Smooth muscle tumors of the vulva are uncommon. Nielsen et al listed criteria for the histologic classification for these tumors. The authors are from Harvard Medical School.
Patient selection: smooth muscle tumor of the vulva
Parameters:
(1) diameter in centimeters
(2) pattern at the advancing margin of the tumor
(3) number of mitotic figures per high power field (hpf)
(4) cyologic atypia
|
Parameter |
Finding |
Points |
|
diameter |
< 5 cm |
0 |
|
|
>= 5 cm |
1 |
|
pattern at advancing margin |
not infiltrative |
0 |
|
|
infiltrative |
1 |
|
mitotic rate |
0 to 4 per 10 hpf |
0 |
|
|
>= 5 per 10 hpf |
1 |
|
cytologic atypia |
none to mild |
0 |
|
|
moderate or severe |
1 |
number of abnormal findings =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
|
Total Score |
Diagnosis |
Management |
|
0 or 1 |
leiomyoma |
excised conservatively |
|
2 |
atypical leiomyoma |
excised conservatively |
|
3 or 4 |
leiomyosarcoma |
wide excision with negative margins |
All patients should have careful long-term follow-up.
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
