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Retroperitoneal recurrence of uterine smooth muscle tumor of uncertain malignant potential as leiomyosarcoma

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주제분류산부인과학

초록

A 57-year-old Korean woman visited 37 months after initial surgery with fetal head sized pelvic mass. Initially, she underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and para-aortic lymph node biopsy. The initial pathological report showed uterine smooth muscle tumors of uncertain malignant potential (STUMP). She had not received adjuvant therapy. Transvaginal ultrasound revealed multiple solid masses in the pelvic cavity. Abdomino-pelvic computed tomography scan revealed heterogeneous lobulated rounding masses. Tumor markers were all within the normal range. She underwent explorative laparotomy. The pathological diagnosis was epitheloid leiomyosarcoma. Patients with STUMP should be counseled regarding the potential for recurrence as leiomyosarcoma, and may require closer surveillance than a yearly.

Abstract

A 57-year-old Korean woman visited 37 months after initial surgery with fetal head sized pelvic mass. Initially, she underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and para-aortic lymph node biopsy. The initial pathological report showed uterine smooth muscle tumors of uncertain malignant potential (STUMP). She had not received adjuvant therapy. Transvaginal ultrasound revealed multiple solid masses in the pelvic cavity. Abdomino-pelvic computed tomography scan revealed heterogeneous lobulated rounding masses. Tumor markers were all within the normal range. She underwent explorative laparotomy. The pathological diagnosis was epitheloid leiomyosarcoma. Patients with STUMP should be counseled regarding the potential for recurrence as leiomyosarcoma, and may require closer surveillance than a yearly.

참고문헌 (10)

  1. Guntupalli SR, "Uterine smooth muscle tumor of uncertain malignant potential: a retrospective analysis", Gynecol Oncol, 113, pp.324~326 (2009)
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  3. Shapiro A, "Uterine smooth-muscle tumor of uncertain malignant potential metastasizing to the humerus as a high-grade leiomyosarcoma", Gynecol Oncol, 94, pp.818~820 (2004)
  4. D’Angelo E, "Uterine sarcomas: a review", Gynecol Oncol, 116, pp.131~139 (2010)
  5. Bell SW, "Problematic uterine smooth muscle neoplasms. A clinicopathologic study of 213 cases", Am J Surg Pathol, 18, pp.535~558 (1994)
  6. Hart WR, "Problematic uterine smooth muscle neoplasms", Am J Surg Pathol, 21, pp.252~255 (1997)
  7. Amant F, "Report of an unusual problematic uterine smooth muscle neoplasm, emphasizing the prognostic importance of coagulative tumor cell necrosis", Int J Gynecol Cancer, 15, pp.1210~1212 (2005)
  8. Ip PP, "Uterine smooth muscle tumors of uncertain malignant potential (STUMP): a clinicopathologic analysis of 16 cases", Am J Surg Pathol, 33, pp.992~1005 (2009)
  9. Atkins KA, "The Use of p16 in enhancing the histologic classification of uterine smooth muscle tumors", Am J Surg Pathol, 32, pp.98~102 (2008)
  10. Slik K, "Uterine smooth muscle tumors: clinicopathological evaluation. Free communication oral presentations", Int J Gynecol Obstet, 107(S2), pp.393~396 (2009)

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