Mesenchymal Tumors and Other Rare Neoplasms

  • Tricia A. Murdock
  • Emanuela F. T. Veras
  • Robert J. Kurman
  • Michael T. Mazur


Uterine tumors other than benign polyps or carcinoma are rarely encountered in endometrial biopsies and curettings. Even submucosal leiomyomas rarely are sampled by an endometrial biopsy or curettage. The classification in Table 11.1 lists most of these other neoplasms. It has been reported that prior to a hysterectomy, the diagnosis of endometrial stromal sarcoma is missed in 20% of cases [1]. Similarly for leiomyosarcoma, inaccurate or inconclusive diagnosis on curettings ranges from 20% to 80% [1, 2, 3, 4]. Although these tumors have morphologic features that readily assist in their recognition, it is often impossible to classify them accurately from biopsy material alone.


Smooth muscle tumors Mesenchymal tumors Leiomyomas Leiomyosarcoma Endometrial stromal sarcoma Adenofibroma Adenosarcoma Inflammatory myofibroblastic tumor 


  1. 1.
    Goff BA, Rice LW, Fleischhacker D, Muntz HG, Falkenberry SS, Nikrui N, Fuller AF. Uterine leiomyosarcoma and endometrial stromal sarcoma: lymph node metastases and sites of recurrence. Gynecol Oncol. 1993;50:105–9.PubMedGoogle Scholar
  2. 2.
    Leibsohn S, d’Ablaing G, Mishell DR, Schlaerth JB. Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. Am J Obstet Gynecol. 1990;162:968–74. discussion 974–976PubMedGoogle Scholar
  3. 3.
    Kahanpää KV, Wahlström T, Gröhn P, Heinonen E, Nieminen U, Widholm O. Sarcomas of the uterus: a clinicopathologic study of 119 patients. Obstet Gynecol. 1986;67:417–24.PubMedGoogle Scholar
  4. 4.
    Hinchcliff EM, Esselen KM, Watkins JC, Oduyebo T, Rauh-Hain JA, Del Carmen MG, Quade BJ, Muto MG. The role of endometrial biopsy in the preoperative detection of uterine leiomyosarcoma. J Minim Invasive Gynecol. 2016;23:567–72.Google Scholar
  5. 5.
    Deligdish L, Loewenthal M. Endometrial changes associated with myomata of the uterus. J Clin Pathol. 1970;23:676–80.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Lethaby A, Puscasiu L, Vollenhoven B. Preoperative medical therapy before surgery for uterine fibroids. Cochrane Database Syst Rev. 2017;11:CD000547.PubMedGoogle Scholar
  7. 7.
    Silverberg S, Kurman R. Tumors of the uterine corpus and gestational trophoblastic disease, Atlas of tumor pathology 3rd series. Washington, DC: Armed Forces Institute of Pathology; 1992.Google Scholar
  8. 8.
    Zaloudek CJ, Hendrickson MR, Soslow RA. Mesenchymal tumors of the uterus. In: Kurman RJ, Hedrick Ellenson L, Ronnett BM, editors. Blaustein’s pathology of the female genital tract. 6th ed. New York: Springer; 2011. p. 453–527.Google Scholar
  9. 9.
    Clement P, Young R, editors. Pure mesenchymal tumors. Tumor and tumorlike lesions of the uterine corpus and cervix. New York: Churchill Livingstone; 1993. p. 265–328.Google Scholar
  10. 10.
    Kempson RL, Hendrickson MR. Pure mesenchymal neoplasms of the uterine corpus: selected problems. Semin Diagn Pathol. 1988;5:172–98.PubMedGoogle Scholar
  11. 11.
    Clement PB. Pathology of the uterine corpus. Hum Pathol. 1991;22:776–91.PubMedGoogle Scholar
  12. 12.
    Evans HL, Chawla SP, Simpson C, Finn KP. Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases, with emphasis on diagnostic criteria and prognostic factors. Cancer. 1988;62:2239–47.PubMedGoogle Scholar
  13. 13.
    Prayson RA, Hart WR. Mitotically active leiomyomas of the uterus. Am J Clin Pathol. 1992;97:14–20.PubMedGoogle Scholar
  14. 14.
    O’Connor DM, Norris HJ. Mitotically active leiomyomas of the uterus. Hum Pathol. 1990;21:223–7.PubMedGoogle Scholar
  15. 15.
    Kurman RJ, Norris HJ. Mesenchymal tumors of the uterus. VI. Epithelioid smooth muscle tumors including leiomyoblastoma and clear-cell leiomyoma: a clinical and pathologic analysis of 26 cases. Cancer. 1976;37:1853–65.PubMedGoogle Scholar
  16. 16.
    Mazur MT, Kraus FT. Histogenesis of morphologic variations in tumors of the uterine wall. Am J Surg Pathol. 1980;4:59–74.PubMedGoogle Scholar
  17. 17.
    Hendrickson M, Longacre T, Kempson R. The uterine corpus. Sternberg SS, diagnostic surgical pathology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins’; 1999. p. 2203–305.Google Scholar
  18. 18.
    Perrone T, Dehner LP. Prognostically favorable “mitotically active” smooth-muscle tumors of the uterus. A clinicopathologic study of ten cases. Am J Surg Pathol. 1988;12:1–8.PubMedGoogle Scholar
  19. 19.
    Downes KA, Hart WR. Bizarre leiomyomas of the uterus: a comprehensive pathologic study of 24 cases with long-term follow-up. Am J Surg Pathol. 1997;21:1261–70.PubMedGoogle Scholar
  20. 20.
    Ly A, Mills AM, McKenney JK, Balzer BL, Kempson RL, Hendrickson MR, Longacre TA. Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. Am J Surg Pathol. 2013;37:643–9.PubMedGoogle Scholar
  21. 21.
    Bell SW, Kempson RL, Hendrickson MR. Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases. Am J Surg Pathol. 1994;18:535–58.PubMedGoogle Scholar
  22. 22.
    Clement PB, Young RH, Scully RE. Diffuse, perinodular, and other patterns of hydropic degeneration within and adjacent to uterine leiomyomas. Problems in differential diagnosis. Am J Surg Pathol. 1992;16:26–32.PubMedGoogle Scholar
  23. 23.
    Boyd C, McCluggage WG. Unusual morphological features of uterine leiomyomas treated with progestogens. J Clin Pathol. 2011;64:485–9.PubMedGoogle Scholar
  24. 24.
    Ferry JA, Harris NL, Scully RE. Uterine leiomyomas with lymphoid infiltration simulating lymphoma. A report of seven cases. Int J Gynecol Pathol. 1989;8:263–70.PubMedGoogle Scholar
  25. 25.
    Prayson RA, Goldblum JR, Hart WR. Epithelioid smooth-muscle tumors of the uterus: a clinicopathologic study of 18 patients. Am J Surg Pathol. 1997;21:383–91.PubMedGoogle Scholar
  26. 26.
    Roth LM, Reed RJ. Cotyledonoid leiomyoma of the uterus: report of a case. Int J Gynecol Pathol. 2000;19:272–5.PubMedGoogle Scholar
  27. 27.
    Sanz-Ortega J, Vocke C, Stratton P, Linehan WM, Merino MJ. Morphologic and molecular characteristics of uterine leiomyomas in hereditary leiomyomatosis and renal cancer (HLRCC) syndrome. Am J Surg Pathol. 2013;37:74–80.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Alsolami S, El-Bahrawy M, Kalloger SE, AlDaoud N, Pathak TB, Chung CT, Cheung CT, Mulligan AM, Tomlinson IP, Pollard PJ, Gilks CB, McCluggage WG, Clarke BA. Current morphologic criteria perform poorly in identifying hereditary leiomyomatosis and renal cell carcinoma syndrome-associated uterine leiomyomas. Int J Gynecol Pathol. 2014;33:560–7.PubMedGoogle Scholar
  29. 29.
    Siegler L, Erber R, Burghaus S, Brodkorb T, Wachter D, Wilkinson N, Bolton J, Stringfellow H, Haller F, Beckmann MW, Hartmann A, Agaimy A. Fumarate hydratase (FH) deficiency in uterine leiomyomas: recognition by histological features versus blind immunoscreening. Virchows Arch. 2018;472(5):789–96.PubMedGoogle Scholar
  30. 30.
    Mäkinen N, Kämpjärvi K, Frizzell N, Bützow R, Vahteristo P. Characterization of MED12, HMGA2, and FH alterations reveals molecular variability in uterine smooth muscle tumors. Mol Cancer. 2017;16:101.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Miettinen M, Felisiak-Golabek A, Wasag B, Chmara M, Wang Z, Butzow R, Lasota J. Fumarase-deficient uterine leiomyomas: an immunohistochemical, molecular genetic, and clinicopathologic study of 86 cases. Am J Surg Pathol. 2016;40:1661–9.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Kurman RJ, Carcangiu ML, Herrington CS, Young RH. WHO classification of tumors of female reproductive organs. 4th ed. Lyon: International Agency for Research on Cancer; 2014.Google Scholar
  33. 33.
    Croce S, Chibon F. MED12 and uterine smooth muscle oncogenesis: state of the art and perspectives. Eur J Cancer. 2015;51:1603–10.PubMedGoogle Scholar
  34. 34.
    Abeler VM, Røyne O, Thoresen S, Danielsen HE, Nesland JM, Kristensen GB. Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients. Histopathology. 2009;54:355–64.PubMedGoogle Scholar
  35. 35.
    Skorstad M, Kent A, Lieng M. Preoperative evaluation in women with uterine leiomyosarcoma. A nationwide cohort study. Acta Obstet Gynecol Scand. 2016;95:1228–34.PubMedGoogle Scholar
  36. 36.
    Yuk J-S, Shin J-Y, Moon H-S, Lee JH. The incidence of unexpected uterine malignancy in women undergoing hysteroscopic myomectomy or polypectomy: a national population-based study. Eur J Obstet Gynecol Reprod Biol. 2018;224:12–6.PubMedGoogle Scholar
  37. 37.
    Taylor HB, Norris HJ. Mesenchymal tumors of the uterus. IV. Diagnosis and prognosis of leiomyosarcomas. Arch Pathol. 1966;82:40–4.PubMedGoogle Scholar
  38. 38.
    Peacock G, Archer S. Myxoid leiomyosarcoma of the uterus: case report and review of the literature. Am J Obstet Gynecol. 1989;160:1515–8. discussion 1518–1519PubMedGoogle Scholar
  39. 39.
    Burch DM, Tavassoli FA. Myxoid leiomyosarcoma of the uterus. Histopathology. 2011;59:1144–55.PubMedGoogle Scholar
  40. 40.
    Oliva E, Young RH, Amin MB, Clement PB. An immunohistochemical analysis of endometrial stromal and smooth muscle tumors of the uterus: a study of 54 cases emphasizing the importance of using a panel because of overlap in immunoreactivity for individual antibodies. Am J Surg Pathol. 2002;26:403–12.PubMedGoogle Scholar
  41. 41.
    Zaloudek CJ, Norris HJ. Adenofibroma and adenosarcoma of the uterus: a clinicopathologic study of 35 cases. Cancer. 1981;48:354–66.PubMedGoogle Scholar
  42. 42.
    Kaminski PF, Tavassoli FA. Plexiform tumorlet: a clinical and pathologic study of 15 cases with ultrastructural observations. Int J Gynecol Pathol. 1984;3:124–34.PubMedGoogle Scholar
  43. 43.
    Seidman JD, Thomas RM. Multiple plexiform tumorlets of the uterus. Arch Pathol Lab Med. 1993;117:1255–6.PubMedGoogle Scholar
  44. 44.
    Conlon N, Soslow RA, Murali R. Perivascular epithelioid tumours (PEComas) of the gynaecological tract. J Clin Pathol. 2015;68:418–26.PubMedPubMedCentralGoogle Scholar
  45. 45.
    Martignoni G, Pea M, Reghellin D, Gobbo S, Zamboni G, Chilosi M, Bonetti F. Molecular pathology of lymphangioleiomyomatosis and other perivascular epithelioid cell tumors. Arch Pathol Lab Med. 2010;134:33–40.PubMedGoogle Scholar
  46. 46.
    Lim GSD, Oliva E. The morphologic spectrum of uterine PEC-cell associated tumors in a patient with tuberous sclerosis. Int J Gynecol Pathol. 2011;30:121–8.PubMedGoogle Scholar
  47. 47.
    Longacre TA, Hendrickson MR, Kapp DS, Teng NN. Lymphangioleiomyomatosis of the uterus simulating high-stage endometrial stromal sarcoma. Gynecol Oncol. 1996;63:404–10.PubMedGoogle Scholar
  48. 48.
    Vang R, Kempson RL. Perivascular epithelioid cell tumor (‘PEComa’) of the uterus: a subset of HMB-45-positive epithelioid mesenchymal neoplasms with an uncertain relationship to pure smooth muscle tumors. Am J Surg Pathol. 2002;26:1–13.PubMedGoogle Scholar
  49. 49.
    Folpe AL, Mentzel T, Lehr H-A, Fisher C, Balzer BL, Weiss SW. Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: a clinicopathologic study of 26 cases and review of the literature. Am J Surg Pathol. 2005;29:1558–75.PubMedGoogle Scholar
  50. 50.
    Schoolmeester JK, Howitt BE, Hirsch MS, Dal Cin P, Quade BJ, Nucci MR. Perivascular epithelioid cell neoplasm (PEComa) of the gynecologic tract: clinicopathologic and immunohistochemical characterization of 16 cases. Am J Surg Pathol. 2014;38:176–88.PubMedGoogle Scholar
  51. 51.
    Chang KL, Crabtree GS, Lim-Tan SK, Kempson RL, Hendrickson MR. Primary uterine endometrial stromal neoplasms. A clinicopathologic study of 117 cases. Am J Surg Pathol. 1990;14:415–38.PubMedGoogle Scholar
  52. 52.
    Tavassoli FA, Norris HJ. Mesenchymal tumours of the uterus. VII. A clinicopathological study of 60 endometrial stromal nodules. Histopathology. 1981;5:1–10.PubMedGoogle Scholar
  53. 53.
    Hart WR, Yoonessi M. Endometrial stromatosis of the uterus. Obstet Gynecol. 1977;49:393–403.PubMedGoogle Scholar
  54. 54.
    Norris HJ, Taylor HB. Mesenchymal tumors of the uterus. I. A clinical and pathological study of 53 endometrial stromal tumors. Cancer. 1966;19:755–66.PubMedGoogle Scholar
  55. 55.
    Yoonessi M, Hart WR. Endometrial stromal sarcomas. Cancer. 1977;40:898–906.PubMedGoogle Scholar
  56. 56.
    Fekete PS, Vellios F. The clinical and histologic spectrum of endometrial stromal neoplasms: a report of 41 cases. Int J Gynecol Pathol. 1984;3:198–212.PubMedGoogle Scholar
  57. 57.
    Evans HL. Endometrial stromal sarcoma and poorly differentiated endometrial sarcoma. Cancer. 1982;50:2170–82.PubMedGoogle Scholar
  58. 58.
    Nucci MR. Practical issues related to uterine pathology: endometrial stromal tumors. Mod Pathol. 2016;29(Suppl 1):S92–103.PubMedGoogle Scholar
  59. 59.
    Conklin CMJ, Longacre TA. Endometrial stromal tumors: the new WHO classification. Adv Anat Pathol. 2014;21:383–93.PubMedGoogle Scholar
  60. 60.
    Piver MS, Rutledge FN, Copeland L, Webster K, Blumenson L, Suh O. Uterine endolymphatic stromal myosis: a collaborative study. Obstet Gynecol. 1984;64:173–8.PubMedGoogle Scholar
  61. 61.
    Mansi JL, Ramachandra S, Wiltshaw E, Fisher C. Endometrial stromal sarcomas. Gynecol Oncol. 1990;36:113–8.PubMedGoogle Scholar
  62. 62.
    Larson B, Silfverswärd C, Nilsson B, Pettersson F. Endometrial stromal sarcoma of the uterus. A clinical and histopathological study. The Radiumhemmet series 1936–1981. Eur J Obstet Gynecol Reprod Biol. 1990;35:239–49.PubMedGoogle Scholar
  63. 63.
    Gloor E, Schnyder P, Cikes M, Hofstetter J, Cordey R, Burnier F, Knobel P. Endolymphatic stromal myosis. Surgical and hormonal treatment of extensive abdominal recurrence 20 years after hysterectomy. Cancer. 1982;50:1888–93.PubMedGoogle Scholar
  64. 64.
    Thatcher SS, Woodruff JD. Uterine stromatosis: a report of 33 cases. Obstet Gynecol. 1982;59:428–34.PubMedGoogle Scholar
  65. 65.
    Oliva E, Clement PB, Young RH, Scully RE. Mixed endometrial stromal and smooth muscle tumors of the uterus: a clinicopathologic study of 15 cases. Am J Surg Pathol. 1998;22:997–1005.PubMedGoogle Scholar
  66. 66.
    Lloreta J, Prat J. Endometrial stromal nodule with smooth and skeletal muscle components simulating stromal sarcoma. Int J Gynecol Pathol. 1992;11:293–8.PubMedGoogle Scholar
  67. 67.
    Baker PM, Moch H, Oliva E. Unusual morphologic features of endometrial stromal tumors: a report of 2 cases. Am J Surg Pathol. 2005;29:1394–8.PubMedGoogle Scholar
  68. 68.
    Oliva E, Clement PB, Young RH. Endometrial stromal tumors: an update on a group of tumors with a protean phenotype. Adv Anat Pathol. 2000;7:257–81.PubMedGoogle Scholar
  69. 69.
    Dionigi A, Oliva E, Clement PB, Young RH. Endometrial stromal nodules and endometrial stromal tumors with limited infiltration: a clinicopathologic study of 50 cases. Am J Surg Pathol. 2002;26:567–81.PubMedGoogle Scholar
  70. 70.
    Oliva E, Young RH, Clement PB, Bhan AK, Scully RE. Cellular benign mesenchymal tumors of the uterus. A comparative morphologic and immunohistochemical analysis of 33 highly cellular leiomyomas and six endometrial stromal nodules, two frequently confused tumors. Am J Surg Pathol. 1995;19:757–68.PubMedGoogle Scholar
  71. 71.
    McCluggage WG, Sumathi VP, Maxwell P. CD10 is a sensitive and diagnostically useful immunohistochemical marker of normal endometrial stroma and of endometrial stromal neoplasms. Histopathology. 2001;39:273–8.PubMedGoogle Scholar
  72. 72.
    Agoff SN, Grieco VS, Garcia R, Gown AM. Immunohistochemical distinction of endometrial stromal sarcoma and cellular leiomyoma. Appl Immunohistochem Mol Morphol. 2001;9:164–9.PubMedGoogle Scholar
  73. 73.
    Chu PG, Arber DA, Weiss LM, Chang KL. Utility of CD10 in distinguishing between endometrial stromal sarcoma and uterine smooth muscle tumors: an immunohistochemical comparison of 34 cases. Mod Pathol. 2001;14:465–71.PubMedGoogle Scholar
  74. 74.
    Bartosch C, Exposito MI, Lopes JM. Low-grade endometrial stromal sarcoma and undifferentiated endometrial sarcoma: a comparative analysis emphasizing the importance of distinguishing between these two groups. Int J Surg Pathol. 2010;18:286–91.PubMedGoogle Scholar
  75. 75.
    Oliva E, Young RH, Clement PB, Scully RE. Myxoid and fibrous endometrial stromal tumors of the uterus: a report of 10 cases. Int J Gynecol Pathol. 1999;18:310–9.PubMedGoogle Scholar
  76. 76.
    Devaney K, Tavassoli FA. Immunohistochemistry as a diagnostic aid in the interpretation of unusual mesenchymal tumors of the uterus. Mod Pathol. 1991;4:225–31.PubMedGoogle Scholar
  77. 77.
    Farhood AI, Abrams J. Immunohistochemistry of endometrial stromal sarcoma. Hum Pathol. 1991;22:224–30.PubMedGoogle Scholar
  78. 78.
    Franquemont DW, Frierson HF, Mills SE. An immunohistochemical study of normal endometrial stroma and endometrial stromal neoplasms. Evidence for smooth muscle differentiation. Am J Surg Pathol. 1991;15:861–70.PubMedGoogle Scholar
  79. 79.
    Lillemoe TJ, Perrone T, Norris HJ, Dehner LP. Myogenous phenotype of epithelial-like areas in endometrial stromal sarcomas. Arch Pathol Lab Med. 1991;115:215–9.PubMedGoogle Scholar
  80. 80.
    Binder SW, Nieberg RK, Cheng L, al- Jitawi S. Histologic and immunohistochemical analysis of nine endometrial stromal tumors: an unexpected high frequency of keratin protein positivity. Int J Gynecol Pathol. 1991;10:191–7.PubMedGoogle Scholar
  81. 81.
    McCluggage WG, Date A, Bharucha H, Toner PG. Endometrial stromal sarcoma with sex cord-like areas and focal rhabdoid differentiation. Histopathology. 1996;29:369–74.PubMedGoogle Scholar
  82. 82.
    Baker RJ, Hildebrandt RH, Rouse RV, Hendrickson MR, Longacre TA. Inhibin and CD99 (MIC2) expression in uterine stromal neoplasms with sex-cord-like elements. Hum Pathol. 1999;30:671–9.PubMedGoogle Scholar
  83. 83.
    Irving JA, Carinelli S, Prat J. Uterine tumors resembling ovarian sex cord tumors are polyphenotypic neoplasms with true sex cord differentiation. Mod Pathol. 2006;19:17–24.PubMedGoogle Scholar
  84. 84.
    Fukunaga M, Miyazawa Y, Ushigome S. Endometrial low-grade stromal sarcoma with ovarian sex cord-like differentiation: report of two cases with an immunohistochemical and flow cytometric study. Pathol Int. 1997;47:412–5.PubMedGoogle Scholar
  85. 85.
    Ohta Y, Suzuki T, Kojima M, Shiokawa A, Mitsuya T. Low-grade endometrial stromal sarcoma with an extensive epithelial-like element. Pathol Int. 2003;53:246–51.PubMedGoogle Scholar
  86. 86.
    Sumathi VP, Al-Hussaini M, Connolly LE, Fullerton L, McCluggage WG. Endometrial stromal neoplasms are immunoreactive with WT-1 antibody. Int J Gynecol Pathol. 2004;23:241–7.PubMedGoogle Scholar
  87. 87.
    Zámecník M, Michal M. Endometrial stromal nodule with retiform sex-cord-like differentiation. Pathol Res Pract. 1998;194:449–53.PubMedGoogle Scholar
  88. 88.
    Jung C-K, Jung J-H, Lee A, Lee Y-S, Choi Y-J, Yoon S-K, Lee K-Y. Diagnostic use of nuclear beta-catenin expression for the assessment of endometrial stromal tumors. Mod Pathol. 2008;21:756–63.PubMedGoogle Scholar
  89. 89.
    Clement PB, Scully RE. Uterine tumors resembling ovarian sex-cord tumors. A clinicopathologic analysis of fourteen cases. Am J Clin Pathol. 1976;66:512–25.PubMedGoogle Scholar
  90. 90.
    McCluggage WG, Shah V, Walsh MY, Toner PG. Uterine tumour resembling ovarian sex cord tumour: evidence for smooth muscle differentiation. Histopathology. 1993;23:83–5.PubMedGoogle Scholar
  91. 91.
    Oliva E, Clement PB, Young RH. Epithelioid endometrial and endometrioid stromal tumors: a report of four cases emphasizing their distinction from epithelioid smooth muscle tumors and other oxyphilic uterine and extrauterine tumors. Int J Gynecol Pathol. 2002;21:48–55.PubMedGoogle Scholar
  92. 92.
    Clement PB, Scully RE. Endometrial stromal sarcomas of the uterus with extensive endometrioid glandular differentiation: a report of three cases that caused problems in differential diagnosis. Int J Gynecol Pathol. 1992;11:163–73.PubMedGoogle Scholar
  93. 93.
    Huang H-Y, Ladanyi M, Soslow RA. Molecular detection of JAZF1-JJAZ1 gene fusion in endometrial stromal neoplasms with classic and variant histology: evidence for genetic heterogeneity. Am J Surg Pathol. 2004;28:224–32.PubMedGoogle Scholar
  94. 94.
    Koontz JI, Soreng AL, Nucci M, Kuo FC, Pauwels P, van Den Berghe H, Dal Cin P, Fletcher JA, Sklar J. Frequent fusion of the JAZF1 and JJAZ1 genes in endometrial stromal tumors. Proc Natl Acad Sci U S A. 2001;98:6348–53.PubMedPubMedCentralGoogle Scholar
  95. 95.
    Nucci MR, Harburger D, Koontz J, Dal Cin P, Sklar J. Molecular analysis of the JAZF1-JJAZ1 gene fusion by RT-PCR and fluorescence in situ hybridization in endometrial stromal neoplasms. Am J Surg Pathol. 2007;31:65–70.PubMedGoogle Scholar
  96. 96.
    Oliva E, de Leval L, Soslow RA, Herens C. High frequency of JAZF1-JJAZ1 gene fusion in endometrial stromal tumors with smooth muscle differentiation by interphase FISH detection. Am J Surg Pathol. 2007;31:1277–84.PubMedGoogle Scholar
  97. 97.
    Dal Cin P, Aly MS, De Wever I, Moerman P, Van Den Berghe H. Endometrial stromal sarcoma t(7;17)(p15–21;q12–21) is a nonrandom chromosome change. Cancer Genet Cytogenet. 1992;63:43–6.PubMedGoogle Scholar
  98. 98.
    Micci F, Walter CU, Teixeira MR, Panagopoulos I, Bjerkehagen B, Saeter G, Heim S. Cytogenetic and molecular genetic analyses of endometrial stromal sarcoma: nonrandom involvement of chromosome arms 6p and 7p and confirmation of JAZF1/JJAZ1 gene fusion in t(7;17). Cancer Genet Cytogenet. 2003;144:119–24.PubMedGoogle Scholar
  99. 99.
    Kurihara S, Oda Y, Ohishi Y, Iwasa A, Takahira T, Kaneki E, Kobayashi H, Wake N, Tsuneyoshi M. Endometrial stromal sarcomas and related high-grade sarcomas: immunohistochemical and molecular genetic study of 31 cases. Am J Surg Pathol. 2008;32:1228–38.PubMedGoogle Scholar
  100. 100.
    Micci F, Panagopoulos I, Bjerkehagen B, Heim S. Consistent rearrangement of chromosomal band 6p21 with generation of fusion genes JAZF1/PHF1 and EPC1/PHF1 in endometrial stromal sarcoma. Cancer Res. 2006;66:107–12.PubMedGoogle Scholar
  101. 101.
    Stemme S, Ghaderi M, Carlson JW. Diagnosis of endometrial stromal tumors: a clinicopathologic study of 25 biopsy specimens with identification of problematic areas. Am J Clin Pathol. 2014;141:133–9.PubMedGoogle Scholar
  102. 102.
    Lee C-H, Mariño-Enriquez A, Ou W, Zhu M, Ali RH, Chiang S, Amant F, Gilks CB, van de Rijn M, Oliva E, Debiec-Rychter M, Dal Cin P, Fletcher JA, Nucci MR. The clinicopathologic features of YWHAE-FAM22 endometrial stromal sarcomas: a histologically high-grade and clinically aggressive tumor. Am J Surg Pathol. 2012;36:641–53.PubMedGoogle Scholar
  103. 103.
    Lee C-H, Ali RH, Rouzbahman M, Marino-Enriquez A, Zhu M, Guo X, Brunner AL, Chiang S, Leung S, Nelnyk N, Huntsman DG, Blake Gilks C, Nielsen TO, Dal Cin P, van de Rijn M, Oliva E, Fletcher JA, Nucci MR. Cyclin D1 as a diagnostic immunomarker for endometrial stromal sarcoma with YWHAE-FAM22 rearrangement. Am J Surg Pathol. 2012;36:1562–70.PubMedPubMedCentralGoogle Scholar
  104. 104.
    Lee C-H, Hoang LN, Yip S, Reyes C, Marino-Enriquez A, Eilers G, Tao D, Chiang S, Fletcher JA, Soslow RA, Nucci MR, Oliva E. Frequent expression of KIT in endometrial stromal sarcoma with YWHAE genetic rearrangement. Mod Pathol. 2014;27:751–7.PubMedGoogle Scholar
  105. 105.
    Chiang S, Lee C-H, Stewart CJR, Oliva E, Hoang LN, Ali RH, Hensley ML, Arias-Stella JA, Frosina D, Jungbluth AA, Benayed R, Ladanyi M, Hameed M, Wang L, Kao Y-C, Antonescu CR, Soslow RA. BCOR is a robust diagnostic immunohistochemical marker of genetically diverse high-grade endometrial stromal sarcoma, including tumors exhibiting variant morphology. Mod Pathol. 2017;30:1251–61.PubMedPubMedCentralGoogle Scholar
  106. 106.
    Lee C-H, Nucci MR. Endometrial stromal sarcoma – the new genetic paradigm. Histopathology. 2015;67:1–19.PubMedGoogle Scholar
  107. 107.
    Lee C-H, Ou W-B, Mariño-Enriquez A, Zhu M, Mayeda M, Wang Y, Guo X, Brunner AL, Amant F, French CA, West RB, McAlpine JN, Gilks CB, Yaffe MB, Prentice LM, McPherson A, Jones SJM, Marra MA, Shah SP, van de Rijn M, Huntsman DG, Dal Cin P, Debiec-Rychter M, Nucci MR, Fletcher JA. 14-3-3 fusion oncogenes in high-grade endometrial stromal sarcoma. Proc Natl Acad Sci U S A. 2012;109:929–34.PubMedPubMedCentralGoogle Scholar
  108. 108.
    Sciallis AP, Bedroske PP, Schoolmeester JK, Sukov WR, Keeney GL, Hodge JC, Bell DA. High-grade endometrial stromal sarcomas: a clinicopathologic study of a group of tumors with heterogenous morphologic and genetic features. Am J Surg Pathol. 2014;38:1161–72.PubMedGoogle Scholar
  109. 109.
    Croce S, Hostein I, Ribeiro A, Garbay D, Velasco V, Stoeckle E, Guyon F, Floquet A, Neuville A, Coindre J-M, MacGrogan G, Chibon F. YWHAE rearrangement identified by FISH and RT-PCR in endometrial stromal sarcomas: genetic and pathological correlations. Mod Pathol. 2013;26:1390–400.PubMedGoogle Scholar
  110. 110.
    Hoang LN, Aneja A, Conlon N, Delair DF, Middha S, Benayed R, Hensley ML, Park KJ, Hollmann TJ, Hameed MR, Antonescu CR, Soslow RA, Chiang S. Novel high-grade endometrial stromal sarcoma: a morphologic mimicker of myxoid leiomyosarcoma. Am J Surg Pathol. 2017;41:12–24.PubMedPubMedCentralGoogle Scholar
  111. 111.
    Mariño-Enriquez A, Lauria A, Przybyl J, Ng TL, Kowalewska M, Debiec-Rychter M, Ganesan R, Sumathi V, George S, McCluggage WG, Nucci MR, Lee C-H, Fletcher JA. BCOR internal tandem duplication in high-grade uterine sarcomas. Am J Surg Pathol. 2018;42:335–41.PubMedGoogle Scholar
  112. 112.
    Lewis N, Soslow RA, Delair DF, Park KJ, Murali R, Hollmann TJ, Davidson B, Micci F, Panagopoulos I, Hoang LN, Arias-Stella JA, Oliva E, Young RH, Hensley ML, Leitao MM, Hameed M, Benayed R, Ladanyi M, Frosina D, Jungbluth AA, Antonescu CR, Chiang S. ZC3H7B-BCOR high-grade endometrial stromal sarcomas: a report of 17 cases of a newly defined entity. Mod Pathol. 2018;31:674–84.PubMedGoogle Scholar
  113. 113.
    Gremel G, Liew M, Hamzei F, Hardell E, Selling J, Ghaderi M, Stemme S, Pontén F, Carlson JW. A prognosis based classification of undifferentiated uterine sarcomas: identification of mitotic index, hormone receptors and YWHAE-FAM22 translocation status as predictors of survival. Int J Cancer. 2015;136:1608–18.PubMedGoogle Scholar
  114. 114.
    Nucci MR, O’Connell JT, Huettner PC, Cviko A, Sun D. Quade BJ: h-Caldesmon expression effectively distinguishes endometrial stromal tumors from uterine smooth muscle tumors. Am J Surg Pathol. 2001;25:455–63.PubMedGoogle Scholar
  115. 115.
    Blake EA, Sheridan TB, Wang KL, Takiuchi T, Kodama M, Sawada K, Matsuo K. Clinical characteristics and outcomes of uterine tumors resembling ovarian sex-cord tumors (UTROSCT): a systematic review of literature. Eur J Obstet Gynecol Reprod Biol. 2014;181:163–70.PubMedGoogle Scholar
  116. 116.
    de Leval L, Lim GSD, Waltregny D, Oliva E. Diverse phenotypic profile of uterine tumors resembling ovarian sex cord tumors: an immunohistochemical study of 12 cases. Am J Surg Pathol. 2010;34:1749–61.PubMedGoogle Scholar
  117. 117.
    Hurrell DP, McCluggage WG. Uterine tumour resembling ovarian sex cord tumour is an immunohistochemically polyphenotypic neoplasm which exhibits coexpression of epithelial, myoid and sex cord markers. J Clin Pathol. 2007;60:1148–54.PubMedGoogle Scholar
  118. 118.
    Croce S, de Kock L, Boshari T, Hostein I, Velasco V, Foulkes WD, McCluggage WG. Uterine tumor resembling ovarian sex cord tumor (UTROSCT) commonly exhibits positivity with sex cord markers FOXL2 and SF-1 but lacks FOXL2 and DICER1 mutations. Int J Gynecol Pathol. 2016;35:301–8.PubMedGoogle Scholar
  119. 119.
    Stewart CJR, Crook M, Tan A. SF1 immunohistochemistry is useful in differentiating uterine tumours resembling sex cord-stromal tumours from potential histological mimics. Pathology. 2016;48:434–40.PubMedGoogle Scholar
  120. 120.
    Clement P, Young R, editors. Tumors with mixed epithelial and mesenchymal elements. Tumor and tumorlike lesions of the uterine corpus and cervix. 1st ed. New York: Churchill Livingstone; 1993. p. 329–70.Google Scholar
  121. 121.
    Clement PB, Scully RE. Mullerian adenosarcoma of the uterus: a clinicopathologic analysis of 100 cases with a review of the literature. Hum Pathol. 1990;21:363–81.PubMedGoogle Scholar
  122. 122.
    Clement PB, Scully RE. Müllerian adenosarcoma of the uterus. A clinicopathologic analysis of ten cases of a distinctive type of müllerian mixed tumor. Cancer. 1974;34:1138–49.PubMedGoogle Scholar
  123. 123.
    Kaku T, Silverberg SG, Major FJ, Miller A, Fetter B, Brady MF. Adenosarcoma of the uterus: a gynecologic oncology group clinicopathologic study of 31 cases. Int J Gynecol Pathol. 1992;11:75–88.PubMedGoogle Scholar
  124. 124.
    Vellios F, Ng AB, Reagen JW. Papillary adenofibroma of the uterus: a benign mesodermal mixed tumor of Müllerian origin. Am J Clin Pathol. 1973;60:543–51.PubMedGoogle Scholar
  125. 125.
    Shinnick JK, Kumar N, Beffa L, Miller K, Friedman MA, Kalife E, DiSilvestro P, Mathews C. Management of low-grade Cervical Müllerian Adenosarcoma in a 14-year-old girl. J Pediatr Adolesc Gynecol. 2017;30:652–4.PubMedGoogle Scholar
  126. 126.
    Clement PB, Oliva E, Young RH. Mullerian adenosarcoma of the uterine corpus associated with tamoxifen therapy: a report of six cases and a review of tamoxifen-associated endometrial lesions. Int J Gynecol Pathol. 1996;15:222–9.PubMedGoogle Scholar
  127. 127.
    Bocklage T, Lee KR, Belinson JL. Uterine mullerian adenosarcoma following adenomyoma in a woman on tamoxifen therapy. Gynecol Oncol. 1992;44:104–9.PubMedGoogle Scholar
  128. 128.
    Kerner H, Lichtig C. Müllerian adenosarcoma presenting as cervical polyps: a report of seven cases and review of the literature. Obstet Gynecol. 1993;81:655–9.PubMedGoogle Scholar
  129. 129.
    Seagle B-LL, Kanis M, Strohl AE, Shahabi S. Survival of women with Mullerian adenosarcoma: a national cancer data base study. Gynecol Oncol. 2016;143:636–41.PubMedGoogle Scholar
  130. 130.
    Abell MR. Papillary adenofibroma of the uterine cervix. Am J Obstet Gynecol. 1971;110:990–3.PubMedGoogle Scholar
  131. 131.
    Clement PB. Müllerian adenosarcomas of the uterus with sarcomatous overgrowth. A clinicopathological analysis of 10 cases. Am J Surg Pathol. 1989;13:28–38.PubMedGoogle Scholar
  132. 132.
    Clement PB, Scully RE. Müllerian adenosarcomas of the uterus with sex cord-like elements. A clinicopathologic analysis of eight cases. Am J Clin Pathol. 1989;91:664–72.PubMedGoogle Scholar
  133. 133.
    Soslow RA, Ali A, Oliva E. Mullerian adenosarcomas: an immunophenotypic analysis of 35 cases. Am J Surg Pathol. 2008;32:1013–21.PubMedGoogle Scholar
  134. 134.
    Hodgson A, Amemiya Y, Seth A, Djordjevic B, Parra-Herran C. High-grade Müllerian Adenosarcoma: genomic and clinicopathologic characterization of a distinct neoplasm with prevalent TP53 pathway alterations and aggressive behavior. Am J Surg Pathol. 2017;41:1513–22.PubMedGoogle Scholar
  135. 135.
    Gallardo A, Prat J. Mullerian adenosarcoma: a clinicopathologic and immunohistochemical study of 55 cases challenging the existence of adenofibroma. Am J Surg Pathol. 2009;33:278–88.PubMedGoogle Scholar
  136. 136.
    Howitt BE, Sholl LM, Dal Cin P, Jia Y, Yuan L, MacConaill L, Lindeman N, Kuo F, Garcia E, Nucci MR, Quade BJ. Targeted genomic analysis of Müllerian adenosarcoma. J Pathol. 2015;235:37–49.PubMedGoogle Scholar
  137. 137.
    Blom R, Guerrieri C. Adenosarcoma of the uterus: a clinicopathologic, DNA flow cytometric, p53 and mdm-2 analysis of 11 cases. Int J Gynecol Cancer. 1999;9:37–43.PubMedGoogle Scholar
  138. 138.
    Swisher EM, Gown AM, Skelly M, Ek M, Tamimi HK, Cain JM, Greer BE, Muntz HG, Goff BA. The expression of epidermal growth factor receptor, HER-2/Neu, p53, and Ki-67 antigen in uterine malignant mixed mesodermal tumors and adenosarcoma. Gynecol Oncol. 1996;60:81–8.PubMedGoogle Scholar
  139. 139.
    Howitt BE, Dal Cin P, Nucci MR, Quade BJ. Involvement of chromosome 8 in Müllerian Adenosarcoma. Int J Gynecol Pathol. 2017;36:24–30.PubMedGoogle Scholar
  140. 140.
    Daya DA, Scully RE. Sarcoma botryoides of the uterine cervix in young women: a clinicopathological study of 13 cases. Gynecol Oncol. 1988;29:290–304.PubMedGoogle Scholar
  141. 141.
    Houghton JP, McCluggage WG. Embryonal rhabdomyosarcoma of the cervix with focal pleomorphic areas. J Clin Pathol. 2007;60:88–9.PubMedPubMedCentralGoogle Scholar
  142. 142.
    McClean GE, Kurian S, Walter N, Kekre A, McCluggage WG. Cervical embryonal rhabdomyosarcoma and ovarian Sertoli-Leydig cell tumour: a more than coincidental association of two rare neoplasms? J Clin Pathol. 2007;60:326–8.PubMedPubMedCentralGoogle Scholar
  143. 143.
    Bennett JA, Nardi V, Rouzbahman M, Morales-Oyarvide V, Nielsen GP, Oliva E. Inflammatory myofibroblastic tumor of the uterus: a clinicopathological, immunohistochemical, and molecular analysis of 13 cases highlighting their broad morphologic spectrum. Mod Pathol. 2017;30:1489–503.PubMedGoogle Scholar
  144. 144.
    Rabban JT, Zaloudek CJ, Shekitka KM, Tavassoli FA. Inflammatory myofibroblastic tumor of the uterus: a clinicopathologic study of 6 cases emphasizing distinction from aggressive mesenchymal tumors. Am J Surg Pathol. 2005;29:1348–55.PubMedGoogle Scholar
  145. 145.
    Haimes JD, Stewart CJR, Kudlow BA, Culver BP, Meng B, Koay E, Whitehouse A, Cope N, Lee J-C, Ng T, McCluggage WG, Lee C-H. Uterine inflammatory Myofibroblastic tumors frequently harbor ALK fusions with IGFBP5 and THBS1. Am J Surg Pathol. 2017;41:773–80.PubMedGoogle Scholar
  146. 146.
    Harris NL, Scully RE. Malignant lymphoma and granulocytic sarcoma of the uterus and vagina. A clinicopathologic analysis of 27 cases. Cancer. 1984;53:2530–45.PubMedGoogle Scholar
  147. 147.
    Ferry JA, Young RH. Malignant lymphoma, pseudolymphoma, and hematopoietic disorders of the female genital tract. Pathol Annu. 1991;26(Pt 1):227–63.PubMedPubMedCentralGoogle Scholar
  148. 148.
    Nasioudis D, Kampaktsis PN, Frey M, Witkin SS, Holcomb K. Primary lymphoma of the female genital tract: an analysis of 697 cases. Gynecol Oncol. 2017;145:305–9.PubMedGoogle Scholar
  149. 149.
    Vang R, Medeiros LJ, Ha CS, Deavers M. Non-Hodgkin’s lymphomas involving the uterus: a clinicopathologic analysis of 26 cases. Mod Pathol. 2000;13:19–28.PubMedGoogle Scholar
  150. 150.
    Masunaga A, Abe M, Tsujii E, Suzuki Y, Ohgida T, Toyama M, Nakamura H, Mori S, Sugawara I, Itoyama S. Primary uterine T-cell lymphoma. Int J Gynecol Pathol. 1998;17:376–9.PubMedGoogle Scholar
  151. 151.
    van de Rijn M, Kamel OW, Chang PP, Lee A, Warnke RA, Salhany KE. Primary low-grade endometrial B-cell lymphoma. Am J Surg Pathol. 1997;21:187–94.PubMedGoogle Scholar
  152. 152.
    Clement P. Miscellaneous primary neoplasms and metastatic neoplasms. In: Clement P, Young RH, editors. Tumors and tumorlike lesions of the uterine corpus and cervix. New York: Churchill Livingstone; 1993. p. 371–418.Google Scholar
  153. 153.
    Young RH, Harris NL, Scully RE. Lymphoma-like lesions of the lower female genital tract: a report of 16 cases. Int J Gynecol Pathol. 1985;4:289–99.PubMedPubMedCentralGoogle Scholar
  154. 154.
    Vakiani M, Mawad J, Talerman A. Heterologous sarcomas of the uterus. Int J Gynecol Pathol. 1982;1:211–9.PubMedGoogle Scholar
  155. 155.
    De Young B, Bitterman P, Lack EE. Primary osteosarcoma of the uterus: report of a case with immunohistochemical study. Mod Pathol. 1992;5:212–5.PubMedGoogle Scholar
  156. 156.
    Clement PB. Chondrosarcoma of the uterus: report of a case and review of the literature. Hum Pathol. 1978;9:726–32.PubMedGoogle Scholar
  157. 157.
    Chiarle R, Godio L, Fusi D, Soldati T, Palestro G. Pure alveolar rhabdomyosarcoma of the corpus uteri: description of a case with increased serum level of CA-125. Gynecol Oncol. 1997;66:320–3.PubMedGoogle Scholar
  158. 158.
    Holcomb K, Francis M, Ruiz J, Abulafia O, Matthews RP, Lee YC. Pleomorphic rhabdomyosarcoma of the uterus in a postmenopausal woman with elevated serum CA125. Gynecol Oncol. 1999;74:499–501.PubMedGoogle Scholar
  159. 159.
    McCluggage WG, Lioe TF, McClelland HR, Lamki H. Rhabdomyosarcoma of the uterus: report of two cases, including one of the spindle cell variant. Int J Gynecol Cancer. 2002;12:128–32.PubMedGoogle Scholar
  160. 160.
    Ordi J, Stamatakos MD, Tavassoli FA. Pure pleomorphic rhabdomyosarcomas of the uterus. Int J Gynecol Pathol. 1997;16:369–77.PubMedGoogle Scholar
  161. 161.
    Schammel DP, Tavassoli FA. Uterine angiosarcomas: a morphologic and immunohistochemical study of four cases. Am J Surg Pathol. 1998;22:246–50.PubMedGoogle Scholar
  162. 162.
    Zheng G, Richmond A, Liu C, Berrebi A, Pallavajjala A, Haley L, Stone RL, McCarthy E, Vang R, Xing D. Clinicopathologic features and genetic alterations of a primary osteosarcoma of the uterine corpus. Int J Gynecol Pathol. 2018 Apr 6. doi: 10.1097/PGP.0000000000000511. [Epub ahead of print]Google Scholar
  163. 163.
    Abraham C, O’Cearbhaill R, Soslow R. Primary osteosarcoma of the uterus with cardiac and pulmonary metastases. Gynecol Oncol Rep. 2015;11:4–6.PubMedGoogle Scholar
  164. 164.
    Liu Y, Guo S, Wang L, Suzuki S, Sugimura H, Li Y. Uterine Angiosarcoma: a case report and literature review. Int J Gynecol Pathol. 2016;35:264–8.PubMedGoogle Scholar
  165. 165.
    Pinto A, Kahn RM, Rosenberg AE, Slomovitz B, Quick CM, Whisman MK, Huang M. Uterine rhabdomyosarcoma in adults. Hum Pathol. 2018.; (in press).Google Scholar
  166. 166.
    Guillou L, Lamoureux E, Masse S, Costa J. Alveolar soft-part sarcoma of the uterine corpus: histological, immunocytochemical and ultrastructural study of a case. Virchows Arch A Pathol Anat Histopathol. 1991;418:467–71.PubMedGoogle Scholar
  167. 167.
    Cho KR, Rosenshein NB, Epstein JI. Malignant rhabdoid tumor of the uterus. Int J Gynecol Pathol. 1989;8:381–7.PubMedGoogle Scholar
  168. 168.
    Gray GF, Glick AD, Kurtin PJ, Jones HW. Alveolar soft part sarcoma of the uterus. Hum Pathol. 1986;17:297–300.PubMedGoogle Scholar
  169. 169.
    Nolan NP, Gaffney EF. Alveolar soft part sarcoma of the uterus. Histopathology. 1990;16:97–9.PubMedGoogle Scholar
  170. 170.
    Radig K, Buhtz P, Roessner A. Alveolar soft part sarcoma of the uterine corpus. Report of two cases and review of the literature. Pathol Res Pract. 1998;194:59–63.PubMedGoogle Scholar
  171. 171.
    Gaertner EM, Farley JH, Taylor RR, Silver SA. Collision of uterine rhabdoid tumor and endometrioid adenocarcinoma: a case report and review of the literature. Int J Gynecol Pathol. 1999;18:396–401.PubMedGoogle Scholar
  172. 172.
    Schoolmeester JK, Carlson J, Keeney GL, Fritchie KJ, Oliva E, Young RH, Nucci MR. Alveolar soft part sarcoma of the female genital tract: a morphologic, Immunohistochemical, and molecular cytogenetic study of 10 cases with emphasis on its distinction from morphologic mimics. Am J Surg Pathol. 2017;41:622–32.PubMedGoogle Scholar
  173. 173.
    Joseph MG, Fellows FG, Hearn SA. Primary endodermal sinus tumor of the endometrium. A clinicopathologic, immunocytochemical, and ultrastructural study. Cancer. 1990;65:297–302.PubMedGoogle Scholar
  174. 174.
    Ohta M, Sakakibara K, Mizuno K, Kano T, Matsuzawa K, Tomoda Y, Nakashima N, Ogawa T. Successful treatment of primary endodermal sinus tumor of the endometrium. Gynecol Oncol. 1988;31:357–64.PubMedGoogle Scholar
  175. 175.
    McNamee T, Damato S, McCluggage WG. Yolk sac tumours of the female genital tract in older adults derive commonly from somatic epithelial neoplasms: somatically derived yolk sac tumours. Histopathology. 2016;69:739–51.PubMedGoogle Scholar
  176. 176.
    Ravishankar S, Malpica A, Ramalingam P, Euscher ED. Yolk sac tumor in extragonadal pelvic sites: still a diagnostic challenge. Am J Surg Pathol. 2017;41:1–11.PubMedGoogle Scholar
  177. 177.
    Martin E, Scholes J, Richart RM, Fenoglio CM. Benign cystic teratoma of the uterus. Am J Obstet Gynecol. 1979;135:429–31.PubMedGoogle Scholar
  178. 178.
    Wang W-C, Lee M-S, Ko J-L, Lai Y-C. Origin of uterine teratoma differs from that of ovarian teratoma: a case of uterine mature cystic teratoma. Int J Gynecol Pathol. 2011;30:544–8.PubMedGoogle Scholar
  179. 179.
    Euscher ED, Deavers MT, Lopez-Terrada D, Lazar AJ, Silva EG, Malpica A. Uterine tumors with neuroectodermal differentiation: a series of 17 cases and review of the literature. Am J Surg Pathol. 2008;32:219–28.PubMedGoogle Scholar
  180. 180.
    Daya D, Lukka H, Clement PB. Primitive neuroectodermal tumors of the uterus: a report of four cases. Hum Pathol. 1992;23:1120–9.PubMedGoogle Scholar
  181. 181.
    Hendrickson MR, Scheithauer BW. Primitive neuroectodermal tumor of the endometrium: report of two cases, one with electron microscopic observations. Int J Gynecol Pathol. 1986;5:249–59.PubMedGoogle Scholar
  182. 182.
    Chiang S, Snuderl M, Kojiro-Sanada S, Quer Pi-Sunyer A, Daya D, Hayashi T, Bosincu L, Ogawa F, Rosenberg AE, Horn L-C, Wang L, Iafrate AJ, Oliva E. Primitive neuroectodermal tumors of the female genital tract: a morphologic, Immunohistochemical, and molecular study of 19 cases. Am J Surg Pathol. 2017;41:761–72.PubMedPubMedCentralGoogle Scholar
  183. 183.
    Murdock T, Orr B, Allen S, Ibrahim J, Sharma R, Ronnett B, Rodriguez F. Central nervous system-type neuroepithelial tumors and tumor-like proliferations developing in the gynecologic tract and pelvis: clinicopathologic analysis of 23 cases. Am J Surg Path. (in press).Google Scholar
  184. 184.
    Beham A, Schmid C, Fletcher CD, Auböck L, Pickel H. Malignant paraganglioma of the uterus. Virchows Arch A Pathol Anat Histopathol. 1992;420:453–7.PubMedGoogle Scholar
  185. 185.
    Tavassoli FA. Melanotic paraganglioma of the uterus. Cancer. 1986;58:942–8.PubMedGoogle Scholar
  186. 186.
    Young TW, Thrasher TV. Nonchromaffin paraganglioma of the uterus. A case report. Arch Pathol Lab Med. 1982;106:608–9.PubMedGoogle Scholar
  187. 187.
    van Leeuwen J, van der Putten HWHM, Demeyere TBJ, Creemers G-J, JMA P. Paraganglioma of the uterus. A case report and review of literature. Gynecol Oncol. 2011;121:418–9.PubMedGoogle Scholar
  188. 188.
    Young RH, Kleinman GM, Scully RE. Glioma of the uterus. Report of a case with comments on histogenesis. Am J Surg Pathol. 1981;5:695–9.PubMedGoogle Scholar
  189. 189.
    Bittencourt AL, Britto JF, Fonseca LE. Wilms’ tumor of the uterus: the first report of the literature. Cancer. 1981;47:2496–9.PubMedGoogle Scholar
  190. 190.
    Muc RS, Grayson W, Grobbelaar JJ. Adult extrarenal Wilms tumor occurring in the uterus. Arch Pathol Lab Med. 2001;125:1081–3.PubMedGoogle Scholar
  191. 191.
    McAlpine J, Azodi M, O’Malley D, Kelly M, Golenewsky G, Martel M, Rutherford T, Tavassoli F. Extrarenal Wilms’ tumor of the uterine corpus. Gynecol Oncol. 2005;96:892–6.PubMedGoogle Scholar
  192. 192.
    Carlier MT, Dardick I, Lagace AF, Sreeram V. Adenomatoid tumor of uterus: presentation in endometrial curettings. Int J Gynecol Pathol. 1986;5:69–74.PubMedGoogle Scholar
  193. 193.
    McCluggage GW. Benign diseases of the endometrium. In: Kurman RJ, editor. Blaustein’s pathology of the female genital tract. 6th ed. New York: Springer; 2011. p. 305–58.Google Scholar
  194. 194.
    Garg D, Bekker G, Akselrod F, Narasimhulu DM. Endometrial osseous metaplasia: an unusual cause of infertility. BMJ Case Rep. 2015.Google Scholar
  195. 195.
    Cayuela E, Perez-Medina T, Vilanova J, Alejo M, Cañadas P. True osseous metaplasia of the endometrium: the bone is not from a fetus. Fertil Steril. 2009;91:1293.e1-4.PubMedGoogle Scholar
  196. 196.
    Alpert LC, Haufrect EJ, Schwartz MR. Uterine lithiasis. Am J Surg Pathol. 1990;14:1071–5.PubMedGoogle Scholar
  197. 197.
    Herbold DR, Magrane DM. Calcifications of the benign endometrium. Arch Pathol Lab Med. 1986;110:666–9.PubMedGoogle Scholar
  198. 198.
    Untawale VG, Gabriel JB, Chauhan PM. Calcific endometritis. Am J Obstet Gynecol. 1982;144:482–3.PubMedGoogle Scholar
  199. 199.
    Ceccacci L, Clancy G. Endometrial ossification: report of an additional case. Am J Obstet Gynecol. 1981;141:103–4.PubMedGoogle Scholar
  200. 200.
    Bhatia NN, Hoshiko MG. Uterine osseous metaplasia. Obstet Gynecol. 1982;60:256–9.PubMedGoogle Scholar
  201. 201.
    Waxman M, Moussouris HF. Endometrial ossification following an abortion. Am J Obstet Gynecol. 1978;130:587–8.PubMedGoogle Scholar
  202. 202.
    Valicenti JF, Priester SK. Psammoma bodies of benign endometrial origin in cervicovaginal cytology. Acta Cytol. 1977;21:550–2.PubMedGoogle Scholar
  203. 203.
    Fausett MB, Zahn CM, Kendall BS, Barth WH. The significance of psammoma bodies that are found incidentally during endometrial biopsy. Am J Obstet Gynecol. 2002;186:180–3.PubMedGoogle Scholar
  204. 204.
    Cameron RI, McCluggage WG. Extensive psammomatous calcification of the uterus and cervix associated with a uterine serous carcinoma. J Clin Pathol. 2004;57:888–90.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Tricia A. Murdock
    • 1
  • Emanuela F. T. Veras
    • 1
  • Robert J. Kurman
    • 1
  • Michael T. Mazur
    • 2
  1. 1.Department of PathologyThe Johns Hopkins HospitalBaltimoreUSA
  2. 2.Department of Pathology and Laboratory MedicineState University of New York Upstate Medical UniversitySyracuseUSA

Personalised recommendations