[Communication] Potential Life Prognostic Marker for Mesenchymal Tumor Resembling Uterine Leiomyosarcoma

Abstract

BACKGROUND/AIM: Benign uterine leiomyoma (U.LMA) and malignant uterine leiomyosarcoma (U.LMS), which are both uterine mesenchymal tumors, are distinguished by the number of cells with mitotic activity. However, uterine mesenchymal tumors contain tumor cells with various cell morphologies; therefore, making a diagnosis, including differentiation between benign tumors and malignant tumors, is difficult. For example, cotyledonary dissecting leiomyoma (CDL) or uterine smooth muscle tumors of uncertain malignant potential (STUMPs), etc. are a group of uterine mesenchymal tumors for which performing a differential diagnosis is challenging. A standardized classification system for uterine mesenchymal tumors has not yet been established. Furthermore, definitive preoperative imaging techniques or hematological examinations for the potential inclusion of CDL or STUMP in the differential diagnosis have not been defined. Several clinical studies showed that there is no correlation between biomarker expression and mitotic rate or tumor recurrence. The immunohistochemical biomarkers reported so far cannot effectively help determine the malignant potential of CDL or STUMPs in patients who wish to become pregnant in the future. MATERIALS AND METHODS: The establishment of gene expression profiles or detection of pathogenic variants by employing next-generation molecular techniques can aid in disease prediction, diagnosis, treatment, and prognosis. We examined the oncological properties of STUMP in adults using molecular pathological techniques on tissue excised from patients with uterine mesenchymal tumor. RESULT: In a clinical study conducted by our medical team, the gene expression profiling results identified factors that may be associated with the malignancy of uterine mesenchymal tumors. CONCLUSION: Here, we describe the problems in diagnosing uterine mesenchymal tumors along with the results of the latest clinical studies. It is expected that establishing a diagnostic targeting characteristics of mesenchymal tumor cells will lead to the treatment of malignant tumors with a low risk of recurrence and metastasis.