Abstract
Background : Although most uterine leiomyosarcomas develop de novo, there are rare cases in which the leiomyosarcoma has arisen from the uterine leiomyoma. We report herein on two such cases and include the imprint cytology findings of the tumors.
Cases : Case 1 was a 60-year-old female who presented with abdominal fullness. An imaging study showed a large mass of the uterus and hydronephrosis. Imprint cytology of the tumor showed hyperchromatic tumor cells with prominent nucleoli and bizarre giant cells, suggesting malignancy. The final histologic diagnosis of the resected tumor was a leiomyosarcoma in a lipoleiomyoma. Case 2 was a 30-year-old female with abnormal genital bleeding and hyperprolactinemia. The intraoperative diagnosis based on imprint cytology and frozen histologic section was indefinite for malignancy. The final histologic diagnosis of the specimens from a myomectomy was a leiomyosarcoma in a bizarre leiomyoma.
Conclusion : It should be borne in mind that leiomyosarcomas rarely develop from uterine leiomyomas, when imprint cytology is used as an ancillary intraoperative diagnostic tool for uterine smooth muscle tumors.
