An Unusual Clinical and MorphologicalFeatures of Uterine Leiomyosarcoma:Immunohistochemistry Solves theDiagnostic Pitfalls of Uterine Sarcomas

摘要

Introduction: Leiomyosarcoma (LMS) arises from smooth muscle of the uterus and is a rare tumour that accounts for 2% to 5% of all uterine malignancies. Very few cases are reported in the literature. Our patient presented with a pelvic mass and did not have any history of genital bleeding, which is the usual presentation in uterine sarcoma. We report here an original case report of an unusual presentation of this rare tumour in the endometrial cavity with combined features of epithelioid differentiation and haemangiopericytoma (HPC) like areas in a single tumour which is not yet reported in the published literature. Case Report: A 55- years multiparous woman presented with a pelvic mass for 8 months duration with a rapid increase in size over the last three months. Ultrasonography showed a mass arising from the uterus. An exploratory laparotomy was performed and the histopathology report confirmed the diagnosis of uterine sarcoma combined with epithelioid differentiation and haemangiopericytoma like areas and hence a panel of immunohistochemical (IHC) workup was done which confirmed leiomyosarcoma. Conclusion: Our report highlights how a good index of suspicion, detailed histopathological diagnosis which when complemented with immunohistochemical work up could prevent the pitfalls of misdiagnosis and mismanagement of uterine sarcomas.