A Rare Uterine Cancer: Epithelioid Leiomyosarcoma

Upadhya Rekha, V. G. Poojari, M. Pai, J. Nambiar
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Abstract

A uterine epithelioid leiomyosarcoma is a type of uterine mesenchymal tumour that arises from the smooth muscle lining the walls of the uterus. The specific cause of leiomyosarcoma is uncertain, with uterine leiomyosarcoma accounting for 5 to 10% of cases. The most prevalent subtype of uterine sarcoma, leiomyosarcoma, accounts for 1-2 percent of all uterine malignancies. Recent application of molecular techniques has identified numerous lesions with distinctive genetic abnormalities and clinicopathological characteristics. Menopausal women who are not on hormonal replacement medication and have tumour development should be suspected of malignancy. A 64-year-old woman had reached menopause 16 years prior and had been experiencing postmenopausal haemorrhage for the past two months, with a palpable mass measuring 16 weeks in size. The whorled mass lesions, endometrium, and myometrium could not be seen separately on ultrasonography. Uterus with both ovaries removed. Intraoperative investigations revealed a 16-week-old uterine mass with a diameter of 15x15 cm and a weight of 1kg, as well as an intramural fibroid. On cut section, necrotic and haemorrhagic regions with degenerative alterations suggest cancer. Epithelioid leiomyosarcoma was discovered using histopathology and immunohistochemistry.
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一例罕见子宫癌:上皮样平滑肌肉瘤
子宫上皮样平滑肌肉瘤是一种起源于子宫壁平滑肌的子宫间质肿瘤。平滑肌肉瘤的具体病因不确定,子宫平滑肌肉瘤占病例的5% ~ 10%。子宫肉瘤最常见的亚型是平滑肌肉瘤,占所有子宫恶性肿瘤的1- 2%。最近应用分子技术已经确定了许多病变具有独特的遗传异常和临床病理特征。绝经期妇女未使用激素替代药物,肿瘤发展应怀疑恶性肿瘤。一名64岁女性,16年前进入更年期,在过去的两个月里经历了绝经后出血,可触及的肿块有16周大。螺旋状肿块病变、子宫内膜和子宫肌层在超声检查中不能单独显示。切除了两个卵巢的子宫。术中检查发现16周大的子宫肿块,直径15x15cm,重量1kg,同时发现子宫壁内肌瘤。在切面上,坏死和出血区域伴有退行性改变提示癌症。上皮样平滑肌肉瘤经组织病理学和免疫组织化学检查发现。
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