@entity6019 with unusual histologic features: a report of 24 primary and XXXX emphasizing fibroblastic and smooth muscle differentiation.

@entity20866 @entity1 @entity2283 @entity242 @entity5 @entity4 @entity2 @entity2282 @entity6019 @entity5642 @entity1822 @entity3 @entity11090 @entity258 @entity2909 @entity4607
We report the clinicopathologic features of 24 uterine primary and metastatic @entity6019 with fibromyxoid features (ESS-F) and smooth muscle differentiation (ESS-SM) ( @entity6019 variants). Two groups of @entity5 were retrieved from the surgical pathology files at Memorial Sloan-Kettering Cancer Center: 1) gynecologic mesenchymal neoplasms with striking smooth muscle or fibroblastic differentiation that did not meet the clinical or histologic criteria for @entity1822 or other established neoplasms containing smooth muscle; and 2) metastatic lesions showing ovoid and spindle cell morphology, involving lung, originally diagnosed as @entity258 , low-grade smooth @entity11090 , @entity20866 , @entity4607 , and benign metastasizing @entity2909 . We identified 12 @entity1 with 30 @entity5 ; 24 were available for review. The mean age was 51 years (range 21-74 years). Follow-up >1 year was available for eight @entity1 , with a mean time of 8.5 years. Each @entity1 had a uterine primary and 10 experienced @entity3 . Mean time to recurrence was 6.8 years. Sites of @entity3 included lung, retroperitoneum, right atrium/inferior vena cava, colon, and ovaries. No @entity1 died of disease, but in many cases the follow-up period ended with the discovery of a @entity3 . Four @entity1 were originally diagnosed with @entity6019 , but other presenting diagnoses included benign metastasizing @entity2909 , @entity2 , smooth @entity11090 of uncertain or low malignant potential, and @entity5642 . On review each @entity1 had at least one @entity5 (primary and/or @entity3 ) that was determined to be an @entity6019 variant. Review diagnoses were as follows: @entity6019 (nonvariant), ESS-F, and ESS-SM. Eight of 10 @entity5 with available slides were endometrial stomal @entity242 variants (six ESS-F and two ESS-SM). When these variant features were present, they comprised between 50% and 100% of the @entity5 . The variant histology @entity5 exhibited prominent spiral arterioles, perivascular @entity4 , and stromal cell condensation around blood vessels. All @entity3 but one were @entity5 ; eight were ESS-F and five were ESS-SM. Four @entity3 did not resemble the uterine primary. @entity2283 marked smooth muscle mostly but not specifically. h-Caldesmon marked smooth muscle exclusively. Endometrial stromal cells as well as some fibroblasts and smooth muscle cells expressed @entity2282 . We conclude that the presence of even focal endometrial stromal differentiation in an invasive uterine mesenchymal lesion with a predominant low-grade smooth muscle, fibroblastic, and/or myxoid phenotype should permit classification as low-grade @entity242 -they should be considered @entity6019 .
