Long lasting clinical response to chemotherapy for advanced uterine leiomyosarcoma: a case report

Abstract

Introduction: Uterine leiomyosarcoma is one of the most frequent uterine sarcomas. In the metastatic setting it is sensitive to doxorubicin, ifosfamide, gemcitabine, docetaxel and a few other drugs, but time to progression is generally short. For this reason prognosis is often poor and there are few reports in the literature of long responders.

Case presentation: We report a case of a 40-year-old Caucasian woman with metastatic uterine leiomyosarcoma who began treatment six years before the presentation of this case report and for the following six years underwent ten lines of chemotherapy, achieving excellent results and a good quality of life. Among the treatments administered we observed a long response to temolozomide, an unconventional drug for this kind of disease.

Conclusion: Although there are few chemotherapeutic options for the management of metastatic uterine leiomyosarcoma, a small number of patients have an unexpected long lasting response to treatment. For this reason further research is needed to identify new therapeutic agents and the predictive factors for the achievement of response.

Figure 1

Effect of temozolomide on pelvic metastasis. A: before the beginning of treatment. B: after 11 months of treatment.

Figure 2

Effect of temozolomide on one of the lung metastases. A: before the beginning of treatment. B: after 11 months of treatment.