Cervical Leiomyosarcoma: A Case Report

Abstract

Introduction: Sarcoma of the cervix is uncommon and its prevalence is about 1% of malignancies of the cervix. One type of sarcoma is leiomyosarcoma and the location of this tumor in cervix is very rare. Although uterine sarcoma can involve the cervix and lead to misdiagnosis of cervical leiomyosarcoma, the location of the bulk of the tumor in uterine cervix (not isthmus) for diagnosis of cervical leiomyosarcoma is mandatory. The origin of sarcoma is from mesodermal tissue. Due to the rarity of cervical leiomyosarcoma and response to debulking surgery after recurrence, report of this case is interesting. Case Presentation: We hereby report on a 34-year-old unmarried patient, who was a known case of leiomyosarcoma of uterine cervix that was referred with recurrence of tumor in parietal peritoneum, retropobic retzius space and around the bladder and ureter and sigmoid colon. The patient was treated with debulking surgery of the tumor and chemotherapy. Conclusions: Sarcoma as a genital tract malignancy is very rare and the location of sarcoma at pediatric age is in the vagina and at middle age is in the cervix and at postmenopausal women in the uterine corpus. Cervical sarcoma as a rare tumor of the cervix arises from stromal tissue. Due to hematogenous spread of sarcoma, metastasis in lungs is seen and recurrence of this tumor is not uncommon. In this article, recurrence of a known case with leiomyosarcoma of uterine cervix in previous hysterectomy that responded to debulking surgery with removal of metastatic lesions in peritoneal and retroperitoneal spaces and adjuvant therapy with standard chemotherapy drugs and monoclonal antibody therapy is reported. Due to non-hormonal dependence of sarcoma to hormonal secretion from the ovaries and benefit of the ovaries in young women for protection of bone health and cardiovascular system, oophorectomy is a challenging idea and an issue of debate, thus primary surgery, in this case oophorectomy, was not done.

Polypectomy as a Complete Therapy for Leiomyosarcoma of the Cervix Uteri: An Unusual Treatment

“…There have been reports on LMS located in the uterus, ovaries, bone, liver, and the lungs, but the occurrence of this condition in the cervix has not been widely reported (7). When present in the cervix, the women may have vaginal bleeding and mass (5,7). The patient under our study did present with the classic symptoms because of the location of the tumor.…”

“…Frequency of cervical malignancies occurring due to sarcomas are fewer than 1% (1)(2)(3)(4), which commonly occur in the perimenopausal (5) and postmenopausal women with quite a small number of reported cases of LMS amongst young women (3,4). LMS usually affects the uterine corpus, metastasizing to other peritoneal organs and even beyond.…”

“…LMS usually affects the uterine corpus, metastasizing to other peritoneal organs and even beyond. Interestingly, less than 25 cases of cervical LMS have been reported (5). Hence, it is a proliferating sarcoma with no encouraging outcome.…”