Leiomyosarcoma of the uterus: ultrasonography and serum lactate dehydrogenase level.
Between January 1, 1979, and September 30, 1990, a total of 1,886 patients in the National Defense Medical College Hospital, a self-referred population, had a hysterectomy because of signs and symptoms presumably resulting from uterine myomas. After hysterectomy with presumed benign disease, a histologic diagnosis of leiomyosarcoma was made in 7 patients (0.37%). Preoperative diagnosis of leiomyosarcoma was not made in any of the 7 patients. However, serum lactate dehydrogenase levels were abnormally elevated in 3 of them, and degenerative changes were found within the tumor by ultrasonography in 5 of them. Furthermore, increased lactate dehydrogenase levels and degenerative changes within the tumor were found in 3 of the patients whose tumors had 10 or more mitoses per 10 high-power fields. The prognosis for the leiomyosarcomas with increased mitotic rates is very poor. Therefore, a degenerative change within the uterine mass and an increased lactate dehydrogenase level, when present, should suggest the diagnosis of leiomyosarcoma.
Seki
K
K
Department of Obstetrics and Gynecology, National Defense Medical College, Saitama, Japan.
Hoshihara
T
T
Nagata
I
I
D000328:Adult; D004796:Clinical Enzyme Tests; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D007889:Leiomyoma / Q000175:diagnosis* / Q000601:surgery; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging
D007770:L-Lactate Dehydrogenase