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J Obstet Gynaecol Res. 2010 Feb;36(1):187-90. doi: 10.1111/j.1447-0756.2009.01117.x.

Leiomyosarcoma arising in a patient with prior mitotically active leiomyoma.

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  • 1Department of Obstetrics and Gynecology, Catholic University, Seoul, Korea.


Mitotically active leiomyomas exhibiting insignificant cytologic atypia (none to mild) with an increased mitotic count of 5-20 mitotic figures per 10 high power fields, and without coagulative tumor cell necrosis or atypical mitoses, tend to have a benign clinical course. We encountered a case of a mitotically active leiomyoma and malignant transformation after a total hysterectomy. The recurrent multiple abdominal masses were removed surgically; most of them were benign leiomyomas, but some were leiomyosarcomas. Although most mitotically active leiomyomas have a benign clinical course, these lesions can recur and have the potential for malignant transformation. Therefore, patients with mitotically active leiomyomas require close follow-up.

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