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Large Leiomyosarcoma of The Uterus: A Challenging, Difficult-to-Treat, Case of an Indian Patient

Leiomyosarcoma is a rare tumor that accounts for about 2 to 5% of uterine malignancies originating from the smooth muscles of the uterus. Women can be affected at any age group; however, the majority get diagnosed at their perimenopausal age. The early-stage diseases are managed by hysterectomy and complete surgical resection. In the present case report, we discuss a 41-year-old female with a tumor mass of approximately 32-week gestation at the time of examination. The patient had a regular menstrual cycle with no abnormal uterine bleeding except for abdominal pain for three months. A large, lobulated mass (25 x 18 x14 cm) with solid, cystic, and hemorrhagic components was removed surgically (total abdominal hysterectomy) from the uterus's fundus and spalingo-oophorectomy. The patient developed severe hypotension and tachycardia post-surgery and required a longer recovery time. We referred the patient to the medical oncologist for further treatment. In our patient, the tumor rapidly increased, and metastasis was noted in the peritoneal fluid. A further follow-up will be needed to understand the course of the disease and its outcome. Keywords: Leiomyosarcoma; Smooth muscle tumors; Uterine fibroid; Uterine myoma