The problem of differential diagnosis of leiomyosarcoma in patients planning surgical treatment for uterine fibroids

Tskhay V.B., Pashov A.I., Rachkovskaya V.V.

1) Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia, Krasnoyarsk, Russia; 2) Immanuel Kant Baltic Federal University, Kaliningrad, Russia

Uterine leiomyosarcoma is known to have no clear diagnostic criteria due to its similarity to uterine fibroids. Therefore, clinicians tend to make the wrong diagnosis and/or administer the wrong treatment. This can lead to rapid progression of tumor growth and an increased tendency to metastasis. The article presents the main definitions, classifications, and statistical data on the prevalence of these diseases. A review of literature data on current methods of preoperative diagnosis of tumors was carried out, and special attention was paid to the differential diagnosis of these pathologies. The review covers the general principles of surgical treatment of pathology, as well as the possible extent of surgical intervention. Due to the active introduction and application of uterine artery embolization and intra-abdominal tumor morcellation in gynecological practice, there is a growing interest in preoperative differential diagnosis between leiomyosarcoma and uterine fibroids. These methods of treatment are inadequate if the diagnosis of uterine sarcoma is made in the postoperative period.
Conclusion: Preoperative differential diagnosis between uterine fibroids and sarcomas is extremely important in modern gynecological practice. It is associated not only with the progression of the disease, but also with a deterioration in the prognosis of the disease for the patient after surgical organ-preserving treatment.

Authors’ contributions: Tskhay V.B., Pashov A.I. – developing the idea and design of the study; Tskhay V.B., Pashov A.I., Rachkovskaya V.V. – collecting and processing the material; Pashov A.I. – editing the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
For citation: Tskhay V.B., Pashov A.I., Rachkovskaya V.V. The problem of differential diagnosis of leiomyosarcoma in patients planning surgical treatment for uterine fibroids.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (1): 42-49 (in Russian)


uterine body cancer
uterine fibroids
organ-preserving treatment


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Received 28.08.2023

Accepted 20.12.2023

About the Authors

Vitaly B. Tskhay, Dr. Med. Sci., Professor, Head of the Department of Perinatology, Obstetrics and Gynecology of the Medical Faculty, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia, +7(923)287-21-34,, 660022, Russia, Krasnoyarsk, P. Zheleznyak str., 1.
Alexander I. Pashov, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology of the Medical Institute, I. Kant Baltic Federal University,
+7(911)461-49-98,, 236016, Russia, Kaliningrad, A. Nevsky str., 14.
Valeria V. Rachkovskaya, postgraduate student of the Department of Obstetrics and Gynecology of the Medical Institute, I. Kant Baltic Federal University, +7(952)117-48-18,, 236016, Russia, Kaliningrad, A. Nevsky str., 14.
Corresponding author: Valeria V. Rachkovskaya,

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