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Guilherme Mazui

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What is the Difference Between Leiomyoma and Leiomyosarcoma?

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Leiomyoma and leiomyosarcoma are both tumors that arise from the uterine myometrium, but they have distinct differences in their characteristics and prognosis. Here are the main differences between the two:

  1. Nature of the tumor: Leiomyomas are benign smooth muscle tumors, while leiomyosarcomas are aggressive, malignant tumors.
  2. Incidence: Leiomyomas are the most common benign tumors of the uterus, while leiomyosarcomas are rare malignant uterine tumors that account for a significant proportion of uterine cancer deaths.
  3. Clinical manifestations: Symptoms such as increased uterine size, abdominal pain, and per vaginal bleeding can be present in both leiomyomas and leiomyosarcomas, making it difficult to differentiate between the two based on clinical presentation alone.
  4. Diagnosis: Imaging plays a crucial role in differentiating between leiomyomas and leiomyosarcomas. While there is significant overlap in imaging findings, some key features suggestive of leiomyosarcoma include marked nuclear atypia, high mitotic rate (≥10 mitoses/10 high power fields), and tumor cell necrosis.
  5. Treatment and prognosis: Leiomyomas typically have a better prognosis, while leiomyosarcomas have a poorer prognosis with early complete surgical removal being the primary treatment.

In summary, leiomyomas are benign tumors, while leiomyosarcomas are malignant tumors that both arise from the uterine myometrium. Differentiating between the two is crucial for appropriate treatment and prognosis, and imaging plays a significant role in this differentiation process.

On this page
  • What is the Difference Between Leiomyoma and Leiomyosarcoma?
  • Comparative Table: Leiomyoma vs Leiomyosarcoma

    • Comparative Table: Leiomyoma vs Leiomyosarcoma

    Here is a table comparing the differences between leiomyoma and leiomyosarcoma:

    Feature Leiomyoma Leiomyosarcoma
    Definition Benign, hormonally dependent smooth muscle tumors Malignant smooth muscle tumors
    MRI Findings Non-degenerated leiomyomas have a well-defined microscopic whorled pattern of smooth muscle fascicles separated by well-vascularized Marked nuclear atypia, high mitotic rate (≥10 mitoses/10 HPFs), and tumor cell necrosis (2 out of 3 needed to reach a leiomyosarcoma diagnosis)
    Clinical Manifestations Increased uterine size, abdominal pain, and per vaginal bleeding Increased uterine size, abdominal pain, and per vaginal bleeding
    Differential Diagnosis Degenerated leiomyomas and variants can have hypercellularity, hypoechoic solid components (similar to leiomyosarcoma on ultrasound) Suspected leiomyosarcomas can have irregular borders, T1 hyperintense signal, T2 dark areas, and central unenhanced areas on MRI
    Preoperative Differentiation Difficult to differentiate between leiomyomas and leiomyosarcomas based on clinical manifestations and imaging findings alone A new transcriptome-based classifier has shown potential in accurately distinguishing uterine leiomyoma from leiomyosarcoma using data from preoperative specimens

    Clinical manifestations of uterine sarcomas and leiomyomas are similar, making it challenging to differentiate between the two entities. However, imaging techniques such as MRI can provide important information for making a diagnosis.

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    Guilherme Mazui

    Guilherme Mazui is graduated in journalism from the Federal University of Minas Gerais (UFMG) and a master's degree in Communication from the University of São Paulo (USP). In addition, he has experience in advertising writing and has worked as a content editor in several companies.