Abstract
Uterine leiomyomas (LMs), currently the most common gynecological complaint around the world, are a serious medical, social and economic problem. Accurate diagnosis is the necessary prerequisite of the diagnostic-therapeutic process. Statistically, mistakes may occur more often in case of disease entities with high prevalence rates. Histopathology, based on increasingly advanced immunohistochemistry methods, is routinely used in the diagnosis of neoplastic diseases. Markers of the highest sensitivity and specificity profiles are used in the process. As far as LMs are concerned, the crux of the matter is to identify patients with seemingly benign lesions which turn out to be suspicious (e.g., atypical LM) or malignant (e.g., leiomyosarcoma (LMS)), which is not uncommon. In this study, we present the current state of knowledge about the use of immunohistochemical markers in the differential diagnosis of LM, atypical LM, smooth muscle tumors of uncertain malignant potential (STUMP), and LMS, as well as their clinical predictive value.
Highlights
The results of the population observations have been confirmed by hysterectomy preparations—LMs are diagnosed in 77–96% of the patients [5,6], followed by lipoleiomyomas, which are relatively common LM variants among postmenopausal women who require surgical intervention [6]
Databases were extensively searched for all original and review articles/book chapters published in English until September 2018 and related to myometrial neoplasms using the following keywords: uterine fibroid; uterine leiomyoma; uterine leiomyosarcoma; uterine sarcoma; smooth muscle tumor of uncertain malignant potential (STUMP); immunohistochemistry (IHC)
In many doubtful cases it is replaced, or better, supported by molecular methods (in first line by: Western Blot, polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA) or others) as well genetic methods. These are in some cases techniques irreplaceable in differential diagnostics of LMS and proliferative LM of the uterus
Summary
Tumors arising from the smooth muscle cells of the uterus are the most common neoplasms of the female genital tract around the world [1,2], chief among them leiomyomas (LMs), which are benign lesions of the uterus. Their prevalence is age-dependent, reaching 70–80% among women >50 years of age, and has been estimated at approximately 40–60% among women
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