Kani Vallal, Arumugam Sumithra, Rajendran Karthika, Esakki Muthuvel
Department of Pathology, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technnical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Sep 13;16(9):e69374. doi: 10.7759/cureus.69374. eCollection 2024 Sep.
Primary ovarian leiomyosarcoma (LMS) is an extremely rare and aggressive tumor that originates in the smooth muscle tissue of the ovary. Typically affecting older women, it is diagnosed at an advanced stage and is associated with a poor prognosis, with most patients succumbing within the first year. The effectiveness of adjuvant chemotherapy and radiotherapy remains unclear due to the rarity of reported cases. In this case report, a 66-year-old woman presented with lower abdominal pain persisting for four months, accompanied by weight loss and appetite reduction. Imaging revealed a large, heterogeneous solid lesion in the left adnexa, suggesting a malignant ovarian neoplasm. Surgery was performed, and histopathological analysis confirmed the presence of a high-grade spindle cell sarcoma, consistent with ovarian LMS. Immunohistochemistry showed positive smooth muscle actin (SMA) and negative S100 and Myo D1, supporting the diagnosis. The patient completed two cycles of chemotherapy and was then lost to follow-up. This case highlights the diagnostic challenges and limited treatment options associated with primary ovarian LMS. Given the scarcity of cases, there is no established standard therapy, and the prognosis remains poor. Further research is needed to develop effective therapeutic strategies for this aggressive malignancy.
原发性卵巢平滑肌肉瘤（LMS）是一种极其罕见且侵袭性强的肿瘤，起源于卵巢的平滑肌组织。该肿瘤通常影响老年女性，多在晚期被诊断出来，预后较差，大多数患者在第一年内死亡。由于报告病例稀少，辅助化疗和放疗的有效性尚不清楚。在本病例报告中，一名66岁女性因下腹部疼痛持续四个月就诊，伴有体重减轻和食欲减退。影像学检查显示左侧附件有一个大的、异质性实性病变，提示为恶性卵巢肿瘤。进行了手术，组织病理学分析证实存在高级别梭形细胞肉瘤，符合卵巢LMS。免疫组化显示平滑肌肌动蛋白（SMA）阳性，S100和肌分化抗原（Myo D1）阴性，支持诊断。患者完成了两个周期的化疗，随后失访。该病例突出了原发性卵巢LMS相关的诊断挑战和有限的治疗选择。鉴于病例稀少，尚无既定的标准治疗方法，预后仍然很差。需要进一步研究以开发针对这种侵袭性恶性肿瘤的有效治疗策略。
