Skip to main content
SpringerLink
Log in

Endometriale und weitere seltene uterine Sarkome

Diagnostische Aspekte im Kontext der WHO-Klassifikation 2020

Endometrial and other rare uterine sarcomas

Diagnostic aspects in the context of the 2020 WHO classification

  • Schwerpunkt: Connective (tissue) pathology: Was uns verbindet!
  • Published:
Der Pathologe Aims and scope Submit manuscript

Zusammenfassung

Uterine Sarkome sind eine heterogene Gruppe seltener Malignome. Meist (40–50 %) handelt es sich um Leiomyosarkome, gefolgt von endometrialen Stromasarkomen (ESS), low-grade (LG) und high-grade (HG), sowie undifferenzierten Sarkomen des Uterus (UUS) und Adenosarkomen (AS). Differenzialdiagnostisch äußerst schwierig sind einzelne, nicht organspezifische Tumoren wie die NTRK-rearrangierte Spindelzellneoplasie, der primäre perivaskuläre epitheloidzellige Tumor (PECom) und der inflammatorische myofibroblastäre Tumor (IMT).

In der jüngsten WHO-Klassifikation werden endometriale Stromatumoren unterteilt in: benigner, expansiv wachsender endometrialer Stromaknoten (ESN) mit scharfer Begrenzung, das histologisch gleichartig aussehende LG-ESS mit infiltrativem Wachstum und das hochmaligne HG-ESS sowie als Ausschlussdiagnose das hochaggressive UUS ohne Liniendifferenzierung. Das LG-ESS lässt sich meist histologisch und immunhistochemisch vom HG-ESS unterscheiden, molekulare Untersuchungen sind in Einzelfällen jedoch notwendig. Das HG-ESS kann auf Basis molekularer Befunde in 4 Subtypen (YWHAE/NUTM2-Fusion low-grade Komponente, YWHAE/NUTM2-Fusion high-grade Komponente, ZC3H7B-BCOR-Fusion oder BCOR-ITD) unterteilt werden. Prognostisch ungünstige Faktoren beim AS sind: starke sarkomatöse Überwucherung, tiefe Myometriuminvasion, high-grade Histologie, Lymphgefäßinvasion. Tumoren mit NTRK-Fusion sind immunhistochemisch positiv für S100 und TRK. Das PECom exprimiert Cathepsin K und HMB45 sowie TFE3 bei vorhandener Translokation. Nahezu jedes IMT weist eine Alteration im ALK-Gen auf. Eine Absicherung durch immunhistochemische und eventuell molekulare Untersuchungen ist bei überschneidender Morphologie und gleichzeitiger therapeutisch und prognostischer Relevanz von immer größerer Bedeutung.

Abstract

Uterine sarcomas are a heterogeneous group of rare malignancies. Mostly (40–50%), they are leiomyosarcomas, followed by endometrial stromal sarcomas (ESS), low-grade (LG) and high-grade (HG), as well as undifferentiated sarcoma of the uterus (UUS) and adenosarcomas (AS). Other, non-organ-specific tumours such as NTRK-rearranged spindle cell neoplasia, perivascular epithelioid cell tumour (PEComa) and inflammatory myofibroblastic tumour (IMT) are extremely difficult to differentiate.

In the most recent WHO classification, endometrial stromal tumours are subdivided as follows: benign, expansively growing endometrial stromal nodule (ESN) with sharp demarcation, the histologically similar-looking LG-ESS with infiltrative growth, the highly malignant HG-ESS and, as a diagnosis of exclusion, the highly aggressive UUS lacking specific lines of differentiation. LG-ESS can be differentiated from HG-ESS in most cases histomorphologically and immunohistochemically, but molecular investigations are necessary in individual cases. HG-ESS can be divided into 4 subtypes (YWHAE/NUTM2 fusion low-grade component, YWHAE/NUTM2 fusion high-grade component, ZC3H7B-BCOR fusion or BCOR-ITD) on the basis of molecular findings. Prognostically unfavourable factors in AS are severe sarcomatous overgrowth, deep myometrial invasion, high-grade histology and lymphatic vessel invasion. Tumours with NTRK fusion are immunohistochemically positive for S100 and TRK. PEComas express cathepsin K and HMB45, as well as TFE3 when translocation is present. Almost every IMT shows an alteration in the ALK gene In the case of overlapping morphology and simultaneous therapeutic and prognostic relevance, it is becoming increasingly important to verify or confirm the suspected histomorphological diagnosis by immunohistochemical and possibly molecular investigations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5

Literatur

  1. Aggarwal N, Bhargava R, Elishaev E (2012) Uterine adenosarcomas: diagnostic use of the proliferation marker Ki-67 as an adjunct to morphologic diagnosis. Int J Gynecol Pathol 31:447–452. https://doi.org/10.1097/PGP.0b013e318249285b

    Article  CAS  PubMed  Google Scholar 

  2. Akaev I, Yeoh CC, Rahimi S (2021) Update on endometrial stromal tumours of the uterus. Diagnostics (Basel). https://doi.org/10.3390/diagnostics11030429

    Article  Google Scholar 

  3. Ali RH, Rouzbahman M (2015) Endometrial stromal tumours revisited: an update based on the 2014 WHO classification. J Clin Pathol 68:325–332. https://doi.org/10.1136/jclinpath-2014-202829

    Article  PubMed  Google Scholar 

  4. Allen AJ, Ali SM, Gowen K, Elvin JA, Pejovic T (2017) A recurrent endometrial stromal sarcoma harbors the novel fusion JAZF1-BCORL1. Gynecol Oncol Rep 20:51–53. https://doi.org/10.1016/j.gore.2017.03.002

    Article  PubMed  PubMed Central  Google Scholar 

  5. Amant F, Schurmans K, Steenkiste E, Verbist L, Abeler VM, Tulunay G, De Jonge E, Massuger L, Moerman P, Vergote I (2004) Immunohistochemical determination of estrogen and progesterone receptor positivity in uterine adenosarcoma. Gynecol Oncol 93:680–685. https://doi.org/10.1016/j.ygyno.2004.03.021

    Article  CAS  PubMed  Google Scholar 

  6. Amant F, Steenkiste E, Schurmans K, Verbist L, Abeler VM, Tulunay G, De Jonge E, Massuger L, Moerman P, Vergote I (2004) Immunohistochemical expression of CD10 antigen in uterine adenosarcoma. Int J Gynecol Cancer 14:1118–1121. https://doi.org/10.1111/j.1048-891X.2004.14610.x

    Article  CAS  PubMed  Google Scholar 

  7. Arend R, Bagaria M, Lewin SN, Sun X, Deutsch I, Burke WM, Herzog TJ, Wright JD (2010) Long-term outcome and natural history of uterine adenosarcomas. Gynecol Oncol 119:305–308. https://doi.org/10.1016/j.ygyno.2010.07.001

    Article  PubMed  Google Scholar 

  8. Ban Y, Fischer JV, Maniar KP, Guo H, Zeng C, Li Y, Zhang Q, Wang X, Zhang W, Bulun SE, Wei JJ (2020) Whole-genome sequencing and target validation analysis of Mullerian adenosarcoma: a tumor with complex but specific genetic alterations. Front Oncol 10:538. https://doi.org/10.3389/fonc.2020.00538

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bennett JA, Braga AC, Pinto A, Van de Vijver K, Cornejo K, Pesci A, Zhang L, Morales-Oyarvide V, Kiyokawa T, Zannoni GF, Carlson J, Slavik T, Tornos C, Antonescu CR, Oliva E (2018) Uterine PEComas: a morphologic, immunohistochemical, and molecular analysis of 32 tumors. Am J Surg Pathol 42:1370–1383. https://doi.org/10.1097/PAS.0000000000001119

    Article  PubMed  PubMed Central  Google Scholar 

  10. Busca A, Gulavita P, Parra-Herran C, Islam S (2018) IFITM1 outperforms CD10 in differentiating low-grade endometrial stromal sarcomas from smooth muscle neoplasms of the uterus. Int J Gynecol Pathol 37:372–378. https://doi.org/10.1097/PGP.0000000000000424

    Article  CAS  PubMed  Google Scholar 

  11. Chew I, Oliva E (2010) Endometrial stromal sarcomas: a review of potential prognostic factors. Adv Anat Pathol 17:113–121. https://doi.org/10.1097/PAP.0b013e3181cfb7c2

    Article  PubMed  Google Scholar 

  12. Chiang S, Lee CH, Stewart CJR, Oliva E, Hoang LN, Ali RH, Hensley ML, Arias-Stella JA 3rd, Frosina D, Jungbluth AA, Benayed R, Ladanyi M, Hameed M, Wang L, Kao YC, Antonescu CR, Soslow RA (2017) BCOR is a robust diagnostic immunohistochemical marker of genetically diverse high-grade endometrial stromal sarcoma, including tumors exhibiting variant morphology. Mod Pathol 30:1251–1261. https://doi.org/10.1038/modpathol.2017.42

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Coffey D, Kaplan AL, Ramzy I (2005) Intraoperative consultation in gynecologic pathology. Arch Pathol Lab Med 129:1544–1557. https://doi.org/10.5858/2005-129-1544-ICIGP

    Article  PubMed  Google Scholar 

  14. Cotzia P, Benayed R, Mullaney K, Oliva E, Felix A, Ferreira J, Soslow RA, Antonescu CR, Ladanyi M, Chiang S (2019) Undifferentiated uterine sarcomas represent under-recognized high-grade endometrial stromal sarcomas. Am J Surg Pathol 43:662–669. https://doi.org/10.1097/PAS.0000000000001215

    Article  PubMed  PubMed Central  Google Scholar 

  15. Croce S, Hostein I, Ribeiro A, Garbay D, Velasco V, Stoeckle E, Guyon F, Floquet A, Neuville A, Coindre JM, MacGrogan G, Chibon F (2013) YWHAE rearrangement identified by FISH and RT-PCR in endometrial stromal sarcomas: genetic and pathological correlations. Mod Pathol 26:1390–1400. https://doi.org/10.1038/modpathol.2013.69

    Article  CAS  PubMed  Google Scholar 

  16. Dickson BC, Lum A, Swanson D, Bernardini MQ, Colgan TJ, Shaw PA, Yip S, Lee CH (2018) Novel EPC1 gene fusions in endometrial stromal sarcoma. Genes Chromosomes Cancer 57:598–603. https://doi.org/10.1002/gcc.22649

    Article  CAS  PubMed  Google Scholar 

  17. Dionigi A, Oliva E, Clement PB, Young RH (2002) Endometrial stromal nodules and endometrial stromal tumors with limited infiltration: a clinicopathologic study of 50 cases. Am J Surg Pathol 26:567–581. https://doi.org/10.1097/00000478-200205000-00003

    Article  PubMed  Google Scholar 

  18. Ferreira J, Felix A, Lennerz JK, Oliva E (2018) Recent advances in the histological and molecular classification of endometrial stromal neoplasms. Virchows Arch 473:665–678. https://doi.org/10.1007/s00428-018-2470-6

    Article  PubMed  Google Scholar 

  19. Friedlander ML, Covens A, Glasspool RM, Hilpert F, Kristensen G, Kwon S, Selle F, Small W, Witteveen E, Russell P (2014) Gynecologic cancer intergroup (GCIG) consensus review for mullerian adenosarcoma of the female genital tract. Int J Gynecol Cancer 24:S78–82. https://doi.org/10.1097/IGC.0000000000000239

    Article  PubMed  Google Scholar 

  20. Halbwedl I, Ullmann R, Kremser ML, Man YG, Isadi-Moud N, Lax S, Denk H, Popper HH, Tavassoli FA, Moinfar F (2005) Chromosomal alterations in low-grade endometrial stromal sarcoma and undifferentiated endometrial sarcoma as detected by comparative genomic hybridization. Gynecol Oncol 97:582–587. https://doi.org/10.1016/j.ygyno.2005.01.002

    Article  CAS  PubMed  Google Scholar 

  21. Hardell E, Josefson S, Ghaderi M, Skeie-Jensen T, Westbom-Fremer S, Cheek EH, Bell D, Selling J, Schoolmeester JK, Masback A, Davidson B, Carlson JW (2017) Validation of a mitotic index cutoff as a prognostic marker in undifferentiated uterine sarcomas. Am J Surg Pathol 41:1231–1237. https://doi.org/10.1097/PAS.0000000000000894

    Article  PubMed  Google Scholar 

  22. Hoang L, Chiang S, Lee CH (2018) Endometrial stromal sarcomas and related neoplasms: new developments and diagnostic considerations. Pathology 50:162–177. https://doi.org/10.1016/j.pathol.2017.11.086

    Article  CAS  PubMed  Google Scholar 

  23. Hodgson A, Amemiya Y, Seth A, Djordjevic B, Parra-Herran C (2017) High-grade Mullerian adenosarcoma: genomic and clinicopathologic characterization of a distinct neoplasm with prevalent TP53 pathway alterations and aggressive behavior. Am J Surg Pathol 41:1513–1522. https://doi.org/10.1097/PAS.0000000000000907

    Article  PubMed  Google Scholar 

  24. Hosh M, Antar S, Nazzal A, Warda M, Gibreel A, Refky B (2016) Uterine sarcoma: analysis of 13,089 cases based on surveillance, epidemiology, and end results database. Int J Gynecol Cancer 26:1098–1104. https://doi.org/10.1097/IGC.0000000000000720

    Article  PubMed  Google Scholar 

  25. Howitt BE, Sholl LM, Dal Cin P, Jia Y, Yuan L, MacConaill L, Lindeman N, Kuo F, Garcia E, Nucci MR, Quade BJ (2015) Targeted genomic analysis of Mullerian adenosarcoma. J Pathol 235:37–49. https://doi.org/10.1002/path.4442

    Article  CAS  PubMed  Google Scholar 

  26. Kihara A, Amano Y, Matsubara D, Fukushima N, Fujiwara H, Niki T (2021) Infrequent loss of SMARCA4, SMARCA2, and SMARCB1 expression in uterine mesenchymal tumors. Hum Pathol 116:12–21. https://doi.org/10.1016/j.humpath.2021.07.001

    Article  CAS  PubMed  Google Scholar 

  27. Kolin DL, Dong F, Baltay M, Lindeman N, MacConaill L, Nucci MR, Crum CP, Howitt BE (2018) SMARCA4-deficient undifferentiated uterine sarcoma (malignant rhabdoid tumor of the uterus): a clinicopathologic entity distinct from undifferentiated carcinoma. Mod Pathol 31:1442–1456. https://doi.org/10.1038/s41379-018-0049-z

    Article  PubMed  Google Scholar 

  28. Kurihara S, Oda Y, Ohishi Y, Iwasa A, Takahira T, Kaneki E, Kobayashi H, Wake N, Tsuneyoshi M (2008) Endometrial stromal sarcomas and related high-grade sarcomas: immunohistochemical and molecular genetic study of 31 cases. Am J Surg Pathol 32:1228–1238. https://doi.org/10.1097/PAS.0b013e31816a3b42

    Article  PubMed  Google Scholar 

  29. Lee CH, Hoang LN, Yip S, Reyes C, Marino-Enriquez A, Eilers G, Tao D, Chiang S, Fletcher JA, Soslow RA, Nucci MR, Oliva E (2014) Frequent expression of KIT in endometrial stromal sarcoma with YWHAE genetic rearrangement. Mod Pathol 27:751–757. https://doi.org/10.1038/modpathol.2013.199

    Article  CAS  PubMed  Google Scholar 

  30. Lee CH, Marino-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 (2012) The clinicopathologic features of YWHAE-FAM22 endometrial stromal sarcomas: a histologically high-grade and clinically aggressive tumor. Am J Surg Pathol 36:641–653. https://doi.org/10.1097/PAS.0b013e31824a7b1a

    Article  PubMed  Google Scholar 

  31. Lee CH, Nucci MR (2015) Endometrial stromal sarcoma—the new genetic paradigm. Histopathology 67:1–19. https://doi.org/10.1111/his.12594

    Article  PubMed  Google Scholar 

  32. Lee JC, Lu TP, Changou CA, Liang CW, Huang HN, Lauria A, Huang HY, Lin CY, Chiang YC, Davidson B, Lin MC, Kuo KT (2016) Genomewide copy number analysis of Mullerian adenosarcoma identified chromosomal instability in the aggressive subgroup. Mod Pathol 29:1070–1082. https://doi.org/10.1038/modpathol.2016.99

    Article  CAS  PubMed  Google Scholar 

  33. Li JY, Mutlu L, Tymon-Rosario J, Khadraoui W, Nagarkatti N, Hui P, Buza N, Lu L, Schwartz P, Menderes G (2022) Clinicopathologic characteristics and oncologic outcomes in adenosarcoma of gynecologic sites. Gynecol Oncol Rep 39:100913. https://doi.org/10.1016/j.gore.2021.100913

    Article  PubMed  Google Scholar 

  34. Mansor S, Kuick CH, Lim SL, Quek R, Wong APC, Lim-Tan SK, Lim TYK, Chang KTE (2019) ZC3H7B-BCOR-rearranged endometrial stromal sarcomas: a distinct subset merits its own classification? Int J Gynecol Pathol 38:420–425. https://doi.org/10.1097/PGP.0000000000000523

    Article  CAS  PubMed  Google Scholar 

  35. McCluggage WG (2010) Mullerian adenosarcoma of the female genital tract. Adv Anat Pathol 17:122–129. https://doi.org/10.1097/PAP.0b013e3181cfe732

    Article  PubMed  Google Scholar 

  36. McCluggage WG (2016) A practical approach to the diagnosis of mixed epithelial and mesenchymal tumours of the uterus. Mod Pathol 29(1):S78–91. https://doi.org/10.1038/modpathol.2015.137

    Article  CAS  PubMed  Google Scholar 

  37. McCluggage WG, Fisher C, Hirschowitz L (2014) Dataset for histological reporting of uterine sarcomas

    Google Scholar 

  38. McCluggage WG, Ganesan R, Herrington CS (2009) Endometrial stromal sarcomas with extensive endometrioid glandular differentiation: report of a series with emphasis on the potential for misdiagnosis and discussion of the differential diagnosis. Histopathology 54:365–373. https://doi.org/10.1111/j.1365-2559.2009.03230.x

    Article  PubMed  Google Scholar 

  39. Wittekind C (2020) TNM-Klassifikation maligner Tumoren, 8. Aufl. Wiley-VCH, Weinheim (Korrigierter Nachdruck 2020)

    Google Scholar 

  40. Nathenson MJ, Conley AP (2018) Prognostic factors for uterine adenosarcoma: a review. Expert Rev Anticancer Ther 18:1093–1100. https://doi.org/10.1080/14737140.2018.1518136

    Article  CAS  PubMed  Google Scholar 

  41. Nilforoushan N, Wethington SL, Nonogaki H, Gross J, Vang R, Xing D (2021) NTRK-fusion sarcoma of the uterine cervix: report of 2 cases with comparative clinicopathologic features. Int J Gynecol Pathol. https://doi.org/10.1097/PGP.0000000000000834

    Article  PubMed  Google Scholar 

  42. Oliva E (2014) Cellular mesenchymal tumors of the uterus: a review emphasizing recent observations. Int J Gynecol Pathol 33:374–384. https://doi.org/10.1097/PGP.0000000000000141

    Article  CAS  PubMed  Google Scholar 

  43. Oliva E, Carcangiu ML, Carinelli SG, Ip P, Loening T, Longacre TA, Nucci MR, Prat J, Zaloudek CJ (2014) Mesenchymal tumors of the uterus. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH (Hrsg) WHO classification of tumours of female reproductive tract. IARC Press, Lyon, S 135–147

    Google Scholar 

  44. Otis CN, Ocampo AC, Nucci MR, McCluggage WG (2013) Protocol for the examination of specimens from patients with sarcoma. http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2013/UterineSarcomaProtocol_3000.pdf. Zugegriffen: 27.08.2018

  45. Rabban JT, Devine WP, Sangoi AR, Poder L, Alvarez E, Davis JL, Rudzinski E, Garg K, Bean GR (2020) NTRK fusion cervical sarcoma: a report of three cases, emphasising morphological and immunohistochemical distinction from other uterine sarcomas, including adenosarcoma. Histopathology 77:100–111. https://doi.org/10.1111/his.14069

    Article  PubMed  Google Scholar 

  46. Schick U, Bolukbasi Y, Thariat J, Abdah-Bortnyak R, Kuten A, Igdem S, Caglar H, Ozsaran Z, Lossl K, Schleicher U, Zwahlen D, Villette S, Vees H (2012) Outcome and prognostic factors in endometrial stromal tumors: a rare cancer network study. Int J Radiat Oncol Biol Phys 82:e757–763. https://doi.org/10.1016/j.ijrobp.2011.11.005

    Article  PubMed  Google Scholar 

  47. Sciallis AP, Bedroske PP, Schoolmeester JK, Sukov WR, Keeney GL, Hodge JC, Bell DA (2014) High-grade endometrial stromal sarcomas: a clinicopathologic study of a group of tumors with heterogenous morphologic and genetic features. Am J Surg Pathol 38:1161–1172. https://doi.org/10.1097/PAS.0000000000000256

    Article  PubMed  Google Scholar 

  48. Selenica P, Conlon N, Gonzalez C, Frosina D, Jungbluth AA, Beets-Tan RGH, Rao MK, Zhang Y, Benayed R, Ladanyi M, Solit DB, Chiang S, Hyman DM, Hensley ML, Soslow RA, Weigelt B, Murali R (2021) Genomic profiling aids classification of diagnostically challenging uterine mesenchymal tumors with myomelanocytic differentiation. Am J Surg Pathol 45:77–92. https://doi.org/10.1097/PAS.0000000000001572

    Article  PubMed  PubMed Central  Google Scholar 

  49. Shukla PS, Mittal K (2019) Inflammatory myofibroblastic tumor in female genital tract. Arch Pathol Lab Med 143:122–129. https://doi.org/10.5858/arpa.2017-0575-RA

    Article  PubMed  Google Scholar 

  50. Soslow RA (2022) Melanocytic marker expression and TSC alterations/TFE3 fusions in uterine PEComas. Mod Pathol. https://doi.org/10.1038/s41379-021-01004-4

    Article  PubMed  Google Scholar 

  51. Soslow RA, Ali A, Oliva E (2008) Mullerian adenosarcomas: an immunophenotypic analysis of 35 cases. Am J Surg Pathol 32:1013–1021. https://doi.org/10.1097/PAS.0b013e318161d1be

    Article  PubMed  Google Scholar 

  52. Trope CG, Abeler VM, Kristensen GB (2012) Diagnosis and treatment of sarcoma of the uterus. A review. Acta Oncol 51:694–705. https://doi.org/10.3109/0284186X.2012.689111

    Article  PubMed  Google Scholar 

  53. Wells M, Oliva E, Palacios J, Prat J (2014) Mixed epithelial and mesenchymal tumors of the uterus. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH (Hrsg) WHO classification of tumours of female reproductive tract. IARC Press, Lyon, S 148–151

    Google Scholar 

  54. Wu TI, Chou HH, Yeh CJ, Hsueh S, Yang JE, Jao MS, Chang TC, Hsu CS, Lin KH, Lai CH (2013) Clinicopathologic parameters and immunohistochemical study of endometrial stromal sarcomas. Int J Gynecol Pathol 32:482–492. https://doi.org/10.1097/PGP.0b013e3182729131

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pathologisches Institut, Ludwig-Maximilians-Universität München, Thalkirchner Straße 36, 80337, München, Deutschland

    Doris Mayr & Elisa Schmoeckel

  2. Institut für Pathologie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland

    Lars-Christian Horn, Grit Gesine Ruth Hiller & Anne Kathrin Höhn

Authors
  1. Doris Mayr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lars-Christian Horn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Grit Gesine Ruth Hiller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anne Kathrin Höhn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elisa Schmoeckel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Doris Mayr.

Ethics declarations

Interessenkonflikt

D. Mayr, L.‑C. Horn, G.G.R. Hiller, A.K. Höhn und E. Schmoeckel geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Schwerpunktherausgeberin

E. Wardelmann, Münster

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mayr, D., Horn, LC., Hiller, G.G.R. et al. Endometriale und weitere seltene uterine Sarkome. Pathologe 43, 183–195 (2022). https://doi.org/10.1007/s00292-022-01072-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00292-022-01072-6

Schlüsselwörter

Keywords

Search

Navigation