scholarly journals Leiomyosarcoma of Uterus in a Nulliparous Female: Mimicking as Ovarian Malignancy

Author(s):  
Jagannath Mishra ◽  
Supratim Bhattacharya ◽  
Arpita Pandia ◽  
Ashok Padhy ◽  
Manoranjan Mahapatra ◽  
...  

AbstractUterine sarcoma is a rare verity of smooth muscle tumor, accounting for 2 to 6% of uterine malignancies. Leiomyosarcoma (LMS) represents ~1% of overall uterine tumors and ~25 to 36% of uterine sarcomas. Here we present a case of uterine LMS in a 34-year-old nulliparous woman presented with huge distension of abdomen which was confused to be an ovarian malignancy. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. The diagnosis of LMS is made by histopathological examination after surgery. Surgery is the only treatment and role of adjuvant therapy has not been clearly defined.

Author(s):  
Nayanika Gaur ◽  
Manish Jha

Leiomyoma is one of the most commonly encountered benign gynaecological neoplasms. With a wide range of symptoms, sometimes even asymptomatic, these tumors are easy to diagnose and treat, unless there are degenerative changes, which makes them difficult to diagnose and differentiating them from other serious conditions including malignancy, thereby, complicating their management also. Here, the case present to you a case of 48-year-old women with symptoms and clinical examination suggesting fibroid uterus but imaging studies inconclusive to differentiate fibroid uterus with ovarian malignancy, thus, creating a diagnostic dilemma. Ultimately, patient underwent exploratory laparotomy, keeping possibility of ovarian malignancy. Histopathological examination of the specimen of total abdominal hysterectomy with bilateral salpingo-oopherectomy concluded extensive cystic degeneration of leiomyoma and no evidence of malignancy.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16079-16079
Author(s):  
A. Yoney ◽  
S. Eskici ◽  
B. Eren ◽  
A. Salman ◽  
M. Unsal

16079 Background: Currently there is no randomized study based or widely accepted therapeutic modality in uterine sarcomas which are rare tumors forming a heterogeneous group in respect to their pathologic classification. Methods: In our trial, 105 pts. with uterine sarcoma who were referred to our clinic between years 1995–2003 have been retrospectively researched to evaluate the results in this tumor group. 43.8% had Leiomyosarcoma (LMS), 28.6% had Endometrial Stromal Sarcoma (ESS) and 27.6% had a Malign Mullarian Mixed Tumor (MMMT) while the distribution according to the histological subgroups were found to be 58.8% and 41.2% in low + middle grade tumors combined and in high grade tumors respectively. 76.2% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy (TAH+BSO), 18.1% had a Total Abdominal Hysterectomy + Bilateral Salphingooverectomy + Lymphadenectomy (TAH+BSO+LND) and 5.7% had a suboptimal surgery as a surgical procedure. 38.1% of the pts. had Radiotherapy (RT), 18.1% had Chemotherapy (CT) and 12.4% had Chemo-radiotherapy (CT+RT) in addition to surgery. Results: The median age of the whole group is 51 (24–87). 55% of our pts. are under 50 years old and 68.5% had an “organ limited disease” ( stages I-II combined). The distant metastases rate is 30% and the local recurrence is 16.2%. All the local recurrences and 90% of the distant metastases have occurred within the first two years. The disease free survival rates at 3 and 5 years are 54.46% and 49.88% ; while the overall survival rates at 3 and 5 years are 54.63% and 51.09% all respectively. The stage is the most important factor effecting on the O.S and 5- year O.S rate is 68.43% in Stage I disease. Conclusions: The aggressive tumor progression pattern and the poor prognosis of uterine sarcomas require adjuvant therapies. The merit of current therapeutic options are still on debate since none of them has proved any specific effects. Planning further multi-center retrospective studies with high number of pts., a more clear description of the prognostic factors and thus the determination of the most appropriate therapeutic option is definitely needed. No significant financial relationships to disclose.


2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Erbil Karaman ◽  
Numan Çim ◽  
Gülay Bulut ◽  
Gülhan Elçi ◽  
Esra Andıç ◽  
...  

Introduction. Uterine leiomyoma is the most common benign pathology in women and lipoleiomyoma is an extremely rare and specific type of leiomyoma. Here, we report an unusual case of giant pedunculated subserous lipoleiomyoma misdiagnosed preoperatively as leiomyosarcoma.Case. A 45-year-old woman admitted to our gynecology outpatient clinic for complaints of abdominal distention, tiredness, and pelvic pain for the last 6 months. Sonography and abdominal magnetic resonance imaging (MRI) showed a giant semisolid mass that filled whole abdominal cavity from pelvis to subdiaphragmatic area. A primary diagnosis of uterine sarcoma or ovarian malignancy was made. On operation, total abdominal hysterectomy with a pedunculated mass of size 30 × 23 × 12 cm and weighing 5.4 kg and bilateral salpingo-oophorectomy were performed. The histopathology revealed a lipoleiomyoma with extensive cystic and fatty degeneration without any malignancy.Discussion. The diagnosis of leiomyoma is done usually with pelvic ultrasound but sometimes it is difficult to reach a correct diagnosis especially in cases of giant and pedunculated lipoleiomyoma that included fatty tissue which may mimick malignancy.Conclusion. Subserous pedunculated giant lipoleiomyoma should be kept in mind in the differential diagnosis of leiomyosarcoma or ovarian malignancy.


2016 ◽  
Vol 8 (3) ◽  
pp. 212-213
Author(s):  
Indu Lata ◽  
Deepa Kapoor

ABSTRACT Struma ovarii (SO) is a rare special type of monodermal teratoma of ovary that predominantly consists of thyroid tissue (> 50%). In only 5 to 20% of cases hyperthyroidism is seen due to functional SO. We are reporting here a case of unilateral benign cystic SO in a 50-year-old postmenopausal lady presented with pain and heaviness in lower abdomen without any signs and symptoms of hyperthyroidism. Pelvic ultrasonogram showed right side tubo-ovarian mass and was planned for laparotomy. In preoperative investigation subclinical hyperthyroidism was diagnosed. Abdominal exploration showed cystic mass lesion in right ovary. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathological examination diagnosed the mass as benign cystic SO. Patient became euthyroid after surgical removal of tumor. How to cite this article Lata I, Kapoor D. A Rare Case of Functional Ectopic Hyperthyroidism: Struma Ovarii. World J Endoc Surg 2016;8(3):212-213.


2003 ◽  
Vol 13 (1) ◽  
pp. 88-89
Author(s):  
A. Shamseddine ◽  
A. Taher ◽  
Y. Abou-Mourad ◽  
M. Seoud ◽  
A. Khalil

Most patients with advanced or recurrent uterine sarcoma experience disease progression and ultimately die. We present a case of uterine sarcoma with lung metastasis treated with systemic chemotherapy and with no evidence of disease for more than 5 years. A 77-year-old woman underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy for carcinosarcoma of the uterus followed by external pelvic radiotherapy. Ten months later, the tumor recurred in the apex of the vagina and was treated with brachytherapy. After 6 months of remission, she presented with pulmonary metastasis. After four cycles of systemic chemotherapy with cisplatin and ifosfamide, the pulmonary nodules completely disappeared. Currently she is still in complete remission after more than 5 years, but unfortunately she has developed myelodysplastic syndrome. This is the first reported case in the literature of cured metastatic uterine carcinosarcoma to lungs, with long-term survival of 5 years.


2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Ioannis Kalogiannidis ◽  
Amalia Mavrona ◽  
Sophia Grammenou ◽  
Georgios Zacharioudakis ◽  
Stamatia Aggelidou ◽  
...  

Appendiceal mucocele is a rare clinical entity, which is however quite often associated with mucinous ovarian tumor. The coexistence of mucinous cystadenoma of the appendix and endometrial adenocarcinoma has not been reported before. A 49-year-old woman presented to our clinic with postmenopausal bleeding and no other symptom. Endometrial biopsy revealed endometrial adenocarcinoma of endometrioid type (grade I). Preoperative CT scanning revealed an appendiceal mucocele, and a colonoscopy confirmed the diagnosis. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and appendectomy. The final histopathological examination showed a mucinous cystadenoma of the appendix and confirmed the diagnosis of endometrioid endometrial adenocarcinoma. The coexistence of appendiceal mucocele and female genital tract pathology is rare. However, gynecologists should keep a high level of suspicion for such possible coexistence. Both the diagnostic approach and the therapeutic management should be multidisciplinary, most importantly with the involvement of general surgeons.


Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5808
Author(s):  
Giulia Dondi ◽  
Eleonora Porcu ◽  
Alessandra De Palma ◽  
Giuseppe Damiano ◽  
Eugenia De Crescenzo ◽  
...  

Uterine sarcomas are rare cancers, sometimes diagnosed in women of childbearing age. Hysterectomy is the standard treatment in early stages. The option of lesion removal to save fertility is described in the literature, but it is still considered experimental. The objective of this systematic review is to report on the available evidence on the reproductive and oncological outcomes of fertility-sparing treatment in women with uterine sarcomas. PubMed, Scopus and Cochrane Central Register of Controlled Trials were searched between 1 January 2011 and 21 June 2021 for publications in English about women with uterine sarcoma treated with a fertility-sparing intervention. Thirty-seven studies were included for a total of 210 patients: 63 low-grade endometrial stromal sarcomas, 35 embryonal rhabdomyosarcomas of the cervix, 19 adenosarcomas, 7 leiomyosarcomas and 2 uterine tumors resembling an ovarian sex cord. Conservative treatment ensured pregnancy in 32% of cases. In terms of oncological outcomes, relapse was related to histology and the worst prognosis was reported for leiomyosarcoma, followed by low-grade endometrial stromal sarcoma, which relapsed in 71% and 54% of cases, respectively. The highest death rate was associated with leiomyosarcoma (57.1%). This study demonstrated that fertility-sparing treatments may be employed in selected cases of early stage uterine sarcoma.


2019 ◽  
Vol 17 (01) ◽  
pp. 128-130
Author(s):  
Karishma Malla Vaidya ◽  
Bigya Shrestha

Lymphangiomas are slow-growing tumors that remain asymptomatic for a long time, with the tumor being identified incidentally during histopathological examination after excision. Mature cystic teratoma is benign tumor consisting of mature tissue derived from two or three germ layers. We have 47-year-old woman who underwent total abdominal hysterectomy for right adnexal mass. As her ultrasound report revealed a right adnexal mass with solid and cystic components. The histological analysis along with immunohistochemistry (D2-40) maker confirmed the diagnosis of lymphangioma of the ovary coexisting with mature cystic teratoma. There is paucity of reported case of co-existing these two tumors in same tissue.Keywords: D2-40; lymphangioma; mature cystic teratoma; ovary.


2010 ◽  
Vol 3 ◽  
pp. CCRep.S5082 ◽  
Author(s):  
Reecha Singh ◽  
S. Shameema ◽  
Koothan Vijaya ◽  
Pradeep Kumar

Background and objectives Mullerian adenosarcoma is an uncommon variant of mixed mesodermal tumour of the uterus. This is a case report of a 65 year old post-menopausal lady who presented with complaints of passing tissue fragments per vaginum for 2 days followed by spotting. On examination, a polypoid mass protruding through the cervix was seen which was biopsied. Following a preliminary histologic diagnosis of poorly differentiated sarcoma on the biopsy; the patient underwent total abdominal hysterectomy with bilateral salpingo-oopherectomy. Method The surgical specimen was formalin fixed and paraffin embedded. Haematoxylin and eosin stained sections were studied. Result and conclusion Histopathological examination of the polypoid mass revealed a tumour comprising of an admixture of benign endometrial glandular component with overgrowth of sarcomatous stromal component and heterologous elements. This may pose a problem in diagnosis due to its rarity, and hence its distinctive morphological features merit attention as described here. In view of the rarity of this tumor, it is mandatory to do extensive histologic sampling to identify areas of sarcomatous overgrowth before arriving at a diagnosis of mullerian adenosarcoma as the clinical course and management vary.


2018 ◽  
Vol 3 (2) ◽  
pp. 423-426
Author(s):  
Sailesh Bahadur Pradhan ◽  
Mamata Sedhain ◽  
Sneh Acharya ◽  
Sailuja Maharjan ◽  
Samikchhya Regmi

Introduction: Uterus is subjected to many non-neoplastic and neoplastic diseases. Hysterectomy is the commonest gynecological surgery done for the management of the pathologies of the female reproductive system. Histopathological examination of hysterectomy specimens is done routinely which has both diagnostic and therapeutic significance.Objective: To study the common pathologies identified in hysterectomy specimens and to correlate them with the clinical findings.Methodology: A cross sectional study was carried out among all the hysterectomy specimens irrespective of primary lesion sent for histopathological examination from January 2016 to December 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital (KMCTH). Relevant history was taken from the requisition form. Ethical clearance was obtained from the Institutional Review Committee of KMCTH.Results: A total of 198 cases were studied. The most common pathology encountered was leiomyoma (60.0%) followed by adenomyosis (14.0%). Atrophic endometrium was seen in 24.3% cases. Chronic cervicitis was found in most of the cases (96.5%) along with endocervical polyp in 8.1% cases. Leiomyoma was found to be the most common indication for hysterectomy comprising 48.0% followed by abnormal uterine bleeding (24.75%) and utero-vaginal prolapse (18.25%). Hysterectomy was most commonly performed in the age group of 41 - 50 years and total abdominal hysterectomy with bilateral salpingo-oophorectomy was found to be the commonest procedure done comprising 8 0.0%.Conclusion: Leiomyoma was found to be the most common pathology in myometrium and chronic cervicitis in cervix. Abnormal uterine bleeding and vaginal prolapsed were also found to be common. Lesions which can be managed conservatively do need hysterectomy or not, is a matter of great concern. BJHS 2018;3(2)6:423-426.


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