Posy H E Stohl, Elkas J C, Yemelyanova A V, Diaz-Montes T P, Bristow R E, Giuntoli R L
Department of Gynecology and Obstetrics, The Kelly Gynecologic Oncology Service, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
Eur J Gynaecol Oncol. 2009;30(2):199-202.
Uterine artery embolization (UAE) allows treatment of recalcitrant fibroids, but does not provide a surgical specimen. In the rare instance that a uterine mass represents a uterine leiomyosarcoma (LMS), UAE may delay diagnosis. We report a case of a 45-year-old woman who underwent resection of a substernal mass five years after UAE. Pathology demonstrated LMS. She received radiation therapy to the surgical site. Upon recovery, she underwent a hysterectomy and bilateral salpingo-oophorectomy. Pathology demonstrated uterine LMS. She was managed conservatively and is without evidence of disease over two years after excision of her substernal mass. Multiple case reports have described a delay in diagnosis of uterine LMS after UAE. The current case is unique in that it the diagnosis was made based on the presence of a distant metastasis, which occurred years after UAE.
子宫动脉栓塞术（UAE）可用于治疗难治性子宫肌瘤，但无法获取手术标本。在罕见情况下，子宫肿块若为子宫平滑肌肉瘤（LMS），UAE可能会延迟诊断。我们报告一例45岁女性，在接受UAE五年后切除了胸骨后肿块。病理显示为LMS。她接受了手术部位的放射治疗。康复后，她接受了子宫切除术和双侧输卵管卵巢切除术。病理显示为子宫LMS。她接受了保守治疗，在切除胸骨后肿块两年多后无疾病迹象。多篇病例报告描述了UAE后子宫LMS诊断延迟的情况。本病例的独特之处在于，诊断是基于远处转移的存在，而这发生在UAE数年之后。
