IntroductionUterine leiomyosarcoma (ULMS) is an uncommon smooth muscle tumour, accounting for approximately 1–2% of all uterine malignancies. Overall 5‐year survival rates range from 15 to 25% for all stages of ULMS. The mechanisms of tumorigenesis, pathogenesis and progression have not been well established. Disease stage has been shown to be the most important prognostic factor in ULMSs. Several series have found older age, large tumour size, non‐conventional subtype, high mitotic index, high‐grade cytological atypia, presence of coagulative tumour cell necrosis (CTN), low expression of hormone receptors and high expression of cell cycle markers to be significant predictors of poor outcomes, whereas other series have denied their prognostic significance.The mediator complex subunit 12 (MED12) gene on Xq13.1 encodes the MED12 protein, which participates in various molecular pathways; for example, the p53 and Wnt/β‐catenin pathways, which have central roles in tumour development. MED12 mutations were identified in several tumours, including colorectal cancer, prostate cancer, breast fibroadenoma and phyllodes tumours. In breast fibroepithelial tumours, MED12 mutations are detected more frequently in fibroadenomas and benign phyllodes tumours compared to malignant phyllodes tumours. As this gene mutation in leiomyomas was described first in 2011 by Makinen et al. in uterine smooth muscle tumours, numerous
Histopathology – Wiley
Published: Jan 1, 2018
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