Uterine leiomyosarcoma diagnosis after treatment of presumed uterine fibroid with the high-intensity focused ultrasound: a case description

[摘要] Uterine leiomyosarcoma is a rare and aggressive gynecologicmalignancy that is difficult to diagnose before surgery; it hashigh recurrence rates and metastatic potential through bloodand lymph nodes (1). Unintentional dissemination of uterinesarcoma may occur in the case of preoperative misdiagnosis,such as when the lesion is thought to be a fibroid or whenthe sarcoma is found within a “fibroid” uterus. However,preoperative diagnosis of sarcoma has remained difficultdespite the implementation of various modalities, such asadvances in ultrasound image resolution, magnetic resonanceimaging (MRI), or the application of different sequences,biochemical and molecular markers, and preoperativecore needle biopsies (2-4). Sometimes, pathology-basedpostoperative diagnosis is also unclear. Clinical symptoms ofsarcoma are often elusive and develop slowly. Some patientsare randomly screened for uterine fibroids during routinephysical check-ups, and the slow growth of fibroids that arethought to be benign is followed up.

[学科分类] 外科医学