Uterine Leiomyosarcoma: A Case Report

Uterine leiomyosarcoma (LMS) is a rare cancer originated from smooth muscle lining the walls of the uterus. LMS is known as an aggressive tumor with high mortality and morbidity rates as compared to other uterine cancers, despite the disease stage at the time of diagnosis. In most cases, LMS has been misdiagnosed as a benign uterine leiomyoma following hysterectomy or myomectomy.
We presented a 53-year-old G7 L7 woman who had referred to GYN clinic in Amir-al-Momenin hospital for abnormal uterine bleeding (AUB) for 6 months. On physical examination, we found an abdominal mass that had grown rapidly in the last 4 months. The computed tomography (CT) scan results showed a heterogeneous mass extending from the epigastric region to the pelvic area. Following an exploratory laparotomy, histopathology report confirmed the diagnosis of LMS. Her uterus, Fallopian tubes and ovaries were removed during a surgery, and she was referred to a gynecologic oncologist for possible chemotherapy.
We found that the surgery is the only treatment for LMS; however, there is a little possibility to diagnose LMS before surgery in the patient with uncertain diagnosis and suspicious of LMS. Analysis of LDH and LDH3 levels along with dynamic diethylenetriaminepentaacetic acid (Gd-DTPA) enhanced, and MRI are recommended.