Clinicopathological Comparison of Leiomyoma Variants and Leiomyosarcomas: A Retrospective Analysis

Objective: To compare leiomyoma variants and leiomyosarcoma (LMS) in terms of clinicopathological characteristics. Material and Methods: We evaluated the clinical and pathology outcomes of 57 patients who underwent myomectomy or hysterectomy between September 2013 and August 2022 and were diagnosed with cellular leiomyoma (CL), mitotically active leiomyoma (MAL), leiomyoma with bizarre nuclei (LBN), or LMS. Intraoperative frozen results were compared with the final pathology results. Leiomyoma variants (CL, MAL, and LBN) were compared with each other and with LMS. Results: Patients in the LMS group were older than those in the leiomyoma variants group (p<0.001). Frozen results in the variant group was 6.7% malignant, whereas 100% in the LMS group. Age (p=0.207), menopausal status (p=0.347), fibroid size (p=0.432), and number (p=0.598) did not differ between CL, MAL, and LBN groups. The median follow-up of leiomyoma variants and LMS groups was 61 months (4-105 months) and 20.5 months (6-85 months), respectively. No recurrence was observed in leiomyoma variants group whereas, recurrence was observed in 5 patients, and 3 patients died after recurrence in the LMS group. Conclusion: In this study, no recurrence was observed in the leiomyoma variants groups during the follow-up period and the prognosis is favorable. Not all tumors in the group of leiomyoma variants already meet the diagnostic criteria for LMS. Therefore, the detailed naming of the leiomyoma variants by subgroups does not seem to be of additional benefit for patient follow-up.