Advanced leiomyosarcoma of the uterus: a case report and literature review

Uterine leiomyosarcoma is a rare malignancy accounting for 1-2% of uterine malignancies with an annual incidence of 0.5-7 per 100,000 women. It occurs mostly between the 5th to 7th decades of life hence found more among postmenopausal women. The aetiology is mostly unknown however, in 0.2% of cases, it originates from sarcomatous degeneration in a pre-existing benign uterine fibroid. Leiomyosarcoma can be mistaken for uterine leiomyoma also known as the uterine fibroid. It is an aggressive tumour that has a poor prognosis, with or without treatment. This case report aimed to report and discuss the occurrence of leiomyosarcoma as a differential diagnosis of abnormal uterine bleeding in this environment among other conditions. This will bring to the fore awareness among gynaecologists, pathologists, radiologists and oncologists that leiomyosarcoma of the uterus, though rare, should be considered in cases of menorrhagia with suspected uterine fibroid to avoid mistaking it for a diagnosis of uterine fibroid/leiomyoma. It is, therefore, imperative to consider leiomyosarcoma in a pre-menopausal and perimenopausal women diagnosed of abnormal uterine bleeding with symptomatic uterine fibroid. MRI serves as a good tool in differentiating the two pathologies.

CHANGES IN THE MUCOSA OF THE UTERINE POD IN CANCER OF THE VAGINAL PART AND CERVIX

Changes in the mucous membrane of the body of the uterus, accompanying cancer of the vaginal part and cervix, drew special attention after the work of Abel (see No. I), which appeared in 1888. The author studied the mucous membrane of the body of the uterus, taken from extirpated cases of 6 uterus for carcinoma portionis and in 1 case for carcinoma cervicis. "In all cases, the mucous membrane is dull," says the author (p. 279, 1. p.), To a high degree of alteration, while the mucous membrane of the cervix is ​​relatively insignificantly diseased. " These changes, as can be seen from the description of each individual case, concern both the gland and the intermediate tissue, and the first in all cases were multiplied and represented corkscrew gyrus; some of them were enlarged or contained ectases of the lateral walls and processes protruding into the lumen of the gland. Changes in the intermediate tissue in cases 1, 2 and 4 consisted in the multiplication of cells in deep layers, and here they had a short-spindle-shaped shape, small size and went in trains in different directions; in the surface layers, they were more or less round, much larger in size and resembled epitheloid cells. In addition, a nested infiltration with small, round cells (lymphoid cells?) Met in places. In the remaining 4 cases, the changes in the intermediate tissue, according to the author's description, were the same as usually in chronic inflammation (cases 5, 6 and 7) or almost absent (case 3). On the basis of these studies, the author comes to the conclusion that changes in the mucous membrane of the body of the uterus in cancer of the vaginal part and cervix have the character of sarcomatous degeneration, which in observed 1, 2 and 4-m, already reached a rather high degree of 4, in the rest, although it did not appear as sharp as especially in the first case, but nevertheless, these changes, according to the author, cannot be considered as inflammatory, but should be taken only as a more weak degree of the same sarcomatous degeneration, by analogy with the first.

A case of sarcomatous degeneration of both ovaries. Successful laparotomy with relative recovery

Peasant woman 27 y.o., virgo intacta, in good general health. Menstruation from 15 liters, not abundant, after 28 days, 3-4 days. About six months ago - the appearance of menorrhagia, but during the last 5 months there is no blood at all. 5 months ago, the patient covered up a swelling on the left side of the abdomen, which was rapidly increasing.

Leiomyomatosis Peritonealis Disseminata with Sarcomatous Transformation: A Rare Case Report and Literature Review

Leiomyomatosis Peritonealis Disseminata (LPD) is an uncommon disease characterized by presence of Multiple Leiomyomas in the abdominal and pelvic cavity. Increasingly, literature supports that LPD is an iatrogenic condition. Malignant transformation of LPD is rarely reported. We hereby report a case of a middle-aged female patient who was diagnosed with malignant sarcomatous degeneration in LPD. Gynecologists may get inspiration from this case report.

Malignant Transformation of an Enchondroma of the Hand: A Case Report

We present the case of the transformation of an enchondroma in the middle phalanx of the fourth finger of the left hand into a chondrosarcoma. The patient presented a lesion with clinical history, examination, and radiology findings consistent with an enchondroma, which was conservatively treated. Two years later, the patient came for a medical visit with a clinical and radiological variation of the lesion. Computed tomography scans and biopsy revealed a lesion with sarcomatous degeneration which was confirmed after the controlled amputation of the fourth finger. The malignant transformation potential of an enchondroma must be considered.

Paget Disease

Chapter 73 discusses Paget disease, which is a progressive bone disease of excessive bone turnover and abnormal, disordered bone remodeling. Paget disease generally affects older patients. Paget disease has an initial active phase with a focal zone of osteolysis and an inactive phase with bone enlargement, trabecular coarsening, and cortical thickening. The diagnosis of Paget disease is usually made with radiographs, though cross-sectional imaging can be useful for early diagnosis in the skull and spine. Rare complications of Paget disease include neural impingement and sarcomatous degeneration. Treatment is provided with medical therapy and surgical treatment of pathologic fracture or prophylactic fixation.