title: A clinicopathological study of atypical leiomyomas: Benign variant leiomyoma or smooth-muscle tumor of uncertain malignant potential.
abstract: Atypical leiomyomas are histopathologically recognized by moderate to severe pleomorphic atypical tumor cells showing low mitotic counts without coagulative tumor cell necrosis. The histopathological features and clinical behavior of these tumors are unclear. The surgical management of these lesions includes myomectomy and hysterectomy. The current study presents 5 cases of women with atypical leiomyomas that were managed surgically. The clinicopathological characteristics of the patients and recurrences were analyzed. The median age of the patients was 43 years old. While 3 out of 5 patients were treated by hysterectomy (with or without salpingo-oophorectomy), the remaining 2 patients were treated by myomectomy. The median mitotic index was 3 mitotic figures/10 high-power fields. The post-operative course of all patients was uneventful, and there was no evidence of local or distant recurrence in a median follow-up time of 72 months. The treatment of choice for atypical leiomyomas is hysterectomy. However, myomectomy may be an option for fertility sparing cases. A thorough consultation with regard to the uncertain behavior of such tumors and a rigorous follow-up must be offered in such patients.
authors.affiliation: Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kalogiannidis
authors.affiliation: Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece.
authors.forename: Thomas
authors.initials: T
authors.lastname: Stavrakis
authors.affiliation: Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece.
authors.forename: Themistoklis
authors.initials: T
authors.lastname: Dagklis
authors.affiliation: Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece.
authors.forename: Stamatios
authors.initials: S
authors.lastname: Petousis
authors.affiliation: Department of Pathology, Hippokration General Hospital, Thessaloniki 54642, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Nikolaidou
authors.affiliation: Department of Pathology, Hippokration General Hospital, Thessaloniki 54642, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Venizelos
authors.affiliation: Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece.
authors.forename: David
authors.initials: D
authors.lastname: Rousso
keywords: atypical leiomyomas; leiomyosarcomas; smooth-muscle tumor of uncertain malignant potential; uterine leiomyomas