Department of Obstetrics and Gynaecology, ESI PGI MSR, ESIC Medical College and ESIC Hospital and ODC (EZ), Diamond Harbour Road, Joka, Kolkata, West Bengal, India, Pin-700104.
Pan Afr Med J. 2024 Sep 9;49:10. doi: 10.11604/pamj.2024.49.10.42105. eCollection 2024.
Uterine leiomyosarcoma is a rare aggressive uterine malignancy that arises from a smooth muscle of the uterus which accounts for 2-5% of all uterine malignancies. Definitive treatment is surgery with a high rate of recurrences. Our patient presented with lower abdominal pain and mass per abdomen which was diagnosed to be uterine leiomyosarcoma. A 56-year-old woman of East Indian origin presented with abdominal pain and a huge rapidly growing suprapubic abdominal mass with an almost monthly doubling. Her CA 125 and Lactate dehydrogenase (LDH) level was elevated and Computed Tomography (CT) scan showed a large irregular-shaped abdominopelvic solid heterogeneously enhanced lesion with focal central hyperdensity and areas of necrosis causing mass effect. A primary cytoreductive surgery was performed and the histopathology report confirmed the diagnosis of uterine leiomyosarcoma. A combination chemotherapy of six cycles was given to prevent recurrence. No recurrence was detected during her more than two years follow-up period. As the cases are rare in nature, screening is impractical. Hence, the diagnosis of uterine leiomyosarcoma is done by histopathologic examination after surgery.
子宫平滑肌肉瘤是一种罕见的侵袭性子宫恶性肿瘤，起源于子宫的平滑肌，占所有子宫恶性肿瘤的 2-5%。明确的治疗方法是手术，但复发率较高。我们的患者表现为下腹痛和腹部肿块，被诊断为子宫平滑肌肉瘤。一位 56 岁的东印度裔女性因腹痛和巨大的快速生长的耻骨上腹部肿块就诊，肿块几乎每月增大一倍。她的 CA 125 和乳酸脱氢酶（LDH）水平升高，计算机断层扫描（CT）显示一个大的不规则形状的腹盆腔实性不均匀增强病变，伴有局灶性中央高密度和坏死区，导致肿块效应。进行了初次减瘤手术，组织病理学报告证实了子宫平滑肌肉瘤的诊断。给予六周期的联合化疗以预防复发。在她两年多的随访期间没有发现复发。由于这种病例较为罕见，因此筛查并不实际。因此，子宫平滑肌肉瘤的诊断是在手术后通过组织病理学检查做出的。
