García-Sánchez Jose María, Bauza Mónica, Pérez-García Alberto, Mayordomo Aranda Empar, Ruiz Valls Alejandro
Department of Plastic Surgery, University and Polytechnic La Fe Hospital, Valencia, Spain.
Department of Pathology, University and Polytechnic La Fe Hospital, Valencia, Spain.
Clin Med Insights Case Rep. 2019 Jun 24;12:1179547619857680. doi: 10.1177/1179547619857680. eCollection 2019.
This report presents uterine smooth muscle tumors of uncertain malignant potential course with an unpredictable clinical behavior and late metastases. Metastases have been described to the humerus, lung, and peritoneum.
Hereby we present the case of a 71-year-old woman with a past surgical history of hysterectomy and bilateral adnexectomy due to a smooth muscle tumor of unknown malignant potential, who was evaluated 6 years later after the appearance of a mass in the proximal third of the right lower limb. The mass was diagnosed as a G1 epithelioid leiomyosarcoma and was surgically removed with immediate reconstruction with a tendinous transfer to the tibialis posterior muscle to maintain foot dorsiflexion.
Patients diagnosed with smooth uterine muscle tumors of uncertain malignant potential should be closely followed up given the possibility of recurrence and late metastases, bearing in mind uncommon locations as well, such as the lower limb.
本报告介绍了具有不确定恶性潜能的子宫平滑肌肿瘤，其临床行为不可预测且转移较晚。已有肱骨、肺和腹膜转移的相关报道。
在此，我们报告一例71岁女性患者，既往因不明恶性潜能的平滑肌肿瘤行子宫切除术和双侧附件切除术，6年后右下肢近端三分之一处出现肿块，遂接受评估。该肿块被诊断为G1上皮样平滑肌肉瘤，并通过手术切除，同时立即进行肌腱转移至胫后肌的重建手术以维持足背屈功能。
鉴于具有不确定恶性潜能的子宫平滑肌肿瘤有复发和晚期转移的可能性，包括下肢等不常见部位，对确诊患者应密切随访。
