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A lobulated mass arising from the uterine fundus.
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Figure 2: A lobulated mass arising from the uterine fundus.

Mentions: Intraoperatively, omental adhesions to the mass were noticed. A mass of 20 weeks' size was arising from the fundus of the uterus (Figure 1). It was lobulated (Figure 2) with solid, cystic and hemorrhagic components. Both ovaries were normal, and the fallopian tubes were edematous (Figure 3).

A rare case of uterine leiomyosarcoma: a case report

Vellanki VS, Rao M, Sunkavalli CB, Chinamotu RN, Kaja S - J Med Case Rep (2010)

Bottom Line: Our patient did not have any history of genital bleeding, which is the usual presentation in uterine sarcoma.Diagnosis is by histopathologic examination and surgery is the only treatment.The prognosis for women with uterine sarcoma primarily depends on the extent of disease at the time of diagnosis and the mitotic index.

Affiliation: Department of Obstetrics and Gynaecology, Kamineni Institute of Medical Sciences Sreepuram, Narketpally, Nalgonda - 508254, Andhra Pradesh, India. sujathavv@yahoo.com.

ABSTRACT

Introduction: Malignant change in a leiomyoma or uterine fibroid is termed leiomyosarcoma. It arises from smooth muscle of the uterus and is a rare tumor that accounts for 2% to 5% of all uterine malignancies. Very few cases are reported in the literature. Our patient did not have any history of genital bleeding, which is the usual presentation in uterine sarcoma. We report an original case report of an unusual presentation of this rare tumor arising from the uterus.

Case presentation: A 40-year-old iparous woman of South Indian origin presented with a mass in her abdomen for one year with a rapid increase in size over the previous three months. Tumor marker CA-125 was raised, and a computed tomography scan showed a mass arising from the pelvis. An exploratory laparotomy was performed and the histopathology report confirmed the diagnosis of uterine leiomyosarcoma.

Conclusion: Because of their rarity, uterine sarcomas are not suitable for screening. Diagnosis is by histopathologic examination and surgery is the only treatment. The prognosis for women with uterine sarcoma primarily depends on the extent of disease at the time of diagnosis and the mitotic index.

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