A 50-year-old woman has a rapidly enlarging uterine mass. Histology shows a spindle cell tumor with coagulative tumor cell necrosis, marked cytologic atypia, and a mitotic count of 15 per 10 high-power fields. Which is the most likely diagnosis?
- A Cellular leiomyoma
- B Intravenous leiomyomatosis
- C Leiomyosarcoma ✓
- D Endometrial stromal sarcoma
Correct answer: C. Leiomyosarcoma
Explanation
Leiomyosarcoma is diagnosed by the presence of the triad: >10 mitoses per 10 HPF, coagulative tumor cell necrosis, and significant cytologic atypia. Cellular leiomyomas lack necrosis and usually have fewer than 5 mitoses per 10 HPF.
Reference: WHO Classification of Tumours of Female Reproductive Organs, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.