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Case report
When the uterine mass is not a leiomyoma
  1. Sofia Pereira1,
  2. Rita Sousa2,
  3. Liliana Constantino3,4 and
  4. Carlos Abrantes5,6
  1. 1Gynaecology, Centro Hospitalar Leiria EPE, Pousos, Portugal
  2. 2Gynaecology, Francisco Gentil Portuguese Institute for Oncology of Coimbra, Coimbra, Coimbra, Portugal
  3. 3ARS Centro, UCSP Anadia I, Anadia, Beira Litoral, Portugal
  4. 4Clínica Universitária de Medicina Geral e Familiar, Universidade de Coimbra Faculdade de Medicina, Coimbra, Beira Litoral, Portugal
  5. 5Pathology Department, Coimbra University Hospital Centre, Coimbra, Portugal
  6. 6Pathology Department, Instituto Portugues de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Coimbra, Portugal
  1. Correspondence to Dr Sofia Pereira; sofiafarinhapereira{at}gmail.com

Abstract

A 37-year-old nulliparous woman with abnormal uterine bleeding and a uterine mass suggestive of a leiomyoma not responding to medical therapy was submitted to two hysteroscopies with histological analysis. The first one showed a ‘leiomyoma’ and the second a ‘uterine smooth muscle tumour of uncertain malignant potential/epithelioid leiomyosarcoma, with positivity for hormonal receptors’. The patient was submitted to a total hysterectomy with bilateral salpingo-oophorectomy, and the microscopic examination of the tumour revealed a ‘uterine tumour resembling ovarian sex-cord tumours’. According to the literature, most cases are diagnosed in postmenopausal women and have a favourable prognosis. These rare tumours have uncertain malignant potential and have no established treatment protocol, but it appears that a fertility-sparing approach is possible once they are well diagnosed.

  • cancer - see oncology
  • gynecological cancer

https://doi.org/10.1136/bcr-2021-243845

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    Footnotes

    • Contributors SFP has contributed to the planning, bibliographic research and reporting. RS has contributed to the conception and reporting. LC has contributed to reporting. CA has contributed to reporting and with the figures. They were all involved as physicians with this case.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.