Leiomyosarcoma in Pregnancy: Incidental Finding During Routine Cesarean Section

Abstract

Uterine leiomyosarcoma (LMS) is an uncommon tumor arising from the female reproductive tract. Incidence of LMS in pregnancy is extremely rare, with only 10 cases reported thus far in medical literature. We present a case of myomectomy performed during elective cesarean section for breech presentation, due to its easy accessibility and well-contracted uterus. Subsequent histology revealed LMS on final specimen. Patient subsequently underwent total abdominal hysterectomy, and bilateral salpingo-oophorectomy. No chemotherapy was given as she opted for close clinical-radiological monitoring instead. This case report highlights the importance of discussion with patients regarding the risk of occult malignancy in a fibroid uterus. Appropriate management of uterine LMS in pregnancy remains unclear. Consideration of removing an enlarging leiomyoma during cesarean section might be ideal in view of its malignant potential, just like in this case; however, location of the tumor and risk of bleeding need to be weighed. Ultimately, management of such cases needs proper discussion between obstetrician and the patient.

J Clin Gynecol Obstet. 2022;11(1):19-22
doi: https://doi.org/10.14740/jcgo767