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Healthy Tadulako Journal

Unexpected Uterine Leiomyosarcoma After Hysterectomy for Presumed Leiomyoma: A Case Report

31 octobre 2026Cas clinique1 min de lecture

Par Muh Lingga Primananda, Aries Maulana, Jasa Nita Listiana et 2 autres.

Contenu en anglais

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Résumé
Mots-clés
Auteurs
Source

Résumé

Background

Uterine leiomyosarcoma is a rare malignant smooth muscle tumor that may remain unsuspected until definitive histopathological examination.

Objectives

To describe diagnostic discordance between benign preoperative and gross impressions and malignant microscopic findings in uterine leiomyosarcoma.

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Methods

This case report retrospectively describes clinical presentation, computed tomography findings, surgical management, histopathological examination, and immunohistochemical results.

Results

A 47 year old multiparous woman presented with six months of progressive abnormal uterine bleeding and abdominal enlargement. Non contrast computed tomography revealed a well circumscribed intramural uterine mass measuring 7.0 × 6.8 × 7.0 cm without detectable extrauterine disease. Total abdominal hysterectomy was performed for presumed leiomyoma. Gross examination revealed a firm whorled mass without evident hemorrhage or geographic necrosis. Microscopy demonstrated moderate to severe cytologic atypia, coagulative tumor cell necrosis, and more than 10 mitoses per 10 high power fields. Strong desmin and h caldesmon positivity supported smooth muscle differentiation. The patient was referred for multidisciplinary oncologic assessment.

Conclusions

Benign appearing imaging and gross morphology cannot exclude uterine leiomyosarcoma. Accurate diagnosis requires adequate histological sampling and integrated clinicopathological assessment.

Mots-clés

Uterine Myomas and Treatments
uterine leiomyosarcoma
uterine fibroids
hysterectomy
diagnostic discordance
malignant transformation
smooth muscle tumor
desmin
h-caldesmon
abnormal uterine bleeding
computed tomography findings
histopathological diagnosis

Auteurs

Muh Lingga Primananda
Aries Maulana
Jasa Nita Listiana
Muh Arfan
Ivy Tania

Source

Publié dans Healthy Tadulako Journal (Jurnal Kesehatan Tadulako). Le résumé est reproduit tel qu’il a été publié et reste l’œuvre de ses auteurs ; lisez l’article complet à la source.

jurnal.fk.untad.ac.id/index.php/htj/article/view/2234

Prognia référence cet article à des fins de documentation et de formation. Il ne constitue pas un avis médical. Lisez toujours l’original et suivez les recommandations en vigueur et les protocoles locaux avant d’agir.

En bref

Revue: Healthy Tadulako Journal
Type: Cas clinique
Publié: 31 octobre 2026
Spécialité: Gynécologie-obstétrique
Temps de lecture: 1 min
Auteurs: 5
DOI: 10.22487/2tyt7840

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