A rare case of aggressive uterine leiomyosarcoma: a case report

Pan Afr Med J. 2024 Sep 9:49:10. doi: 10.11604/pamj.2024.49.10.42105. eCollection 2024.

Abstract

Uterine leiomyosarcoma is a rare aggressive uterine malignancy that arises from a smooth muscle of the uterus which accounts for 2-5% of all uterine malignancies. Definitive treatment is surgery with a high rate of recurrences. Our patient presented with lower abdominal pain and mass per abdomen which was diagnosed to be uterine leiomyosarcoma. A 56-year-old woman of East Indian origin presented with abdominal pain and a huge rapidly growing suprapubic abdominal mass with an almost monthly doubling. Her CA 125 and Lactate dehydrogenase (LDH) level was elevated and Computed Tomography (CT) scan showed a large irregular-shaped abdominopelvic solid heterogeneously enhanced lesion with focal central hyperdensity and areas of necrosis causing mass effect. A primary cytoreductive surgery was performed and the histopathology report confirmed the diagnosis of uterine leiomyosarcoma. A combination chemotherapy of six cycles was given to prevent recurrence. No recurrence was detected during her more than two years follow-up period. As the cases are rare in nature, screening is impractical. Hence, the diagnosis of uterine leiomyosarcoma is done by histopathologic examination after surgery.

Keywords: Uterine leiomyosarcoma; case report; chemotherapy; leiomyoma; postmenopausal bleeding.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain* / etiology
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • CA-125 Antigen / blood
  • Cytoreduction Surgical Procedures
  • Female
  • Follow-Up Studies
  • Humans
  • Leiomyosarcoma* / diagnosis
  • Leiomyosarcoma* / pathology
  • Leiomyosarcoma* / surgery
  • Middle Aged
  • Tomography, X-Ray Computed*
  • Uterine Neoplasms* / diagnosis
  • Uterine Neoplasms* / pathology
  • Uterine Neoplasms* / surgery

Substances

  • CA-125 Antigen