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Primary uterine angiosarcoma is an extremely rare neoplasm. Due to its rarity, knowledge regarding this malignancy is limited to a few scattered case reports. To better understand the prognostic factors and optimal management of these neoplasms, we have performed a systematic analysis of the disease. A systematic literature search of this entity yielded 25 reported cases of this entity. In addition, we searched the National Cancer Institute Surveillance, Epidemiology, and End Results database to find 4 additional cases and added a case diagnosed in our institution. We analyzed the patients' demographic characteristics and the different treatment protocols utilized to treat this malignancy. Patients were primarily treated by surgery with or without adjuvant chemotherapy and radiotherapy. Survival analysis was performed to examine the role of various factors in the outcome for the patients. There was no correlation with age of diagnosis, or treatment modality used, however, better outcomes were seen in patients presenting with smaller sized tumors. Our study is the first attempt to systematically study this rare malignancy in hopes of leading to a more standardized, evidence-based, and improved treatment protocol., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 by the International Society of Gynecological Pathologists.)

Apoplectic leiomyomas-benign uterine leiomyomas with morphologic changes including hemorrhage, hypercellularity, mitotic activity, nuclear atypia, and even necrosis-can be difficult to distinguish from uterine leiomyosarcomas. Apoplectic leiomyomas have been associated with hormonal therapy; however, the relationship between apoplectic leiomyomas, hormones, and ethnicity has not received much attention in the literature. We evaluated the relationship of hormonal therapy and ethnicity in 869 women with uterine leiomyomas, 136 of which qualified as apoplectic leiomyomas.Apoplectic leiomyomas were observed in 23.3% (49/210) of women exposed to hormonal therapy compared to 13.2% (87/659) of women not exposed to hormonal therapy (p < 0.0001). Women taking ethinyl estradiol/norethindrone (Lo-Estrin), leuprolide, and medroxyprogesterone were significantly more likely to have apoplectic leiomyomas compared to women taking other hormonal therapies. Apoplectic leiomyomas were observed in 28.9% (44/152) of African-American women compared to 12.4% (79/639) of Caucasian women (p < 0.0001), and this difference remained statistically significant regardless of hormone use. Apoplectic leiomyomas were observed in 22.1% (77/349) of women ≤ 45 years of age compared to 11.3% (59/520) of women > 45 years of age (p < 0.0001), and this difference remained statistically significant regardless of hormone use.This is the largest study to date examining apoplectic leiomyomas in women on known hormonal therapy compared to women with uterine leiomyomas, but not on hormonal therapy. Information about hormonal therapy, ethnicity, and age can be helpful in the diagnostic interpretation of apoplectic leiomyoma., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Placental neoplasms involving the fetal membranes are exceptionally rare. In leiomyomas and endometrial stromal neoplasms, a uterine origin for nodules in the membranes is also a possibility. We present a case of an incidental endometrial stromal nodule found in the decidua of the free membranes and review the literature.

The differential diagnosis of lesions arising in the broad ligament is quite large. Many of these lesions can be clinically interpreted before surgery as adnexal or uterine neoplasms. Although some lesions are similar to those arising in other müllerian sites, there are unique lesions as well. The lesions are uncommon and may prove challenging to clinicians. The purpose was to review the scope of lesions affecting the broad ligament. A literature review was conducted. A Medline search was performed using the terms broad ligament, mesosalpinx, and mesovarium. A review of the scope of broad ligament lesions is presented to assist in developing a differential diagnosis if a patient with such a lesion is encountered., (Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.)

The risk of occult malignancy being present at the time of uterine morcellation has been estimated to be about 1%. Dissemination of both benign and malignant disease may occur after morcellation, leading to a variety of peritoneal nodules. These lesions are reviewed., (Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.)

Background: Malignant mixed mesodermal tumors (MMMTs) are uncommon, highly aggressive tumors of the uterus composed of both carcinomatous and sarcomatous elements, both likely to be derived from the same original stem cell. There is a strong association between endometrial adenocarcinoma and polycystic ovary disease. However, only two cases of MMMT occurring in women with polycystic ovaries have been reported., Case: A 36-year-old woman with polycystic ovary disease developed an MMMT of the endometrium., Conclusion: Some cases of MMMT may be estrogen related.

Uterine artery embolization (UAE) is frequently performed for symptomatic leiomyomata. There have been no reports of squamous metaplasia of endometrium after such a procedure. Squamous metaplasia of endometrium is often associated with endometrial hyperplasia and carcinoma. In our patient the disorder was diagnosed after UAE. This is the second such case we have encountered. In view of the association of squamous metaplasia with endometrial hyperplasia and carcinoma, a history of recent UAE must be considered in evaluating a patient with this finding, particularly on a biopsy specimen.

Objective: Vaginal vault recurrences of genital tract malignancy are not uncommon, and may be the first sign of recurrent disease. This paper reviews the experience at Columbia Presbyterian Medical Center., Methods: The tumor lists from 1993 to 1996 of the Division of Ob/Gyn Pathology at Columbia Presbyterian Medical Center were reviewed, and correlated with retrospective chart review., Results: Of 36 cases, 13 were from uterine primaries, seven were cervical in origin, eight were ovarian primaries, and in eight cases, the exact primary was not known at the time of biopsy. For the cases where the primary diagnosis and disease free interval were known, the time interval from hysterectomy to vault recurrence ranged from 1.5 months to 84 months, with a mean of 25.6 months., Conclusion: Vaginal vault recurrences are often the site of recurrent female genital tract malignancies. Patients treated for gynecological cancer must have regular pelvic examinations including cytologic examination as part of their oncologic surveillance.

We report on the incidental finding of pituitary tissue in a mature teratoma on the uterosacral ligament of a 56-year-old woman who underwent exploratory laparotomy for ovarian masses. While the occurrence of pituitary tissue has been reported rarely in benign cystic teratoma of the ovary, and while pituitary adenomas can occur in ectopic sites, we have found only one report in the literature of benign cystic teratoma of extragonadal origin composed of mature adenohypophyseal and neurohypophyseal elements.