Uterine Leiomyomas Presenting During Pregnancy and Delivery: Comprehensive Characterization of Features…

StudyThe American journal of surgical pathology· Jul 2026

Uterine Leiomyomas Presenting During Pregnancy and Delivery: Comprehensive Characterization of Features Helpful in the Distinction From Malignant Mimics.

Ekaterina Olkhov-Mitsel, Yutaka Amemiya, Arun Seth … Jelena Mirkovic

Breast & Gynecologic PathologyStudyDiagnosisQ1IF 4.3

Leiomyomas excised during pregnancy show low mitotic activity, unlike leiomyosarcoma

Uterine Leiomyomas Presenting During Pregnancy and Delivery: Comprehensive Characterization of Features Helpful in the Distinction From Malignant Mimics.

Ekaterina Olkhov-Mitsel … Jelena Mirkovic

The American journal of surgical pathology · Jul 2026 · Q1 in Pathology

Background

A subset of uterine leiomyomas becomes clinically apparent during pregnancy/delivery and is typically excised during Cesarean section.

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Results

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mitoses/10 HPFs

few dividing cells, far below the range seen in leiomyosarcoma

n = 71 patients

More results

Ischemic necrosis occurred in 57.7% of tumors.

Focal myxoid changes, affecting ≤30% of tumor volume, were seen in 42.3% of tumors.

Rare, bizarre cells were identified in 48.5% of tumors.

Follow-up data were available for 71 patients (mean: 56 mo), with no malignant transformation or recurrence.

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Conclusion

These findings confirm that LEPs exhibit distinct morphologic and immunophenotypic alterations, including features typically attributed to coagulative tumor cell necrosis.

Uterine Leiomyomas Presenting During Pregnancy and Delivery: Comprehensive Characterization of Features Helpful in the Distinction From Malignant Mimics.

Uterine Leiomyomas Presenting During Pregnancy and Delivery: Comprehensive Characterization of Features Helpful in the Distinction From Malignant Mimics.

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