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.

CLINICAL PROFILE AND MANAGEMENT OPTION OF FIBROID UTERUS PATIENTS OF OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

Background: Fibroids are the most common benign tumours of smooth muscle cells of uterus in females and typically found during the middle and later reproductive years. As fibroid is an estrogen and progesterone dependent tumour, it gradually decreases in size during starting of menopause. The objective of this presented study was to determine management options among fibroid uterus patients. Methods: 50 number of patients were included in this study those who’s age of 20-55, with symptomatic uterine fibroid and undergone hysterectomy or myomectomy. Postmenopausal, Pregnancy and Asymptomatic fibroid were excluded from this study. Results: The study showed that 52 percent of patient having fibroid uterus were belonged to 31-40 years of age. The mean age was 41.2±6.07. The majority 74% of patients in this study presented with menstrual abnormalities, 40% presented with abdominal lump. Dysmenorrhoea was 26%, 6% patient had primary subfertility and 14% secondary subfertility. Total Abdominal Hysterectomy (TAH) with unilateral salpingo- oophorectomy done in 10% cases, TAH with bilateral salpino-oophorectomy in 22% cases, non descent vaginal hysterectomy in 6% cases, myomectomy done in 20% cases and polypectomy was done in 2% cases. Conclusion: Uterine fibroids are very common in women and frequently in late reproductive and perimenopausal years. It is also a common gynecological problem in our country, which frequently disturbs the lives of woman. Women now have choice of therapies for the treatment of fibroids.

The Successful Treatment of Pulmonary Embolism as a Complication after Uterine Fibroid Embolization (Case Report)

Background: Uterine fibroid embolization (UFE) is as an effective alternative to hysterectomy and myomectomy. However, UFE is associated with a wide spectrum of complications including in rare instances thromboembolic events and even pulmonary embolism (PE). Case Presentation: A case of a 36-year-old woman suffering from a symptomatic uterine fibroid is described as follows. The patient underwent UFE and overnight she suddenly collapsed with signs of massive PE. In consequence of cardiopulmonary resuscitation and urgent systemic thrombolytic therapy, cardiac activity was restored successfully. Discussion & Conclusion: This constitutes another report of PE developed following UFE. In the case described here PE occurred 26 hours after the procedure was performed. Before UFE all patients should undergo complete examination for exclusion of pre-existing venous deep thrombosis and coagulopathies.