A Retrospective Analysis Of The Clinicopathologic Characteristics Of151Cases Special Subtypes Of Uterine Leiomyoma

Background Uterine smooth muscle tumors(leiomyoma, LM) is the most common gynecological benign tumor of women of reproductive age. Clinically, the overwhelming majority of the leiomyoma belong to ordinary type whose therapeutic method is operation and observe. In recent years, with the development of pathology and our further understanding of the pathological type of LM, special type of uterine smooth muscle tumors gradually get people’s attention. Although benign, it has special histological features under the microscope, and has different biological behavior from ordinary leiomyomas. There are some limitations for final diagnosis using intraoperative rapid pathological examination, resulting in difficulties to both the pathologists and the clinicians in surgery. Moreover the clinical treatment of special types of uterine fibroids is controversial. In this paper, we analysis the clinical and pathological features of special types of uterine leiomyomas, aims to furtherly understand the clinical and biological behavior of it, and provide a reference for the clinical management of it.Methods A retrospective analysis of151patients collected from QiLu Hospital of Shandong University from January2006to December2011. These patients had already been made definite diagnosis by routine pathology.Results The age distribution of the151cases has no significant difference from that of the patients with ordinary type of uterine tumors (P>0.05). The incidence rate of the special type of uterine smooth muscle tumors is10.25%.74.17%of the151 cases have clinical symptoms, mainly as vaginal bleeding changes and abdominal mass; while asymptomatic ones accounted for25.83%. There was also no significant difference in its clinical manifestations between special type cases and ordinary type cases. For treatment,72.19%choose hysteromyomectomy and27.81%choose hysterectomy.17cases received second surgery.37cases of the151had already been diagnosed by rapid pathological method, while the rest108patients were diagnosed with postoperative routine pathology.96%of the frozen sectionis accord with the rapid pathology.6cases were difficult to be diagnosed, and immunohistochemistry was used to help.Conclusion There is no significant difference of the age distribution and clinical symptoms between special type cases and ordinary type cases.1.Special types of uterine muscle tumors were customarily treated by operation, just like the treatment of common type. But because of the high recent rate, hysterectomy is recommended when the patient has no fertility requirements. Intravenous leiomyomatosis need oophorectomy at the same time.2.The differential diagnosis of the special type of uterine muscle tumors are mainly based on the pathological features. Frozen section diagnosis still has some limitations. Especially in the frozen section found more mitotic figures should delay diagnosis. Postoperative immunohistochemistry is necessary to assist diagnosis.