medigraphic.com
ISSN 1995-9494 (Electronic)
Revista del Hospital Clínico Quirúrgico "Arnaldo Milián Castro"

2022, Number 3

<< Back Next >>

Acta Med Cent 2022; 16 (3)

Clinical and pathological characterization of malignant mesenchymal tumors of the uterus

González VK, Rodríguez SIC, Anoceto AE, León ÁM, López PL, Ferrer PA

Language: Spanish
References: 32
Page: 541-556
PDF size: 560.60 Kb.


ABSTRACT

Introduction: uterine sarcomas are a varied group of infrequent mesenchymal (mesodermal) neoplasms; with a range of characteristics that depends on the histological subtype and tumor grade.
Objective: to clinically and pathologically characterize the malignant mesenchymal tumors of the uterus that were diagnosed in the Pathological Anatomy Department of the "Mariana Grajales" Hospital in the period from January 2010 to December 2017.
Methods: a developmental, descriptive, observational and cross-sectional investigation was carried out at the "Mariana Grajales" Gynecobstetric Hospital in the period from September 2015 to September 2018. The study population was made up of all the patients who were An excisional biopsy was performed in the period from January 2010 to December 2017, with a diagnosis of malignant mesenchymal tumor.
Results: endometrial stromal sarcoma, leiomyosarcomas and adenosarcomas predominated. Smooth muscle tumors, endometrial stromal tumors, and miscellaneous mesenchymal tumors predominated in premenopausal women, whereas mixed tumors predominated in postmenopausal women.
Conclusions: sarcomas occurred more frequently in the uterine body, with a polypoid growth pattern. Poor prognostic factors showed significant values. The epithelioid leiomyosarcomas were large, in most of the tumors there was no evidence of lymphovascular invasion. In endometrial stromal tumors, the low mitotic index predominated, with little invasion of the myometrium.


REFERENCES

  1. Jova Morel R, Rodríguez Salvá A, Díaz Piñera A, Balcindes Acosta S, Sosa Lorenzo I, De Vos P, et al. Modelos de atención a pacientes con enfermedades crónicas no transmisibles en Cuba y el mundo. MEDISAN [Internet]. 2011 [citado 10/05/2021];15(11):1609-1620. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-301920110011000121.

  2. Organización Mundial de la Salud [Internet]. Ginebra: OMS; 2021 [actualizado 13/04/2021; citado 02/11/2021]. Enfermedades no transmisibles; [aprox. 5 pantallas]. Disponible en: http://www.who.int/es/news-room/fact-sheets/detail/noncommunicable-diseases2.

  3. Martínez Navarro J, Socorro Castro C, Fumero Roldan L. Adenocarcinoma de colon. Correlación entre localización, grado histológico y margen radial macroscópico en especímenes quirúrgicos. III Congreso Virtual de Ciencias Morfológicas 2016 [Internet]. La Habana: MINSAP; 2016 [citado 02/11/2021]. Disponible en: http://www.morfovirtual2016.sld.cu/index.php/Morfovirtual/2016/paper/view/563.

  4. Sevillano Tobón A. Características clínicas y epidemiológicas de pacientes con cáncer adscritos a la UMF 66 [tesis]. Xalapa, Veracruz: Universidad Veracruzana; 2014 [citado 02/11/2021]. Disponible en: https://www.uv.mx/blogs/favem2014/files/2014/07/Tesis-Anabel.pdf4.

  5. Siegel R, Miller K, Fedewa S, Ahnen D, Meester R, Barzi A, et al. Colorectal cancer statistics, 2017. CA Cancer J Clin [Internet]. 2017 [citado 02/11/2021];67(3):177-193. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28248415/5. . https://doi.org/10.3322/caac.21395

  6. Brändstedt J. Associations of sex, anthropometric and reproductive factors with clinicopathological and molecular characteristics of colorectal cancer [tesis doctoral]. Lund: Lund University; 2014 [citado 02/11/2021]. Disponible en: https://www.lunduniversity.lu.se/lup/publication/2a56be29-bfba-4aa2-9bec-f893bc06ff8f6.

  7. Agudelo L, Isaza Restrepo A, Figueroa C, Monroy A, Padrón J, Villaveces M. Experiencia en el manejo de cáncer colorrectal en Méderi-Hospital Universitario Mayor, 2012-2014. Rev Colomb Cir [Internet]. 2017 [citado 02/11/2021];32(4):262-268. Disponible en: https://www.revistacirugia.org/index.php/cirugia/article/view/337. . https://doi.org/10.30944/20117582.33

  8. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer [Internet]. 2015 [citado 02/11/2021];136(5):E359-86. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25220842/8. . https://doi.org/10.1002/ijc.29210

  9. Ministerio de Salud Pública. Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2016 [Internet]. La Habana: MINSAP; 2017 [citado 10/05/2021]. Disponible en: http://files.sld.cu/dne/files/2017/05/Anuario_Estad%C3%ADstico_de_Salud_e_2016_edici%C3%B3n_2017.pdf9.

  10. Benson Ch, Miah AB. Uterine sarcoma - current perspectives. Int J Womens Health [Internet]. 2017 [citado 10/05/2021];9:597-606. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587218/10. . https://doi.org/10.2147/ijwh.s117754

  11. Santos P, Cunha TM. Uterine sarcomas: clinical presentation and MRI features. Diagn Interv Radiol [Internet]. 2015 [citado 10/05/2021];21(1):4-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463355/11. . https://doi.org/10.5152/dir.2014.14053

  12. Prieto García B, Maciá Fernández MC, Márquez Batalla S, Sagredo Barra AI, Muradas Mujika K, Rodríguez Vázquez R. Sarcomas uterinos: un reto en el diagnóstico por imagen. seram [Internet]. 2021 [citado 16/06/2021];1(1):1-28. Disponible en: https://piper.espacio-seram.com/index.php/seram/article/view/409312.

  13. Tavassoli FA, Devilee P. Pathology and Genetics: Tumours of the Breast and Female Genital Organs. WHO Classification of Tumours series. Lyon: IARC Press; 2003.

  14. Kurman RJ, Ellenson LH, Ronnett BM. Blaustein´s Pathology of the female genital tract. 6th ed. New York: Springer; 2011.

  15. Rosai J. Rosai and Ackerman's Surgical Pathology. 10th ed. New York: Elsevier; 2011.

  16. Fletcher C. Diagnostic histopathology of tumors. 4th ed. Boston: Elsevier; 2013.

  17. Abu Jamea GA, Al Rikabi AC, Akkour K. Primary low-grade endometrial stromal sarcoma arising in the vagina: report of an unusual case and literature review. J Surg Case Rep [Internet]. 2017 [citado 16/06/2021];2017(11):rjx238. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710654/17. . https://doi.org/10.1093/jscr/rjx238

  18. Gao Y, Meng H, Zhang Y, Jiao T, Hui N. Retrospective analysis of 80 cases with uterine carcinosarcoma, leiomyosarcoma and endometrial stromal sarcoma in China, 1988-2007. Int J Clin Exp Pathol [Internet]. 2014 [citado 16/06/2021];7(4):1616-1624. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014242/18.

  19. Cui R, Yuan F, Wang Y, Li X, Zhang Z, Bai H. Clinicopathological characteristics and treatment strategies for patients with low-grade endometrial stromal sarcoma. Medicine (Baltimore) [Internet]. 2017 [citado 16/06/2021];96(15):e6584. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5403086/19. . https://doi.org/10.1097/MD.0000000000006584

  20. Adiga CP, Gyanchandani M, Goolahally LN, Itagi RM, Kalenahalli KV. Endometrial stromal sarcoma: An aggressive uterine malignancy. J Radiol Case Rep [Internet]. 2016 [citado 16/06/2021];10(9):35-43. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065272/20. . https://doi.org/10.3941/jrcr.v10i9.2770

  21. Robboy SJ. Robboy´s Pathology of the female reproductive tract. 2nd ed. Edinburgh: Churchill Livingstone Elsevier; 2009.

  22. Jetley S, Rana S, Jairajpuri ZS. Low grade endometrial stromal sarcoma in a premenopausal woman. J Nat Sci Biol Med [Internet]. 2014 [citado 16/06/2021];5(1):214-217. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3961941/22. . https://doi.org/10.4103/0976-9668.127339

  23. Micci F, Brunetti M, Dal Cin P, Nucci MR, Gorunova L, Heim S, et al. Fusion of the genes BRD8 and PHF1 in endometrial stromal sarcoma. Genes Chromosomes Cancer [Internet]. 2017 [citado 16/06/2021];56(12):841-845. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763393/23. . https://doi.org/10.1002/gcc.22485

  24. He L, Li J-D, Xiong Y, Huang X, Huang L, Lin J-x, et al. Clinicopathological and molecular markers associated with prognosis and treatment effectiveness of endometrial stromal sarcoma: a retrospective study in China. Arch Gynecol Obstet [Internet]. 2014 [citado 16/06/2021];289(2):383-391. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3894427/24. . https://doi.org/10.1007/s00404-013-2987-5

  25. Shah R, Bhargava S, Wadhwani D, Faujdar M, Gupta S. Bilateral Ovarian Mass: Low-Grade Endometrial Stromal Sarcoma-a Rare Entity. J Gynecol Surg [Internet]. 2015 [citado 16/06/2021];31(6):351-353.Disponible en: https://www.liebertpub.com/doi/10.1089/gyn.2015.000225. . https://doi.org/10.1089/gyn.2015.0002

  26. Richmond AM, Rohrer AJ, Davidson SA, Post MD. Low-grade endometrial stromal sarcoma with extensive sex cord differentiation, heterologous elements, and complex atypical hyperplasia: Case report and review of literature. Gynecol Oncol Rep [Internet]. 2017 [citado 16/06/2021];19:34-38. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5199152/26. . https://doi.org/10.1016/j.gore.2016.12.002

  27. Kho KA, Lin K, Hechanova M, Richardson DL. Risk of Occult Uterine Sarcoma in Women Undergoing Hysterectomy for Benign Indications. Obstet Gynecol [Internet]. 2016 [citado 16/06/2021];127(3):468-473. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5817881/27. . https://doi.org/10.1097/AOG.0000000000001242

  28. González Valcárcel K, Anoceto Armiñana E, López Pérez L, Ferrer Pérez A, Cabrera Abreu Y, Iglesias Yera A, et al. Adenosarcoma uterino con sobrecrecimiento del componente sarcomatoso. Acta Méd Centro [Internet]. 2017 [citado 20/06/2021];11(3):101-107. Disponible en: http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/856/105928.

  29. Parra-Herran C, Schoolmeester JK, Yuan L, Dal Cin P, Fletcher Ch, Quade BJ, et al. Myxoid Leiomyosarcoma of the Uterus: A Clinicopathologic Analysis of 30 Cases and Review of the Literature With Reappraisal of Its Distinction From Other Uterine Myxoid Mesenchymal Neoplasms. Am J Surg Pathol [Internet]. 2016 [citado 20/06/2021];40(3):285-301. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26866354/29. . https://doi.org/10.1097/pas.0000000000000593

  30. González Valcárcel K, Anoceto Armiñana E, Alba Turiño O, Rodríguez Santos IC, Machado Hernández YA, Iglesias Yera AE, et al. Tumor de células epiteliodes perivascular (PEComa) uterino, un raro tumor. Acta Méd Centro [Internet]. 2017 [citado 26/03/2021];11(4):85-92. Disponible en: http://www.revactamedicacentro.sld.cu/index.php/amc/article/view/862/110130.

  31. Hoang LN, Aneja A, Conlon N, Delair DF, Middha S, Benayed R, et al. Novel High-Grade Endometrial Stromal Sarcoma: A Morphologic Mimicker of Myxoid Leiomyosarcoma. Am J Surg Pathol [Internet]. 2017 [citado 26/03/2021];41(1):12-14. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630222/31. . https://doi.org/10.1097/PAS.0000000000000721

  32. Park GE, Rha SE, Oh SN, Lee A, Lee KH, Kim M-R. Ultrasonographic findings of low-grade endometrial stromal sarcoma of the uterus with a focus on cystic degeneration. Ultrasonography [Internet]. 2016 [citado 26/03/2021];35(2):124-130. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825207/32. . https://doi.org/10.14366/usg.15045




2020     |     www.medigraphic.com