In the upper, middle portion of the figure, several symplasmic giant cells are noted. Several mitotic figures are seen. The presence of mitotic figures is required for the diagnosis of leiomyoma sarcoma and helps distinguish this lesion from a cellular leiomyoma. As a general rule, ten mitoses per ten high power fields should be identified. Total abdominal and bilateral salpingo-oophorectomy.
Adjuctive radiotherapy is of very little help as is chemotherapy.
These tumors often spread through vascular dissemination and pulmonary metastasis are not uncommon.