DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20214672

A rare case of uterine myxoid leiomyosarcoma

Shirish S. Dulewad, Varsha Narayana Bhat, Prachi V. Koli

Abstract


Myxoid leiomyosarcoma is an uncommon tumour and in most cases, it is recognised only after the surgery. A 65 years old female patient got admitted at our hospital with history of rapidly growing abdominal mass with pain in abdomen since last 3 months. During abdominal examination 32 weeks huge mass was noted and on prevaginal examination mass couldn’t be separated from uterus. LDH was elevated, USG suggestive of vascular tumour of with neoplastic etiology of ovarain origin. CECT was done and findings suggestive of uterine adenocarcinoma with peritoneal carcinomatosis. Exploratory laparotomy with total abdominal hysterectomy with bilateral salphingoopherectomy with omentectomy with debulking surgery was performed. HPR reports suggestive of myxoid leiomyosarcoma with mitotic index of 10 with tumour cell necrosis suggestive of poor prognosis. Post-operative period patient had developed sudden myocardial infarction and shifted to ICU where she died due to ventricular fibrillation.

 


Keywords


Leiomyosarcoma, Peritoneal carcinomatosis, Debulking surgery

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References


Major FJ, Blessing JA, Silverberg SG, Morrow CP, Creasman WT, Currie JL, et al. Prognostic factors in early-stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer. 1993;71(4):1702-9.

Giuntoli RL, Metzinger DS, Marco CS, Cha SS, Sloan JA, Keeney GL, et al. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol. 2003;89(3):460-9.

Abeler VM, Røyne O, Thoresen S, Danielsen HE, Nesland JM, Kristensen GB. Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients. Histopathology. 2009;54(3):355-64.

Angelo E, Spagnoli LG, Prat J. Comparative clinicopathologic and immunohistochemical analysis of uterine sarcomas diagnosed using the World Health Organization classification system. Hum Pathol. 2009;40(11):1571-85.

Oliva E. Cellular mesenchymal tumors of the uterus: a review emphasizing recent observations. Int J Gynecol Pathol. 2014;33(4):374-84.

Kaur K, Kaur P, Kaur A, Singla A. Uterine leiomyosarcoma: A case report. J Midlife Health. 2014;5(4):202-4.

Reichardt P. The treatment of uterine sarcomas. Ann Oncol. 2012;23(10):151-7.