Aden Durre, Zaheer Sufian, Singh Shruti, Ranga Sunil
Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
J Midlife Health. 2022 Jul-Sep;13(3):241-243. doi: 10.4103/jmh.jmh_36_22. Epub 2023 Jan 14.
Epithelioid leiomyosarcoma of the uterus is a rare soft-tissue tumor of the pelvis with <1% cases. It can be asymptomatic or can reach an enormous size, resulting in chronic pelvic pain, postmenopausal bleeding, or may cause bowel and bladder dysfunction. The diagnostic dilemma arises especially when they have epithelioid morphology. This case is being presented because of its rare incidence along with the diagnostic dilemma it presented due to epithelioid morphology which is a very rare presentation, especially challenging on small biopsies. This case also highlights the usefulness of immunohistochemical markers, such as WT1, p53, and p16, which has important diagnostic as well as prognostic values in rare variants of usual tumors. Leiomyosarcoma is a highly aggressive tumor, therefore, timely diagnosis and management are advised.
子宫上皮样平滑肌肉瘤是一种罕见的盆腔软组织肿瘤，病例占比不到1%。它可以无症状，也可以长得非常大，导致慢性盆腔疼痛、绝经后出血，或可能引起肠道和膀胱功能障碍。尤其是当肿瘤具有上皮样形态时，诊断会陷入困境。之所以呈现这个病例，是因为其发病率罕见，同时由于上皮样形态导致了诊断难题，这种情况非常罕见，在小活检时尤其具有挑战性。这个病例还凸显了免疫组化标志物（如WT1、p53和p16）的作用，这些标志物在常见肿瘤的罕见变体中具有重要的诊断和预后价值。平滑肌肉瘤是一种侵袭性很强的肿瘤，因此，建议及时进行诊断和处理。
