Prevalence of cellular leiomyoma and partially cellular leiomyoma in postoperative samples - analysis of 384 cases.

OBJECTIVES The aim of the study was to evaluate the prevalence of cellular leiomyomas and partially cellular leiomyomas in postoperative samples. MATERIAL AND METHODS A total of 2144 cases of uterine leiomyomas were diagnosed in postoperative samples at the Department of Obstetrics and Gynecology, RSzS, Radom, Poland, between 1998 and 2014. We analyzed 384 cases which were subdivided into 4 groups, taking into account the co-occurrence of leiomyomas and/or endometriosis. The following variables were investigated: age, weight, BMI, parity, type of surgical procedure, prevalence of atypical and borderline tumor forms, and concomitant malignancy of the reproductive system. RESULTS The prevalence of cellular leiomyomas and partially cellular leiomyomas was estimated at 17.9%. Nulliparous patients were significantly more numerous in the subgroups without endometriosis. Concomitant malignancy of the reproductive system was > 2 fold more commonin the subgroups with endometriosis as compared to the other subgroups. CONCLUSIONS The fact that cellular leiomyomas have a varying degree of cell atypia, together with clinical observations reported in the literature, support the view that cellular leiomyomas and partially cellular leiomyomas can progress to malignant leiomyosarcoma (LMS). Hysterectomy and the subsequent follow-up should be the mainstay of therapy for cellular leiomyoma. Conservative management (myomectomy) should be recommended only tothose patients who wish to preserve their fertility.