A case of ruptured uterine leiomyosarcoma with heterologous components

Tanaka Miyu, Takao Yumi, Suzuki Naohiro, Amano Yasuaki, Ujita Mari, Emoto Ikuko, Abiko Kaoru

doi:10.57291/jsgo.40.2_55

<p>Rupture is a rare complication of uterine sarcoma. We report a case of a ruptured leiomyosarcoma with heterologous components, which was diagnosed after colonoscopy. A 48-year-old woman was referred to our department for anemia. Upon magnetic resonance imaging (MRI), a 48×50-mm mass was found on the anterior wall of her uterus and diagnosed as a uterine fibroid. After 8 years of regular visits to the hospital once or twice a year, she experienced abdominal pain after a colonoscopy for occult blood in her stool. Computed tomography revealed an enlarged uterine mass of 90×69 mm. MRI showed mixed signal on T2-weighted images, decreased diffusion, and high signal on T1-weighted images, indicating bleeding. The outline of the uterine mass was disrupted, and rupture of a malignant tumor in the uterus was suspected. Total hysterectomy, bilateral adnexal resection, and partial resection of the ileum and omentum were performed. Pathological findings comprised an irregular, bundle-like proliferation of spindle-shaped cells with prominent nuclear atypia, high mitotic count, coagulative necrosis, and infiltration of multinucleated giant cells with heterologous components of osteosarcoma and chondrosarcoma. A diagnosis of leiomyosarcoma with heterologous components was made. Postoperative chemotherapy was administered, but the tumor recurred with a lung metastasis one year after the surgery.</p>

A case of ruptured uterine leiomyosarcoma with heterologous components

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