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Case Reports
. 2016 Mar 12;18(4):e33892.
doi: 10.5812/ircmj.33892. eCollection 2016 Apr.

Leiomyosarcoma of the Broad Ligament With Fever Presentation: A Case Report and Review of Literature

Shahla Chaichian  1 , Abolfazl Mehdizadehkashi  2 , Kobra Tahermanesh  3 , Bahram Moazzami  4 , Fatemeh Jesmi  4 , Moezedinjavad Rafiee  4 , Katayoun Goharimoghaddam  4
Affiliations
Case Reports

Leiomyosarcoma of the Broad Ligament With Fever Presentation: A Case Report and Review of Literature

Shahla Chaichian et al. Iran Red Crescent Med J. .

Abstract

Introduction: Leiomyosarcoma is a rare gynecologic malignancy that accounts for less than 1% of gynecological malignancies. Leiomyosarcoma of the broad ligament is an even rarer condition. According to Gardner's criteria, the diagnosis is made when the mass is completely separated from the uterus and adnexa. So far, 23 cases of primary leiomyosarcoma of the broad ligament have been reported in the literature published in English.

Case presentation: In September 2014, a 55-year-old, gravida 3, para 3 woman with a BMI of 30 and a chief complaint of fever and dizziness was admitted to the infectious-diseases ward of the Pars general hospital affiliated with Iran University of Medical Sciences in Tehran, Iran. Her symptoms had begun two weeks before. The results of a fever workup and examination for infectious, metabolic, and immunologic problems were all negative. Imaging modalities revealed an endometrial polyp, two calcified myoma in the body of the uterus, and a solid, heterogeneous 70-mm mass in the right para-cervical space, posterior to the broad ligament, and far from the ovary. After surgery, a histologic report revealed leiomyosarcoma.

Conclusions: Although a leiomyosarcoma of the broad ligament is rare, practitioners should consider it when dealing with masses in the region of the broad ligament. If there is any suspicion of malignancy, especially in the presence of fever, it is recommended to avoid morcellation during laparoscopy.

Keywords: Broad Ligament; Fever; Laparoscopy; Laparotomy; Leiomyosarcoma.

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Figures

Figure 1.
Figure 1.. There Was a Large 70 × 65-mm Solid Mass in the Right Pelvis With Heterogeneous Enhancement After Gd Injection
There was mass effect on the bladder and uterus, without obvious invasion, and internal, non-enhancing parts in favor of necrosis. Ovarian mass was ruled out by other cuts.
Figure 2.
Figure 2.. Leiomyosarcoma With Marked Nuclear Atypia and Abnormal Mitotic Shapes
(H and E + 400). (Arrows): fascicles of spindle and devoid cells with large pleomorphic nuclei and abnormal mitotic shapes.
Figure 3.
Figure 3.. Ki67 Marker Showing Prominent Nuclear Staining of Tumor Cells, Indicating High Proliferative Index (X 400)
See this image and copyright information in PMC

References

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