Clinicopathological Correlation of Uterine Corpus Tumors: A Study of 433 Cases

  • Divya Shekhar ShettyEmail author
  • Alka Vikas Gosavi
  • Prashant Shankarrao Murarkar
  • Kalpana Ranjitsingh Sulhyan
Original Article



Uterine corpus tumors are one of the most common reasons for morbidity and mortality of women around the world, and histopathological diagnosis is the key for better management of the patients.


To study the histopathology of uterine tumors, classify them as per WHO 2014 classification and correlate with clinical parameters.


A five-year study was conducted on 433 histopathologically diagnosed cases of uterine corpus tumors.


Benign tumors were the most common (95.6%) followed by malignant (3.9%) and borderline (0.5%). Leiomyoma was the most common benign tumor (91.2%). Majority of the cases were multiparous females (88.6%) in fourth and fifth decades of life (77%) and presenting with heavy menstrual bleeding (35.9%). The most location was intramural (68.9%). Cellular leiomyoma (1.8%) was the most common histologic variant; the secondary change was hyalinization (27.8%). Endometrial carcinoma was the most common malignant tumor (3%) followed by leiomyosarcoma (0.5%) and adenosarcoma (0.2%). Majority of the women with endometrial carcinoma were multiparous (76.9%) and belonging to the age-group of 50–59 years (38.4%). The most common symptom was postmenopausal bleeding (76.9%). Endometrioid carcinoma grade I (75%) was the most common type of endometrial carcinoma. Other lesions were adenomyoma (N = 17), STUMP (N = 2), and one case each of adenomatoid tumor, endometrial stromal nodule and secondary tumor.


Benign tumors were more common than malignant tumors. Leiomyoma was the most common benign tumor, and endometrial carcinoma was the most common malignant tumor. Many uterine tumors present with similar clinical features. However, histopathology plays an important role in the accurate diagnosis of different types of tumors and thus helps in providing the patient with appropriate management.


Leiomyoma Endometrial carcinoma Endometrial stromal nodule Adenomyoma Adenomatoid tumor Leiomyosarcoma Adenosarcoma Secondary tumor STUMP Differential diagnosis Clinicopathological correlation 



This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon: International Agency for Research on Cancer; 2013. Accessed 10 Nov 2015.
  2. 2.
    Dadhania Bhoomika, Dhruva Gauravi, Agravat Amit, Pujara Krupal. Histopathological study of endometrium in dysfunctional uterine bleeding. Int J Res Med. 2013;2(1):20–4.Google Scholar
  3. 3.
    Kurman RJ, Carcangiu ML, Herrington CS, Young RH. Tumors of the uterine corpus, Chap 5. In: Kurman RJ, Carcangiu ML, Herrington CS, Young RH, editors. WHO classification of tumors of female reproductive organs. Lyon: IARC; 2014. p. 121–54.Google Scholar
  4. 4.
    Kurman RJ, Ellenson LH, Ronnett BM. Blaustein’s pathology of the female genital tract. 6th ed. New York: Springer; 2011.CrossRefGoogle Scholar
  5. 5.
    Sutton C. The historical curiosities in the surgical management of myomas. J Am Assoc Gynecol Laparosc. 2004;11(1):4–7.CrossRefGoogle Scholar
  6. 6.
    Ranabat SK, Shrestha R, Tiwari M, Sinha DP, Subedee LR. A retrospective histopathological study of hysterectomy with or without salpingo-ophorectomy specimens. JCMC. 2010;1(1):26–9.Google Scholar
  7. 7.
    Nayak JC, Prajapati VP, Desai KS, Jadav HR, Chaudhary SM, Pensi CA. Uterine leiomyoma: clinical profile at civil hospital, Ahmedabad. NJIRM. 2012;3(4):50–3.Google Scholar
  8. 8.
    Abdullah L, Gomaa W. The clinicopathological characteristics of uterine leiomyomas: a tertiary care centre ecperience in Saudi Arabia. Rep Opin. 2013;5(10):21–6.Google Scholar
  9. 9.
    Gowri M, Mala G, Murthy S, Nayak V. Clinicopathological study of uterine leiomyomas in hysterectomy specimens. J Evol Med Dent Sci. 2013;2(46):9002–9.CrossRefGoogle Scholar
  10. 10.
    Begum S, Khan S. Audit of leiomyoma uterus at Khyber teaching hospital Peshawar. J Ayub Med Coll Abbottabad. 2004;16(2):46–9.PubMedGoogle Scholar
  11. 11.
    Abraham J, Saldanha P. Morphological variants and secondary changes in uterine leiomyomas: Is it important to recognize them? IJBR. 2013;4(12):639–45.Google Scholar
  12. 12.
    Mohammed A, Shehu SM, Ahmed SA, Mayun AA, Tiffin IU, Alkali G, et al. Uterine leiomyomata: a five year clinicopathological review in Zaria, Nigeria. Niger J Surg Res. 2005;7(1):206–8.Google Scholar
  13. 13.
    Ibrar F, Riaz S, Dawood NS, Jabeen A. Frequency of fibroid uterus in multipara women in a tertiary care centre in Rawalpindi. J Ayub Med Coll Abbottabad. 2010;22(3):155–7.PubMedGoogle Scholar
  14. 14.
    Dayal S, Kumar A, Verma A. Clinicopathologic correlation of leiomyoma with clinical findings and secondary changes in a rural population of north India. Am J Clin Pathol. 2014;141:275–9.CrossRefGoogle Scholar
  15. 15.
    Manjula K, Kadam SR, Chandrasekar HR. Variants of leiomyoma: histomorphological study of tumors of myometrium. JSAFOG. 2011;3(2):89–92.CrossRefGoogle Scholar
  16. 16.
    Ramachandran T, Sinha P, Subramanium. Correlation between clinico-pathological and ultrasonographical findings in hysterectomy. JCDR. 2011;5(4):737–40.Google Scholar
  17. 17.
    Jha R, Pant AD, Jha A, Adhikari RC, Sayami G. Histopathological analysis of hysterectomy specimens. J Nepal Med Assoc. 2006;45(163):283–90.Google Scholar
  18. 18.
    Rather GR, Gupta Y, Bardhwaj S. Patterns of lesions in hysterectomy specimens: a prospective study. JK Sci. 2013;15(2):63–8.Google Scholar
  19. 19.
    Kapp DS, Shin JY, Chan JK. Prognostic factors and survival in 1396 patients with uterine leiomyosarcomas: emphasis on impact of lymphadenectomy and oophorectomy. Cancer. 2008;112(4):820–30.CrossRefGoogle Scholar
  20. 20.
    Kim WY, Chang SJ, Chang KH, Yoon JH, Kim JH, Kim BG, et al. Uterine leiomyosarcoma: 14-year two-center experience of 31 cases. Cancer Res Treat. 2009;41(1):24–8.CrossRefGoogle Scholar
  21. 21.
    Loizzi V, Cormio G, Nestola D, Falagario M, Surgo A, Camporeale A, et al. Prognostic factors and outcomes in 28 cases of uterine leiomyosarcoma. Oncology. 2011;81(2):91–7.CrossRefGoogle Scholar
  22. 22.
    Larson B, Silfverswarb C, Nilsson B, Pettersson F. Prognostic factors in uterine leiomyosarcoma: a clinical and histopathological study of 143 cases the Radiumhemmet series 1936-1981. Acta Oncol. 1990;29(2):185–91.CrossRefGoogle Scholar
  23. 23.
    Rosai J. Female reproductive system-uterus corpus, Chap 19. In: Rosai and Ackerman’s surgical pathology, 10th ed. Gurgaon: Elsevier; 2011. pp. 1477–1540.Google Scholar
  24. 24.
    Rathod PS, Reddihalli PV, Krishnappa S, Devi UK, Bafna UD. A retrospective clinicopathological study of 131 cases with endometrial cancers: Is it possible to define the role of retroperitoneal lymphadenectomy in low-resource settings? Indian J Cancer. 2014;51(1):54–7.CrossRefGoogle Scholar
  25. 25.
    Abd El-Wahed MM, Abdou AG, Al-Sharaky DR, Kasem HA. Clinicopathological differences between type I and type II endometrial carcinoma. Menoufia Med J. 2017;30:946–51.Google Scholar
  26. 26.
    Ellenson LH, Pirog EC. The female genital tract. In: Kumar V, Abbas AK, Fausto N, Aster J, editors. Robbins and Cotran pathologic basis of disease. 8th ed. Philadelphia: Elsevier Inc.; 2010. p. 1005–64.CrossRefGoogle Scholar
  27. 27.
    Sherman ME. Theories of endometrial carcinogenesis: a multidisciplinary approach. Mod Pathol. 2000;13(3):295–308.CrossRefGoogle Scholar
  28. 28.
    Tahlan A, Nanda A, Mohan H. Uterine adenomyoma: a clinicopathologic review of 26 cases and a review of the literature. Int J Gynecol Pathol. 2006;25:361–5.CrossRefGoogle Scholar
  29. 29.
    Gilks CB, Clement PB, Hart WR, Young RH. Uterine adenomyomas excluding atypical polypoid adenomyomas and adenomyomas of endocervical type: a clinicopathologic study of 30 cases of an underemphasized lesion that may cause diagnostic problems with brief consideration of adenomyomas of other female genital tract sites. Int J Gynecol Pathol. 2000;19(3):195–205.CrossRefGoogle Scholar
  30. 30.
    Rekhi B, Deodhar KK, Maheshwari A, Menon S, Kerkar R, Bajpai J, et al. Clinicopathological spectrum of 19 adenosarcomas of female genital tract, including uncommon clinical associations and immunohistochemical profile, reviewed at a single institution. Indian J Pathol Microbiol. 2012;55(3):326–32.CrossRefGoogle Scholar
  31. 31.
    Sangoi AR, McKenney JK, Schwartz EJ, Rouse RV, Longacre TA. Adenomatoid tumors of the female and male genital tracts: a clinicopathological and immunohistochemical study of 44 cases. Mod Pathol. 2009;22(9):1228–35.CrossRefGoogle Scholar
  32. 32.
    Ranjan R, Singh L, Nath D, Sable MN, Malhotra N, Bhatla N, et al. Uterine adenomatoid tumors: a study of five cases including three cases of the rare leiomyoadenomatoid variant. J Obstet Gynaecol India. 2015;65(4):255–8.CrossRefGoogle Scholar
  33. 33.
    Üzüm N, Ortaç F, Ataoğlu O. Intramurally located adenomatoid tumor of the uterus: a case report. Gazi Med J. 2009;20(3):139–41.Google Scholar
  34. 34.
    Kundu R, Mohan H, Sehgal A, Takkar N. Adenomatoid tumor of the uterus; report of a rare incidentaloma. Int J Reprod Contracept Obstet Gynecol. 2014;3(3):769–71.CrossRefGoogle Scholar
  35. 35.
    Agashe SR, Kulkarni MP, Momin YA, Sulhyan KR. Superficial extension of squamous cell carcinoma in situ of cervix involving endometrium, bilateral fallopian tubes and ovaries: a case report. Indian J Pathol Microbiol. 2007;50:375–7.PubMedGoogle Scholar
  36. 36.
    Marwah N, Garg M, Singh S, Sethi D, Sen R. Unusual form of squamous cell carcinoma of the cervix extending in situ into the endometrium: three case reports and review of literature. Int J Appl Basic Med Res. 2012;2:139–41.CrossRefGoogle Scholar

Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  • Divya Shekhar Shetty
    • 1
    • 2
    Email author
  • Alka Vikas Gosavi
    • 1
  • Prashant Shankarrao Murarkar
    • 1
  • Kalpana Ranjitsingh Sulhyan
    • 1
  1. 1.Department of PathologyGovernment Medical College MirajDistrict SangliIndia
  2. 2.MumbaiIndia

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