them has been done at CharoenkrungpracharakHospital and in Thailand. Their clinical behaviors areuncertain with some controversies regarding the prognosisincluding the risk of recurrence.Objective : To investigate the frequency of uterine leiomyoma variants andSTUMP and to compare the clinicopathological features andrecurrence rate of these variants to typical leiomyoma (LM).Design : A retrospective study.Setting : Charoenkrung-pracharak Hospital, Bangkok MetropolitanAdministration.Subjects : One thousand and fifty-two patients with smooth muscle tumorof the uterusMaterials and Method : Patients with pathological diagnosis of smooth muscle tumor(SMT) of the uterus from January 1, 1999 to June 30, 2010 weresearched. Those (660 patients) who had associated gynecologicmalignancy were excluded. Collected clinicopathological dataswere: age, menopausal status, symptoms, treatment, andfollow-up time of the patients as well as location, size, color,and consistency of the tumors. The clinicopathological featuresand recurrence rate of these variants were compared to thoseof typical leiomyoma (LM) and leiomyosarcoma (LS).Results : One thousand seven hundred and seventeen cases of SMTwere identified. Six hundred and sixty cases were excludeddue to their associated cervical, ovarian, or endometrial cancers.Out of the 1,052 SMT cases included in the study, we found983 typical LM, 64 uterine LM variants which comprised of41 cellular type, 12 atypical type, 11 mitotically active type and5 cases of STUMP. The frequency of uterine LM variants andSTUMPwere 6.08% and 0.47%. Mean age of the patients was45.3 years. Most were premenopausal and presented withabnormal uterine bleeding. Different features of these variants/STUMP from typical LM were: larger size, softer, non-white,and submucous in location. All 69 patients with uterine LMvariants and STUMPS survived without any evidence of recurrenceor death after a median period of follow-up of 26 months(ranged, 1 - 120 months).Conclusions : The frequency of uterine LM variants and STUMP are 6.08 and0.47% , respectively. The most common variants among themis cellular LM. All patients with these rare tumors have goodprognosis without any recurrence and are alive.


Faculty of Medicine, Chulalongkorn University

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