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Case Reports
. 2022 Sep 26;15(9):e251733.
doi: 10.1136/bcr-2022-251733.

Primary ovarian leiomyosarcoma in a woman with uterovaginal prolapse

Anupama Bahadur  1 , Rajlaxmi Mundhra  2 , Pallavi Verma  1 , Ravi Hari Phulware  3
Affiliations
Case Reports

Primary ovarian leiomyosarcoma in a woman with uterovaginal prolapse

Anupama Bahadur et al. BMJ Case Rep. .

Abstract

Primary ovarian leiomyosarcoma is a very uncommon and aggressive neoplasm. We presented a right-sided ovarian leiomyosarcoma in a woman in her late 40s. No case has been described in the literature till now of primary ovarian leiomyosarcoma in a woman with uterovaginal prolapse. A total abdominal hysterectomy with bilateral adnexectomy, metastasectomy, excision of large tumour deposit over small intestine followed by resection with ileo-ileal anastomosis and omentectomy was performed. The diagnosis was made based on morphology along with immunohistochemistry. The patient was given adjuvant chemotherapy during postoperative period. Due to rarity, there is a dearth of information on the clinical behaviour and best treatment options for these tumours. This case report highlighted the importance of clinical awareness and aimed to provide a baseline to guide clinical practice as well as future research.

Keywords: Cancer - see Oncology; Gynecological cancer.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Contrast-enhanced CT scan images of abdomen and pelvis showing ovarian mass. (A) Axial view, (B) coronal view, (C) sagittal view.
Figure 2
Figure 2
Intraoperative images. (A) Uterine prolapse with pelvic tumour, (B) pelvic mass, (C) pelvic mass orginating from right adnexa, (D) ovarian tumour infiltrating intestinal segment, (E) intestinal segment resection and anastomosis by staplers, (F) excised surgical specimen.
Figure 3
Figure 3
Histopathology images. (A) H&E ×40 scanner view: normal ovarian parenchyma (right side green arrow corpus albicans) along with a tumour arranged in nodules and diffuse sheets. (B) H&E (×100): spindle cells tumour arranged in interlacing fascicles. (C) Higher magnification (×1000): spindle cells with marked cytological atypia, nuclear pleomorphism, cigar shaped nuclei with blunt ends and cytoplasmic vacuolation. These tumour cells are diffusely immunopositive for smooth muscle actin (SMA) (D), while negative for Desmin (E) and CD10 (F). (G) shows high Ki67 proliferative activity.
See this image and copyright information in PMC

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