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Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. We report the case of a rare variant of uterine leiomyosarcoma, in which the tumor showed a prominent myxoid change and contained numerous multinucleated giant cells with marked nuclear pleomorphism.

In addition, mature adipocytes showing no nuclear atypism were scattered. Uterine leiomyosarcomas containing a mature adipocytic 1 or liposarcomatous 2 - 5 component are very rare, and a leiomyosarcoma showing a prominent myxoid change with the appearance of numerous bizarre giant cells and containing mature adipocytes has not been reported to date.

On laparotomy, a large tumor was found to protrude from the left lateral wall of the uterine corpus. The pelvic peritoneum was studded with many small, gelatinous nodules. Despite postoperative chemotherapy, the radiological examination at 7 months after the operation revealed the regrowth of residual intrapelvic tumors.

A large tumor in the left uterine wall showed a gelatinous appearance and contained a firm, white nodular region asterisk. Mature adipocytes were scattered. Multinucleated giant cells showed nuclear hyperchromatism, atypism, and pleomorphism. On microscopic examination, the greater part of the tumor was occupied by palely basophilic, myxoid material containing stellate or spindle cells and multinucleated giant cells.

About 3 mitotic figures were found per 10 high power fields HPF. In addition, a small number of mature adipocytes showing no nuclear atypism were scattered Fig. A plexiform capillary network was not seen. Nuclear atypism and pleomorphism of the stellate or spindle cells were mild to moderate Fig. The cytoplasm was scant, but bipolar or multipolar cytoplasmic processes were observed. The multinucleated giant cells had hyperchromatic and markedly pleomorphic nuclei.

The white, firm nodule within the tumor consisted of a dense proliferation of long spindle cells which formed intersecting, compact cellular fascicles Fig. About 3 mitotic figures were counted per 10 HPF. These areas also contained scattered mature adipocytes. The nuclei of the adipocytes were bland, and atypical lipoblasts were not observed. Although areas showing hyaline necrosis of the ischemic type were seen, coagulation tumor cell necrosis was not observed.

An admixture of malignant epithelial tissue suggestive of carcinosarcoma was not detected. Adipocytes were mature and did not show nuclear atypism. In myxoid leiomyosarcoma of the uterus, stellate or spindle cells with bland nuclei form anastomosing, thin cellular trabeculae.

In the differential diagnosis, well differentiated and dedifferentiated liposarcomas with prominent myxoid stroma should be considered. Also, nuclear immunoreactivity for MDM2 was not seen in tumor cells. We interpret the present tumor as a myxoid leiomyosarcoma containing a heterologous, mature adipocytic component. Some investigators presumed the malignant transformation of lipoleiomyoma, which is an uncommon variant of leiomyoma. Volume 65 , Issue 4.

The full text of this article hosted at iucr. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account.

If the address matches an existing account you will receive an email with instructions to retrieve your username. Pathology International. Letter to the Editor Open Access. Tools Request permission Export citation Add to favorites Track citation. Share Give access Share full text access. Share full text access. Please review our Terms and Conditions of Use and check box below to share full-text version of article. To the Editor : We report the case of a rare variant of uterine leiomyosarcoma, in which the tumor showed a prominent myxoid change and contained numerous multinucleated giant cells with marked nuclear pleomorphism.

Figure 1 Open in figure viewer PowerPoint. Figure 2 Open in figure viewer PowerPoint. Disclosure The authors declare no conflict of interest. Leiomyosarcoma arising in a lipoleiomyoma. Gynecol Oncol ; 39 : — Google Scholar. Citing Literature. Volume 65 , Issue 4 April Pages Figures References Related Information.

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