Uterine Myxoid Leiomyosarcoma with Stromal Chondroid Metaplasia: A Rare Case Report
DOI:
https://doi.org/10.31661/gmj.v10i.1817Keywords:
Myxoid Leiomyosarcoma; Leiomyosarcoma; Metaplasia; UterusAbstract
Background: Uterine leiomyosarcoma is a rare gynecological disease. Myxoid leiomyosarcoma (mLMS) is an aggressive and very uncommon type of leiomyosarcoma, with few cases reported in English literature. Stromal metaplasia is rare in leiomyosarcoma. Here we present huge uterine myxoid leiomyosarcoma with stromal chondroid metaplasia. Case Report: A 48–year–old single woman with lower abdominal pain and increased abdominal circumference. The detected mass on imaging was diagnosed as uterine mLMS with stromal chondroid metaplasia in the histopathological examination after surgery. Conclusion: Myxoid leiomyosarcoma should be considered in uterine mass with extensive myxoid change, infiltrative border, low mitotic count, and mild atypia. Stromal chondroid metaplasia can be seen in the myxoid leiomyosarcoma. [GMJ.2021;10:e1817]
References
King ME, Dickersin GR , Scully RE. Myxoid leiomyosarcoma of the uterus. A report of six cases. Am J Surg Pathol. 1982;6(7):589-598. https://doi.org/10.1097/00000478-198210000-00001PMid:7180961 Ip PP , Cheung AN. Pathology of uterine leiomyosarcomas and smooth muscle tumours of uncertain malignant potential. Best Pract Res Clin Obstet Gynaecol. 2011;25(6):691-704. https://doi.org/10.1016/j.bpobgyn.2011.07.003PMid:21865091 Parra-Herran C, Schoolmeester JK, Yuan L, et al. Myxoid Leiomyosarcoma of the Uterus. AM J SURG PATHOL. 2016;40(3):285-301. https://doi.org/10.1097/PAS.0000000000000593PMid:26866354 Verma M, Joseph G , McCluggage WG. Uterine composite tumor composed of leiomyosarcoma and embryonal rhabdomyosarcoma with immature cartilage. Int J Gynecol Pathol.. 2009;28(4):338-342. https://doi.org/10.1097/PGP.0b013e3181942a4fPMid:19483631 Kotru M, Gupta R, Aggarwal S, Sharma S , Bhatia A. Cartilaginous metaplasia in uterine leiomyoma. Arch Gynecol Obstet. 2009;280(4):671-673. https://doi.org/10.1007/s00404-009-0970-yPMid:19225797 D'Angelo E , Prat J. Uterine sarcomas: a review. Gynecol Oncol. 2010;116(1):131-139. https://doi.org/10.1016/j.ygyno.2009.09.023PMid:19853898 Cruz M, Murakami T, Tsuda K, et al. Myxoid leiomyoma of the uterus: CT and MRI features. Abdom Imaging. 2001;26(1):98-101. https://doi.org/10.1007/s002610000102PMid:11116372 Chen X, Arend R, Hamele-Bena D, et al. Uterine carcinosarcomas: clinical, histopathologic and immunohistochemical characteristics. Int J Gynecol Pathol. 2017;36(5):412-419. https://doi.org/10.1097/PGP.0000000000000346PMid:28700424 Matsuda M, Ichimura T, Kasai M, et al. Preoperative diagnosis of usual leiomyoma, atypical leiomyoma, and leiomyosarcoma. Sarcoma. 2014;2014. https://doi.org/10.1155/2014/498682PMid:25400500 PMCid:PMC4221903 Prat J. Uterine sarcomas. Int J Gynaecol Obstet. 2015;131(S2). doi: 10.1016/j.ijgo.2015.06.006. https://doi.org/10.1016/j.ijgo.2015.06.006PMid:26433666 Parra-Herran C. Myxoid Mesenchymal Tumors of the Uterus: An Update on Classification, Definitions, and Differential Diagnosis. Adv Anat Pathol. 2017;24(6):354-361. https://doi.org/10.1097/PAP.0000000000000164PMid:28787279 Willems SM, Wiweger M, van Roggen JFG , Hogendoorn PC. Running GAGs: myxoid matrix in tumor pathology revisited. Virchows Archiv. 2010;456(2):181-192. https://doi.org/10.1007/s00428-009-0822-yPMid:19705152 PMCid:PMC2828560 Fuehrer NE, Keeney GL, Ketterling RP, Knudson RA , Bell DA. ALK-1 protein expression and ALK gene rearrangements aid in the diagnosis of inflammatory myofibroblastic tumors of the female genital tract. Arch Pathol Lab Med. 2012;136(6):623-626. https://doi.org/10.5858/arpa.2011-0341-OAPMid:22646268 Kasashima S, Kobayashi M, Yamada M , Oda Y. Myxoid endometrial stromal sarcoma of the uterus. Pathol Int. 2003;53(9):637-641. https://doi.org/10.1046/j.1440-1827.2003.01525.xPMid:14507323 Burch DM , Tavassoli FA. Myxoid leiomyosarcoma of the uterus. Histopathology. 2011;59(6):1144-1155. https://doi.org/10.1111/j.1365-2559.2011.04053.xPMid:22175894 Canter RJ, Martinez SR, Tamurian RM, et al. Radiographic and histologic response to neoadjuvant radiotherapy in patients with soft tissue sarcoma. Ann Surg Oncol. 2010;17(10):2578-2584. https://doi.org/10.1245/s10434-010-1156-3PMid:20556523 PMCid:PMC2941714
