Objective: The aim of this study was to determine the clinical features and laboratory tests which define a population with a high risk of leiomyosarcoma.
Method: A retrospective analysis of 660 hysterectomies performed between 1989 and 1994 was conducted. There were 414 cases of leiomyoma and 6 leiomyosarcomas (1.4%).
Results: The indication for hysterectomy was complication of fibromyomatous uterus in all cases. Diagnosis of leiomyosarcoma was never suspected before surgery and the pathology examination. Complimentary radiotherapy was given in 2 patients among the 6 with leiomyosarcoma. Mean survival was 35 months. There were no cases of recurrence or metastasis. None of the laboratory tests performed provided clues to diagnosis.
Conclusion: Physicians should be aware of possible misdiagnosis of a leiomyosarcoma when proposing medical treatment of uterine fibroma.