High Grade Pleomorphic Leiomyosarcoma of Ovary in a Young Female : A Case Report
Sangeeta Pankaj, Vijayanand Choudhary, Rajesh Kumar Singh and Rajesh Harsvardhan
World Journal of Surgical Research 2013, 2:3
Primary leiomyosarcoma of ovary is a very rare tumor with around 55 cases reported so far.
A 27 year old female presented in Gynaecology OPD with complaint of
acute pain in right iliac region and abdominal distention. Per abdominal
examination revealed a soft to firm mass in the right iliac region. Ultrasound
imaging revealed a complex mass with solid and cystic areas in the right adnexal
region measuring 9.7 x 5.2cm. Laparotomy with right ovarian cystectomy was done.
Histopathology report was consistent with High Grade Pleomorphic Sarcoma. The
patient was referred to Gynaecological Oncology department where debulking
surgery comprising of hysterectomy, left salpingo-oophrectomy and resection of
residual tumor mass on right was done with pelvic and para aortic lymph node
dissection. IHC was also advised which revealed cytoplasmic positivity for
desmin and smooth muscle actin in all the cells. Final diagnosis of Pleomorphic
Leiomyosarcoma (High grade) was made. The patient was given chemotherapy 3 weeks
after surgery in consultation with medical oncologist. Response to therapy was
evaluated after 6 months by whole body CT scan and CA-125 levels both of which
were within normal limits. The patient comes for regular follow-up and is doing
well after 30 months of surgery.
We found that surgical debulking along with chemotherapy has given
good response, and the patient is still surviving and is symptom free. Patient
is on regular follow up, after 30 months of surgery.