Diagnostic Histopathology
Volume 14, Issue 4 , Pages 175-188 , April 2008

Uterine mesenchymal tumors: a review of selected topics

References 

  1. Koss LG, Shapiro RH, Brunschwig A. Endometrial stromal sarcoma. Surg Gynecol Obstet. 1965;121:531–537
  2. Major FJ, Blessing JA, Silverberg SG, et al. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer. 1993;71:1702–1709
  3. de Fusco PA, Gaffey TA, Malkasian GD, Long HJ, Cha SS. Endometrial stromal sarcoma: review of Mayo Clinic experience, 1945–1980. Gynecol Oncol. 1989;35:8–14
  4. Chang KL, Crabtree GS, Lim-Tan SK, Kempson RL, Hendrickson MR. Primary uterine endometrial stromal neoplasms. A clinicopathologic study of 117 cases. Am J Surg Pathol. 1990;14:415–438
  5. Kempson RL, Hendrickson MR. Smooth muscle, endometrial stromal, and mixed Mullerian tumors of the uterus. Mod Pathol. 2000;13:328–342
  6. Norris HJ, Taylor HB. Mesenchymal tumors of the uterus I. A clinical and pathological study of 53 endometrial stromal tumors. Cancer. 1966;19:755–766
  7. Oliva E, Clement PB, Young RH. Endometrial stromal tumors: an update on a group of tumors with a protean phenotype. Adv Anat Pathol. 2000;7:257–281
  8. Tavassoli FA, Norris HJ. Mesenchymal tumours of the uterus. VII. A clinicopathological study of 60 endometrial stromal nodules. Histopathology. 1981;5:1–10
  9. Evans HL. Endometrial stromal sarcoma and poorly differentiated endometrial sarcoma. Cancer. 1982;50:2170–2182
  10. Piver MS, Rutledge FN, Copeland L, Webster K, Blumenson L, Suh O. Uterine endolymphatic stromal myosis: a collaborative study. Obstet Gynecol. 1984;64:173–178
  11. McCluggage WG, Haller U, Kurman RJ, Kubik-Huch RA. Mixed epithelial and mesenchymal tumours. In:  Tavassoli FA,  Devilee P editor. World Health Organization classification of tumours. Pathology and genetics of tumours of the breast and female genital organs. Lyon: IARC Press; 2003;p. 245–249
  12. Malpica A, Deavers MT, Silva EG. High-grade sarcoma in endometrial stromal sarcoma: dedifferentiated endometrial stromal sarcoma. Mod Pathol. 2006;19:188A;(abstract 872)
  13. Maluf FC, Sabbatini P, Schwartz L, et al. Endometrial stromal sarcoma: objective response to letrozole. Gynecol Oncol. 2001;82:384–388
  14. Chu MC, Mor G, Lim C, et al. Low-grade endometrial stromal sarcoma: hormonal aspects. Gynecol Oncol. 2003;90:170–176
  15. Schilder JM, Hurd WW, Roth LM, et al. Hormonal treatment of an endometrial stromal nodule followed by local excision. Obstet Gynecol. 1999;93:805–807
  16. Clement PB. The pathology of uterine smooth muscle tumors and mixed endometrial stromal-smooth muscle tumors: a selective review with emphasis on recent advances. Int J Gynecol Pathol. 2000;19:39–55
  17. McCluggage WG, Cromie AJ, Bryson C, et al. Uterine endometrial stromal sarcoma with smooth muscle and glandular differentiation. J Clin Pathol. 2001;54:481–483
  18. Oliva E, Clement PB, Young RH, et al. Mixed endometrial stromal and smooth muscle tumors of the uterus: a clinicopathologic study of 15 cases. Am J Surg Pathol. 1998;22:997–1005
  19. Silverberg SG, Kurman RJ. Atlas of tumor pathology: tumors of the uterine corpus and gestational trophoblastic disease. Vol. 3. Washington, DC: Armed Forces Institute of Pathology; 1992;p. 141–146
  20. Yilmaz A, Rush DS, Soslow RA. Endometrial stromal sarcomas with unusual histologic features: a report of 24 primary and metastatic tumors emphasizing fibroblastic and smooth muscle differentiation. Am J Surg Pathol. 2002;26:1142–1150
  21. Oliva E, Young RH, Clement PB, et al. Myxoid and fibrous endometrial stromal tumors of the uterus: a report of 10 cases. Int J Gynecol Pathol. 2002;18:310–319
  22. Fukunaga M, Miyazawa Y, Ushigome S. Endometrial low-grade stromal sarcoma with ovarian sex cord-like differentiation: report of two cases with an immunohistochemical and flow cytometric study. Pathol Int. 1997;47:412–415
  23. Ohta Y, Suzuki T, Kojima M, et al. Low-grade endometrial stromal sarcoma with an extensive epithelial-like element. Pathol Int. 2003;53:246–251
  24. Oliva E, Clement PB, Young RH. Epithelioid endometrial and endometrioid stromal tumors: a report of four cases emphasizing their distinction from epithelioid smooth muscle tumors and other oxyphilic uterine and extrauterine tumors. Int J Gynecol Pathol. 2002;21:48–55
  25. Clement PB, Scully RE. Endometrial stromal sarcomas of the uterus with extensive endometrioid glandular differentiation: a report of three cases that caused problems in differential diagnosis. Int J Gynecol Pathol. 1992;11:163–173
  26. Levine PH, Abou-Nassar S, Mittal K. Extrauterine low-grade endometrial stromal sarcoma with florid endometrioid glandular differentiation. Int J Gynecol Pathol. 2001;20:395–398
  27. Baker PM, Moch H, Oliva E. Unusual morphologic features of endometrial stromal tumors: a report of 2 cases. Am J Surg Pathol. 2005;29:1394–1398
  28. Aubry MC, Myers JL, Colby TV, Leslie KO, Tazelaar HD. Endometrial stromal sarcoma metastatic to the lung: a detailed analysis of 16 patients. Am J Surg Pathol. 2002;26:440–449
  29. Abrams J, Talcott J, Corson JM. Pulmonary metastases in patients with low-grade endometrial stromal sarcoma: clinicopathologic findings with immunohistochemical characterization. Am J Surg Pathol. 1989;13:133–140
  30. Clement PB, Young RH, Scully RE. Intravenous leiomyomatosis of the uterus: a clinicopathologic analysis of 16 cases with unusual histologic features. Am J Surg Pathol. 1988;12:932–945
  31. Tench WD, Dail D, Gmelich JT, et al. Benign metastasizing leiomyomas: a review of 21 cases. Lab Invest. 1978;38:367;(abstract)
  32. Traweek ST, Rotter AJ, Swartz W, et al. Cystic pulmonary metastatic sarcoma. Cancer. 1990;65:1805–1811
  33. Wolff M, Kaye G, Silva F. Pulmonary metastases (with admixed epithelial elements) from smooth muscle neoplasms: report of nine cases, including three males. Am J Surg Pathol. 1979;3:325–342
  34. Bhargava R, Shia J, Hummer AJ, Thaler HT, Tornos C, Soslow RA. Distinction of endometrial stromal sarcomas from ‘hemangiopericytomatous’ tumors using a panel of immunohistochemical stains. Mod Pathol. 2005;18:40–47
  35. Chu P, Arber DA. Paraffin-section detection of CD10 in 505 nonhematopoietic neoplasms. Frequent expression in renal cell carcinoma and endometrial stromal sarcoma. Am J Clin Pathol. 2000;113:374–382
  36. Chu PG, Arber DA, Weiss LM, Chang KL. Utility of CD10 in distinguishing between endometrial stromal sarcoma and uterine smooth muscle tumors: an immunohistochemical comparison of 34 cases. Mod Pathol. 2001;14:465–471
  37. McCluggage WG, Sumathi VP, Maxwell P. CD10 is a sensitive and diagnostically useful immunohistochemical marker of normal endometrial stroma and of endometrial stromal neoplasms. Histopathology. 2001;39:273–278
  38. Oliva E, Young RH, Amin MB, Clement PB. An immunohistochemical analysis of endometrial stromal and smooth muscle tumors of the uterus: a study of 54 cases emphasizing the importance of using a panel because of overlap in immunoreactivity for individual antibodies. Am J Surg Pathol. 2002;26:403–412
  39. Sumathi VP, Al-Hussaini M, Connolly LE, Fullerton L, McCluggage WG. Endometrial stromal neoplasms are immunoreactive with WT-1 antibody. Int J Gynecol Pathol. 2004;23:241–247
  40. Sabini G, Chumas JC, Mann WJ. Steroid hormone receptors in endometrial stromal sarcomas. A biochemical and immunohistochemical study. Am J Clin Pathol. 1992;97:381–386
  41. Franquemont DW, Frierson HF, Mills SE. An immunohistochemical study of normal endometrial stroma and endometrial stromal neoplasms. Evidence for smooth muscle differentiation. Am J Surg Pathol. 1991;15:861–870
  42. Nucci MR, O’Connell JT, Huettner PC, Cviko A, Sun D, Quade BJ. h-Caldesmon expression effectively distinguishes endometrial stromal tumors from uterine smooth muscle tumors. Am J Surg Pathol. 2001;25:455–463
  43. Rush DS, Tan J, Baergen RN, Soslow RA. h-Caldesmon, a novel smooth muscle-specific antibody, distinguishes between cellular leiomyoma and endometrial stromal sarcoma. Am J Surg Pathol. 2001;25:253–258
  44. Rossi G, Cavazza A, Longo L, Maiorana A. Localized pleural metastatic adenosarcoma of the uterine cervix mimicking a malignant solitary fibrous tumour: CD10 has no value in differential diagnosis. Histopathology. 2002;41:82–88
  45. Bongiovanni M, Viberti L, Pecchioni C, et al. Steroid hormone receptor in pleural solitary fibrous tumours and CD34+ progenitor stromal cells. J Pathol. 2002;198:252–257
  46. Fukunaga M. Atypical solitary fibrous tumor of the vulva. Int J Gynecol Pathol. 2000;19:164–168
  47. Krishnamurthy S, Jungbluth AA, Busam KJ, Rosai J. Uterine tumors resembling ovarian sex-cord tumors have an immunophenotype consistent with true sex-cord differentiation. Am J Surg Pathol. 1998;22:1078–1082
  48. Baker RJ, Hildebrandt RH, Rouse RV, Hendrickson MR, Longacre TA. Inhibin and CD99 (MIC2) expression in uterine stromal neoplasms with sex-cord-like elements. Hum Pathol. 1999;30:671–679
  49. Irving JA, Carinelli S, Prat J. Uterine tumors resembling ovarian sex cord tumors are polyphenotypic neoplasms with true sex cord differentiation. Mod Pathol. 2006;19:17–24
  50. de Leval L, Waltregny D, Dupuis LM, Boniver J, Oliva E. Uterine tumors resembling ovarian sex-cord tumors. A study of 13 cases showing a diverse phenotypic profile. Mod Pathol. 2006;19:176A
  51. Oliva E, de Leval L, Soslow RA, Herens C. High frequency of JAZF1-JJAZ1 gene fusion in endometrial stromal tumors with smooth muscle differentiation by interphase FISH detection. Am J Surg Pathol. 2007;31:1277–1284
  52. Nucci MR, Harburger D, Koontz J, Cin PD, Sklar J. Molecular analysis of the JAZF1-JJAZ1 gene fusion by RT-PCR and fluorescence in situ hybridization in endometrial stromal neoplasms. Am J Surg Pathol. 2007;31:65–70
  53. Huang HY, Ladanyi M, Soslow RA. Molecular detection of JAZF1-JJAZ1 gene fusion in endometrial stromal neoplasms with classic and variant histology: evidence for genetic heterogeneity. Am J Surg Pathol. 2004;28:224–232
  54. Koontz JI, Soreng AL, Nucci M, et al. Frequent fusion of the JAZF1 and JJAZ1 genes in endometrial stromal tumors. Proc Natl Acad Sci USA. 2001;98:6348–6353
  55. Dionigi A, Oliva E, Clement PB, Young RH. Endometrial stromal nodules and endometrial stromal tumors with limited infiltration: a clinicopathologic study of 50 cases. Am J Surg Pathol. 2002;26:567–581
  56. Oliva E, Young RH, Clement PB, Bhan AK, Scully RE. Cellular benign mesenchymal tumors of the uterus. A comparative morphologic and immunohistochemical analysis of 33 highly cellular leiomyomas and six endometrial stromal nodules, two frequently confused tumors. Am J Surg Pathol. 1995;19:757–768
  57. Evans HL, Chawla SP, Simpson C, Finn KP. Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases, with emphasis on diagnostic criteria and prognostic factors. Cancer. 1988;62:2239–2247
  58. Norris HJ, Parmley T. Mesenchymal tumors of the uterus. V. Intravenous leiomyomatosis. A clinical and pathologic study of 14 cases. Cancer. 1975;36:2164–2178
  59. Kurman RJ, Norris HJ. Mesenchymal tumors of the uterus. VI. Epithelioid smooth muscle tumors including leiomyoblastoma and clear-cell leiomyoma: a clinical and pathologic analysis of 26 cases. Cancer. 1976;37:1853–1865
  60. Prayson RA, Goldblum JR, Hart WR. Epithelioid smooth-muscle tumors of the uterus: a clinicopathologic study of 18 patients. Am J Surg Pathol. 1997;21:383–391
  61. Clement PB, Scully RE. Uterine tumors resembling ovarian sex-cord tumors. A clinicopathologic analysis of fourteen cases. Am J Clin Pathol. 1976;66:512–525
  62. Harlow BL, Weiss NS, Lofton S. The epidemiology of sarcomas of the uterus. J Natl Cancer Inst. 1986;76:399–402
  63. Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol. 1994;18:535–558
  64. Gadducci A, Ferdeghini M, Prontera C, et al. The concomitant determination of different tumor markers in patients with epithelial ovarian cancer and benign ovarian masses: relevance for differential diagnosis. Gynecol Oncol. 1992;44:147–154
  65. Leibsohn S, d’Ablaing G, Mishell DR, Schlaerth JB. Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol. 1990;162:968–974(discussion 974–976)
  66. Parker WH, Fu YS, Berek JS. Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing leiomyoma. Obstet Gynecol. 1994;83:414–418
  67. Barter JF, Smith EB, Szpak CA, Hinshaw W, Clarke-Pearson DL, Creasman WT. Leiomyosarcoma of the uterus: clinicopathologic study of 21 cases. Gynecol Oncol. 1985;21:220–227
  68. Berchuck A, Rubin SC, Hoskins WJ, Saigo PE, Pierce VK, Lewis JL. Treatment of uterine leiomyosarcoma. Obstet Gynecol. 1988;71(6 Pt 1):845–850
  69. Burns B, Curry RH, Bell ME. Morphologic features of prognostic significance in uterine smooth muscle tumors: a review of eighty-four cases. Am J Obstet Gynecol. 1979;135:109–114
  70. Larson B, Silfversward C, Nilsson B, Pettersson F. Prognostic factors in uterine leiomyosarcoma. A clinical and histopathological study of 143 cases. The Radiumhemmet series 1936–1981. Acta Oncol. 1990;29:185–191
  71. Wheelock JB, Krebs HB, Schneider V, Goplerud DR. Uterine sarcoma: analysis of prognostic variables in 71 cases. Am J Obstet Gynecol. 1985;151:1016–1022
  72. Kahanpaa KV, Wahlstrom T, Grohn P, Heinonen E, Nieminen U, Widholm O. Sarcomas of the uterus: a clinicopathologic study of 119 patients. Obstet Gynecol. 1986;67:417–424
  73. Marchese MJ, Liskow AS, Crum CP, McCaffrey RM, Frick HC. Uterine sarcomas: a clinicopathologic study, 1965–1981. Gynecol Oncol. 1984;18:299–312
  74. Mayerhofer K, Obermair A, Windbichler G, et al. Leiomyosarcoma of the uterus: a clinicopathologic multicenter study of 71 cases. Gynecol Oncol. 1999;74:196–201
  75. Nola M, Babic D, Ilic J, et al. Prognostic parameters for survival of patients with malignant mesenchymal tumors of the uterus. Cancer. 1996;78:2543–2550
  76. Nordal RR, Kristensen GB, Kaern J, Stenwig AE, Pettersen EO, Trope CG. The prognostic significance of stage, tumor size, cellular atypia and DNA ploidy in uterine leiomyosarcoma. Acta Oncol. 1995;34:797–802
  77. Pautier P, Genestie C, Rey A, et al. Analysis of clinicopathologic prognostic factors for 157 uterine sarcomas and evaluation of a grading score validated for soft tissue sarcoma. Cancer. 2000;88:1425–1431
  78. Wolfson AH, Wolfson DJ, Sittler SY, et al. A multivariate analysis of clinicopathologic factors for predicting outcome in uterine sarcomas. Gynecol Oncol. 1994;52:56–62
  79. Wang WL, Soslow RA, Hensley M, et al. Histologic prognostic factors in stage I uterine leiomyosarcoma: a clinicopathologic study of 28 cases. Mod Pathol. 2007;20:217A;(abstract 994)
  80. Bodner K, Bodner-Adler B, Kimberger O, Czerwenka K, Leodolter S, Mayerhofer K. Evaluating prognostic parameters in women with uterine leiomyosarcoma. A clinicopathologic study. J Reprod Med. 2003;48:95–100
  81. Hsieh CH, Lin H, Huang CC, Huang EY, Chang SY, ChangChien CC. Leiomyosarcoma of the uterus: a clinicopathologic study of 21 cases. Acta Obstet Gynecol Scand. 2003;82:74–81
  82. Jones MW, Norris HJ. Clinicopathologic study of 28 uterine leiomyosarcomas with metastasis. Int J Gynecol Pathol. 1995;14:243–249
  83. Giuntoli RL, Metzinger DS, DiMarco CS, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol. 2003;89:460–469
  84. Giuntoli 2nd RL, Gostout BS, DiMarco CS, et al. Diagnostic criteria for uterine smooth muscle tumors: continued refinement is necessary. In: Thirty-sixth annual meeting on women’s cancer of the society of gynecologic oncologists. Miami, FL, USA; March 2005 (abstract 228).
  85. Omura GA, Major FJ, Blessing JA, et al. A randomized study of adriamycin with and without dimethyl triazenoimidazole carboxamide in advanced uterine sarcomas. Cancer. 1983;52:626–632
  86. Currie J, Blessing JA, Muss HB, Fowler J, Berman M, Burke TW. Combination chemotherapy with hydroxyurea, dacarbazine (DTIC), and etoposide in the treatment of uterine leiomyosarcoma: a Gynecologic Oncology Group study. Gynecol Oncol. 1996;61:27–30
  87. Sutton G, Blessing JA, Malfetano JH. Ifosfamide and doxorubicin in the treatment of advanced leiomyosarcomas of the uterus: a Gynecologic Oncology Group study. Gynecol Oncol. 1996;62:226–229
  88. Hensley ML, Maki R, Venkatraman E, et al. Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol. 2002;20:2824–2831
  89. Hensley ML, Anderson S, Soslow RA, et al. Activity of dose rate-based gemcitabine plus docetaxel in leiomyosarcoma (LMS) and other histologies: report of an expanded phase II trial. Proc Amer Soc Clin Oncol. 2004;23:
  90. Omura GA, Blessing JA, Major F, et al. A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group Study. J Clin Oncol. 1985;3:1240–1245
  91. Hensley ML. Uterine sarcomas: advances for advanced disease and updates on adjuvant therapy. In: American society of clinical oncology 2006 educational book, 2006, p. 301–304.
  92. Hornback NB, Omura G, Major FJ. Observations on the use of adjuvant radiation therapy in patients with stage I and II uterine sarcoma. Int J Radiat Oncol Biol Phys. 1986;12:2127–2130
  93. Atkins K, Bell S, Kempson R, Hendrickson M. Myxoid smooth muscle tumors of the uterus. Mod Pathol. 2001;14:132A
  94. King ME, Dickersin GR, Scully RE. Myxoid leiomyosarcoma of the uterus. A report of six cases. Am J Surg Pathol. 1982;6:589–598
  95. Atkins K, Bell S, Kempson R, Hendrickson M. Epithelioid smooth muscle tumors of the uterus. Mod Pathol. 2001;14:132A
  96. Rizeq MN, van de Rijn M, Hendrickson MR, Rouse RV. A comparative immunohistochemical study of uterine smooth muscle neoplasms with emphasis on the epithelioid variant. Hum Pathol. 1994;25:671–677
  97. Zhai YL, Kobayashi Y, Mori A, et al. Expression of steroid receptors, Ki-67, and p53 in uterine leiomyosarcomas. Int J Gynecol Pathol. 1999;18:20–28
  98. Mittal K, Demopoulos RI. MIB-1 (Ki-67), p53, estrogen receptor, and progesterone receptor expression in uterine smooth muscle tumors. Hum Pathol. 2001;32:984–987
  99. Leitao MM, Soslow RA, Nonaka D, et al. Tissue microarray immunohistochemical expression of estrogen, progesterone, and androgen receptors in uterine leiomyomata and leiomyosarcoma. Cancer. 2004;101:1455–1462
  100. Anderson SE, Nonaka D, Chuai S, et al. p53, epidermal growth factor, and platelet-derived growth factor in uterine leiomyosarcoma and leiomyomas. Int J Gynecol Cancer. 2006;16:849–853
  101. Hall KL, Teneriello MG, Taylor RR, et al. Analysis of Ki-ras, p53, and MDM2 genes in uterine leiomyomas and leiomyosarcomas. Gynecol Oncol. 1997;65:330–335
  102. Zhai YL, Nikaido T, Orii A, Horiuchi A, Toki T, Fujii S. Frequent occurrence of loss of heterozygosity among tumor suppressor genes in uterine leiomyosarcoma. Gynecol Oncol. 1999;75:453–459
  103. Amada S, Nakano H, Tsuneyoshi M. Leiomyosarcoma versus bizarre and cellular leiomyomas of the uterus: a comparative study based on the MIB-1 and proliferating cell nuclear antigen indices, p53 expression, DNA flow cytometry, and muscle specific actins. Int J Gynecol Pathol. 1995;14:134–142
  104. Esteban JM, Allen WM, Schaerf RH. Benign metastasizing leiomyoma of the uterus: histologic and immunohistochemical characterization of primary and metastatic lesions. Arch Pathol Lab Med. 1999;123:960–962
  105. Tietze L, Gunther K, Horbe A, et al. Benign metastasizing leiomyoma: a cytogenetically balanced but clonal disease. Hum Pathol. 2000;31:126–128
  106. Tavassoli FA, Norris HJ. Peritoneal leiomyomatosis (leiomyomatosis peritonealis disseminata): a clinicopathologic study of 20 cases with ultrastructural observations. Int J Gynecol Pathol. 1982;1:59–74
  107. Nucci MR, Drapkin R, Cin PD, Fletcher CD, Fletcher JA. Distinctive cytogenetic profile in benign metastasizing leiomyoma: pathogenetic implications. Am J Surg Pathol. 2007;31:737–743
  108. Folpe AL, Goodman ZD, Ishak KG, et al. Clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres: a novel member of the perivascular epithelioid clear cell family of tumors with a predilection for children and young adults. Am J Surg Pathol. 2000;24:1239–1246
  109. Vang R, Kempson RL. Perivascular epithelioid cell tumor (‘PEComa’) of the uterus: a subset of HMB-45-positive epithelioid mesenchymal neoplasms with an uncertain relationship to pure smooth muscle tumors. Am J Surg Pathol. 2002;26:1–13
  110. Silva EG, Deavers MT, Bodurka DC, Malpica A. Uterine epithelioid leiomyosarcomas with clear cells: reactivity with HMB-45 and the concept of PEComa. Am J Surg Pathol. 2004;28:244–249
  111. Fukunaga M. Perivascular epithelioid cell tumor of the uterus: report of four cases. Int J Gynecol Pathol. 2005;24:341–346
  112. Folpe AL, Mentzel T, Lehr HA, Fisher C, Balzer BL, Weiss SW. Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: a clinicopathologic study of 26 cases and review of the literature. Am J Surg Pathol. 2005;29:1558–1575
  113. Simpson KW, Albores-Saavedra J. HMB-45 reactivity in conventional uterine leiomyosarcomas. Am J Surg Pathol. 2007;31:95–98
  114. Oliva E, Wang WL, Logani S, et al. Expression of melanocytic (“PEComa”) markers in smooth muscle tumors of the uterus: an immunohistochemical analysis of 86 cases. Mod Pathol. 2006;19:191A;(abstract 884)
  115. Kurman RJ, Scully RE, Norris HJ. Trophoblastic pseudotumor of the uterus: an exaggerated form of “syncytial endometritis” simulating a malignant tumor. Cancer. 1976;38:1214–1226
  116. Young RH, Kurman RJ, Scully RE. Proliferations and tumors of intermediate trophoblast of the placental site. Semin Diagn Pathol. 1988;5:223–237
  117. Baergen RN, Rutgers JL, Young RH, Osann K, Scully RE. Placental site trophoblastic tumor: A study of 55 cases and review of the literature emphasizing factors of prognostic significance. Gynecol Oncol. 2006;100:511–520
  118. Bitterman P, Chun B, Kurman RJ. The significance of epithelial differentiation in mixed mesodermal tumors of the uterus. A clinicopathologic and immunohistochemical study. Am J Surg Pathol. 1990;14:317–328
  119. McCluggage WG. Malignant biphasic uterine tumours: carcinosarcomas or metaplastic carcinomas?. J Clin Pathol. 2002;55:321–325
  120. McCluggage WG. Uterine carcinosarcomas (malignant mixed Mullerian tumors) are metaplastic carcinomas. Int J Gynecol Cancer. 2002;12:687–690
  121. Sreenan JJ, Hart WR. Carcinosarcomas of the female genital tract. A pathologic study of 29 metastatic tumors: further evidence for the dominant role of the epithelial component and the conversion theory of histogenesis. Am J Surg Pathol. 1995;19:666–674
  122. Silverberg SG, Major FJ, Blessing JA, et al. Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus. A Gynecologic Oncology Group pathologic study of 203 cases. Int J Gynecol Pathol. 1990;9:1–19
  123. Yamada SD, Burger RA, Brewster WR, Anton D, Kohler MF, Monk BJ. Pathologic variables and adjuvant therapy as predictors of recurrence and survival for patients with surgically evaluated carcinosarcoma of the uterus. Cancer. 2000;88:2782–2786
  124. George E, Lillemoe TJ, Twiggs LB, Perrone T. Malignant mixed mullerian tumor versus high-grade endometrial carcinoma and aggressive variants of endometrial carcinoma: a comparative analysis of survival. Int J Gynecol Pathol. 1995;14:39–44
  125. Soslow RA, Bissonnette JP, Wilton A, et al. Clinicopathologic analysis of 187 high-grade endometrial carcinomas of different histologic subtypes: similar outcomes belie distinctive biologic differences. Am J Surg Pathol. 2007;31:979–987
  126. Alektiar KM, McKee A, Lin O, et al. Is there a difference in outcome between stage I-II endometrial cancer of papillary serous/clear cell and endometrioid FIGO grade 3 cancer?. Int J Radiat Oncol Biol Phys. 2002;54:79–85
  127. Ferguson SE, Tornos C, Hummer A, Barakat RR, Soslow RA. Prognostic features of surgical stage I uterine carcinosarcoma. Am J Surg Pathol. 2007;31:1653–1661
  128. Ferguson SE, Gerald W, Barakat RR, Chi DS, Soslow RA. Clinicopathologic features of rhabdomyosarcoma of gynecologic origin in adults. Am J Surg Pathol. 2007;31:382–389
  129. Shokeir MO, Noel SM, Clement PB. Malignant mullerian mixed tumor of the uterus with a prominent alpha-fetoprotein-producing component of yolk sac tumor. Mod Pathol. 1996;9:647–651
  130. Yamamoto Y, Akagi A, Izumi K, Kishi Y. Carcinosarcoma of the uterine body of mesonephric origin. Pathol Int. 1995;45:303–309(Erratum in: Pathol Int 1995; 45: 541)
  131. Baschinsky DY, Niemann TH, Eaton LA, Frankel WL. Malignant mixed Mullerian tumor with rhabdoid features: a report of two cases and a review of the literature. Gynecol Oncol. 1999;73:145–150
  132. Fukunaga M, Nomura K, Endo Y, Ushigome S, Aizawa S. Carcinosarcoma of the uterus with extensive neuroectodermal differentiation. Histopathology. 1996;29:565–570
  133. Amant F, Moerman P, Davel GH, et al. Uterine carcinosarcoma with melanocytic differentiation. Int J Gynecol Pathol. 2001;20:186–190
  134. Cokelaere K, Michielsen P, De Vos R, Sciot R. Primary mesenteric malignant mixed mesodermal (mullerian) tumor with neuroendocrine differentiation. Mod Pathol. 2001;14:515–520
  135. Donner LR, Wainwright LM, Zhang F, Biegel JA. Mutation of the INI1 gene in composite rhabdoid tumor of the endometrium. Hum Pathol. 2007;38:935–939
  136. Dupont J, Wang X, Marshall DS, et al. Wilms Tumor Gene (WT1) and p53 expression in endometrial carcinomas: a study of 130 cases using a tissue microarray. Gynecol Oncol. 2004;94:449–455
  137. Chitale DA, Soslow RA. Epidermal growth factor receptor (EGFR) protein overexpression is significant in endometrial carcinosarcoma in contrast to other endometrial carcinomas and is not associated with EGFR gene amplification. Mod Pathol. 2007;20:192A;(abstract 878)
  138. Cimbaluk D, Rotmensch J, Scudiere J, Gown A, Bitterman P. Uterine carcinosarcoma: immunohistochemical studies on tissue microarrays with focus on potential therapeutic targets. Gynecol Oncol. 2007;105:138–144
  139. Livasy CA, Reading FC, Moore DT, Boggess JF, Lininger RA. EGFR expression and HER2/neu overexpression/amplification in endometrial carcinosarcoma. Gynecol Oncol. 2006;100:101–106
  140. Amant F, Vloeberghs V, Woestenborghs H, et al. ERBB-2 gene overexpression and amplification in uterine sarcomas. Gynecol Oncol. 2004;95:583–587
  141. Murray SK, Clement PB, Young RH. Endometrioid carcinomas of the uterine corpus with sex cord-like formations, hyalinization, and other unusual morphologic features: a report of 31 cases of a neoplasm that may be confused with carcinosarcoma and other uterine neoplasms. Am J Surg Pathol. 2005;29:157–166
  142. Tornos C, Silva EG, Ordonez NG, Gershenson DM, Young RH, Scully RE. Endometrioid carcinoma of the ovary with a prominent spindle-cell component, a source of diagnostic confusion. A report of 14 cases. Am J Surg Pathol. 1995;19:1343–1353
  143. Silva EG, Deavers MT, Bodurka DC, Malpica A. Association of low-grade endometrioid carcinoma of the uterus and ovary with undifferentiated carcinoma: a new type of dedifferentiated carcinoma?. Int J Gynecol Pathol. 2006;25:52–58
  144. Altrabulsi B, Malpica A, Deavers MT, Bodurka DC, Broaddus R, Silva EG. Undifferentiated carcinoma of the endometrium. Am J Surg Pathol. 2005;29:1316–1321
  145. Clement PB, Scully RE. Mullerian adenosarcoma of the uterus: a clinicopathologic analysis of 100 cases with a review of the literature. Hum Pathol. 1990;21:363–381
  146. Clement PB. Mullerian adenosarcomas of the uterus with sarcomatous overgrowth. A clinicopathological analysis of 10 cases. Am J Surg Pathol. 1989;13:28–38
  147. Zaloudek CJ, Norris HJ. Adenofibroma and adenosarcoma of the uterus: a clinicopathologic study of 35 cases. Cancer. 1981;48:354–366
  148. Seidman JD, Chauhan S. Evaluation of the relationship between adenosarcoma and carcinosarcoma and a hypothesis of the histogenesis of uterine sarcomas. Int J Gynecol Pathol. 2003;22:75–82

PII: S1756-2317(08)00033-9

doi: 10.1016/j.mpdhp.2008.02.009

Diagnostic Histopathology
Volume 14, Issue 4 , Pages 175-188 , April 2008

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