Toki N, Kashimura M, Hasegawa T, Fukuoka K, Kawagoe T, Sugihara K, Koyama C, Hisaoka M
Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Acta Cytol. 2000 May-Jun;44(3):415-9. doi: 10.1159/000328489.
Myxoid leiomyosarcoma is a rare variant of uterine sarcoma, exhibiting malignant biologic behavior despite the absence of cytologic atypia and of significant mitotic activity.
A 20-year-old female was referred with a cystic pelvic mass. At laparotomy, the tumor, weighed 2,200 g and originating in the left lateral uterine wall, was removed. Microscopic examination revealed well-differentiated smooth muscle cells without atypia and with a few mitotic figures in the copious myxoid matrix, suggesting myxoid leiomyosarcoma. Three years following laparotomy, an irregular mass around the uterus was noted on sonographic examination, suggesting local recurrence. Two years and six months later, the second operation was performed, and a locally recurrent, multicystic tumor weighing 3,500 g was excised. The histopathology was similar to that of the primary tumor. Cytologic findings on imprint material from the tumor revealed a few isolated or sheet like small cells consisting of spindle and polygonal cells with round and oval nuclei. Cytologic atypia was also minimal.
Myxoid leiomyosarcoma should be included in the differential diagnosis of smooth muscle neoplasia.
黏液样平滑肌肉瘤是子宫肉瘤的一种罕见变异型，尽管缺乏细胞学异型性和显著的有丝分裂活性，但仍表现出恶性生物学行为。
一名20岁女性因盆腔囊性肿块前来就诊。剖腹手术时，切除了重达2200克、起源于子宫左侧壁的肿瘤。显微镜检查显示平滑肌细胞分化良好，无异型性，在大量黏液样基质中有少量有丝分裂象，提示为黏液样平滑肌肉瘤。剖腹手术后三年，超声检查发现子宫周围有一不规则肿块，提示局部复发。两年零六个月后，进行了第二次手术，切除了一个局部复发的多囊性肿瘤，重达3500克。组织病理学与原发肿瘤相似。肿瘤印片材料的细胞学检查发现有一些孤立的或片状的小细胞，由梭形和多角形细胞组成，核呈圆形和椭圆形。细胞学异型性也很轻微。
黏液样平滑肌肉瘤应纳入平滑肌肿瘤的鉴别诊断。
