CLINICAL-PATHOLOGICAL STUDY OF UTERINE LEIOMYOMAS WITH HIGH MITOTIC-ACTIVITY

Objective. To evaluate clinical-pathological aspects of mitotically ac tive leiomyomas. Study design. Twenty patients with smooth muscle tumo rs of the uterus, with 5-9 mitotic figures per 10 high power fields an d without atypia or necrosis were studied. The clinical and pathologic al characteristics of these tumors were reviewed and analyzed. Results . Patients' ages ranged from 33 to 63 years (mean 42.5 years). The siz e of the tumors ranged from 1.5 to 9.5 cm (mean 5.4 cm). On gross exam ination all tumors appeared as typical leiomyomas. Treatment included hysterectomy in 16 patients and myomectomy in four. Follow-up periods ranged from 1.5 to 11 years (mean 6.8 years). None of the patients dev eloped a recurrent tumor. Conclusion. The benign clinical behavior of such tumors supports their current designation as mitotically active l eiomyomas, thus deleting the previous misnomer 'smooth muscle tumors o f uncertain malignant potential'. Myomectomy is an appropriate treatme nt, particularly in young patients interested in reproduction.