Abstract:

INTRODUCTION: The aim of this study was to compare the accuracy rates of the postoperative histopathological diagnosis with the preoperative diagnose in patients were operated for presumed leiomyoma uteri using the methods of bimanual pelvic examination and ultrasonographic imagine. METHODS: The medical records of 402 cases, who were underwent surgical treatment with the prediagnosis of uterine leiomyoma based on the pelvic examination and ultrasonographic evaluation, were retrospectively reviewed. The patients, in whom the advanced image techniques were used for differential diagnosis, were not included in the study. The type of surgery and the postoperative histopathological diagnoses were recorded for 396 patients. The number of cases, in whom confirmed the diagnosis of leiomyoma by postoperative histopathological examination, were calculated and the other pathologies were analyzed. Patients demographics findings and the results of preoperative endometrial sampling was recorded. RESULTS: The mean age of the patients were 45.7±7.3 years. As a result of histopathological examination, leiomyoma diagnosis was confirmed in 91.4 % of the cases. But, in this cases 1.3 % of cellular leiomyoma, 0.5 % of the high mitotic activity, fibroids, 0.5 % were diagnosed as atypical leiomyoma. Only 89.1 % was the percentage of patients who were diagnosed as leiomyoma. There was no pathology other than cervical chronic inflammation in 3 cases out of 43 without leiomyoma. In 12 patients out of 40, pathologies with surgical indications, presenting as a mass, mimicking leiomyoma (endometrial stromal sarcoma, nörilemmom, adenomatoid tumor, endometrioma) were observed. In the remaining 20 cases, pathologies with disputable necessity for surgery (adenomyosis, endometrial hyperplasia without atypia, endometrial polyp, granulomatous endometritis) are present. DISCUSSION AND CONCLUSION: In the patients, who were selected in the preoperative diagnostic process with the algorithmic assessments and applications and operated for presumed leiomyoma uteri, the correct diagnosis rate can be reached but because of adenomyosis have similar findings with leiomyoma uteri and definitive histopathological diagnosis for sarcomas is not possible without operation, not possible to achieve 100 % accuracy rate.

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