Korean J Obstet Gynecol.  2012 Dec;55(12):996-1000. 10.5468/KJOG.2012.55.12.996.

Retroperitoneal recurrence of uterine smooth muscle tumor of uncertain malignant potential as leiomyosarcoma

• Jung MJ
• Park JH
• Choi SJ
• Song ES
• Hwang SO
• Park JW

• KMID: 2274213
• DOI: http://doi.org/10.5468/KJOG.2012.55.12.996

Abstract

A 57-year-old Korean woman visited 37 months after initial surgery with fetal head sized pelvic mass. Initially, she underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and para-aortic lymph node biopsy. The initial pathological report showed uterine smooth muscle tumors of uncertain malignant potential (STUMP). She had not received adjuvant therapy. Transvaginal ultrasound revealed multiple solid masses in the pelvic cavity. Abdomino-pelvic computed tomography scan revealed heterogeneous lobulated rounding masses. Tumor markers were all within the normal range. She underwent explorative laparotomy. The pathological diagnosis was epitheloid leiomyosarcoma. Patients with STUMP should be counseled regarding the potential for recurrence as leiomyosarcoma, and may require closer surveillance than a yearly.

Keyword

Uterine smooth muscle tumor of uncertain malignant potential; Recurrence; Leiomyosarcoma

MeSH Terms

Biopsy
Female
Head
Humans
Hysterectomy
Laparotomy
Leiomyosarcoma
Lymph Nodes
Muscle, Smooth
Recurrence
Reference Values
Smooth Muscle Tumor
Biomarkers, Tumor

Figure

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  Fig. 1 (A) The tumor was characterized by smooth muscle tumor with high celluarity not accompanied by tumor cell necrosis or significant nuclear atypia (H&E, ×100). (B) However, a minor focal area exhibited moderate to severe nuclear atypia with high mitotic figures (H&E, ×200).

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  Fig. 2 Abdominopelvic computed tomography shows 4 × 4, 4 × 6, 6 × 7 cm sized heterogeneous lobulated rounding masses, suggestive recurrence of pelvic cavity, and lymphatic dissemination of rounding masses along iliac vessels.

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  Fig. 3 Positron emission tomography/computed tomography showed several recurrent masses with abnormal fluorodeoxyglucose uptake in the pelvic cavity.

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  Fig. 4 (A) The tumor consists of poorly differentiated cells with round to oval hyperchromatic nuclei and frequent mitotic figures (H&E, ×400). (B) In some areas showed geographic necrosis (H&E, ×400).

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