Ovarian leiomyomas: Clinicopathologic features in fifteen cases

Ovarian leiomyomas are uncommon and have not been systematically studied. T he clinical and histopathologic features of 15 ovarian leiomyomas were eval uated, including their clinical presentation, size, cellularity, mitotic in dex, presence of degeneration, and hyalinization. The mean age of women wit h ovarian leiomyomas was 45.8 years. The presenting sign was an adnexal mas s in 7 (47%), uterine leiomyomas in 4 (26%), contralateral adnexal mass in 2 (13%), and other signs in 2 (13%) women. Thirteen leiomyomas had mitotic indices <1/10 high-power-fields (HPFs), including one cellular leiomyoma, a nd 2 had mitotic indices between 1 and 2/10 HPFs. The cellular leiomyoma an d those with a mitotic index of greater than or equal to 1/10 HPFs had an a verage size of 10 cm. The remaining leiomyomas with mitotic indices <1/10 H PFs had an average size Of 3.4 cm. Two leiomyomas exhibited central degener ation, and hyaline change was present in 5 leiomyomas, 4 of which were at l east 4 cm in size. The majority of ovarian leiomyomas (78%) were associated with uterine leiomyomas; hyperplastic endometrial polyps were present in 2 cases. Follow-up (mean, 9.6 months) was available in 8 cases: and all had no evidence of recurrence. In conclusion ovarian leiomyomas exhibit a spect rum of features that are similar to uterine leiomyomas. Although the progno sis is presumed to be good, the short follow-up period of this series precl uded definitive evaluation of their natural history.