[Purely mesenchymal homologous uterus sarcomas (leiomyosarcomas and endometrial stroma sarcomas) at the Zurich University Gynecologic Hospital].

From 1960 through 1983 sixty-four so-called pure mesenchymal homologous sarcomas of the uterus were observed at the Women's University Hospital Zürich. A review of the histological slides revealed that only 40 cases represented true sarcomas according to the contemporary diagnostic criteria. These were 25 leiomyosarcomas and 15 endometrial stromal sarcomas. Leiomyosarcomas: The leading symptoms in these patients are uncharacteristic abdominal pain (15/25) as well as bleeding disturbances (11/25), the latter being present with equal frequency in the pre- and post-menopause. In 7 of the 11 patients with bleeding abnormalities the diagnosis was already made on examination of curettings, in all the other patients after laparotomy only. Sixteen patients had Stage I, four Stage III and five Stage IV tumors. The treatment consisted in surgery alone (9/25), surgery combined with radiotherapy (11/25) or with chemotherapy (2/25) as well as radiotherapy alone (1/25). In two cases no therapy was undertaken because of advanced cachexia of the patients. Only three patients are still alive without recurrence 4 to 12 years after the diagnosis, all had Stage I tumors. Endometrial stromal sarcomas: In these patients bleeding abnormalities represent the leading symptom (14/15), especially postmenopausal bleeding (13/14). In all cases with vaginal bloody discharge the diagnosis was made on examination of the curettings, in a single case after laparotomy only. Eight patients had Stage I, three Stage II, three Stage III and one Stage IV tumors. The treatment consisted of surgery alone (4/15) or in combination with radiotherapy (4/15), radiotherapy alone (6/15) and chemotherapy alone (1/15).(ABSTRACT TRUNCATED AT 250 WORDS)