Open AccessA case of unsuspected low-grade endometrial stromal sarcoma successfully treated with two minimally invasive surgeries
Author(s) -
Akira Nakabayashi,
Kensuke Odaira,
Yu Horibe,
Toshiyuki Kanno,
Yoshika Akizawa,
Tsutomu Tabata
Publication year - 2020
Publication title -
gynecology and minimally invasive therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.441
H-Index - 12
eISSN - 2213-3089
pISSN - 2213-3070
DOI - 10.4103/gmit.gmit_67_19
Subject(s) - medicine , endometrial stromal sarcoma , leiomyoma , hysterectomy , magnetic resonance imaging , surgery , sarcoma , radiology , uterus , pathology
It is relatively uncommon to treat patients with a preoperative diagnosis of benign leiomyoma that is then unexpectedly rediagnosed as malignant in postoperative histology. We report the case of a 55-year-old woman with low-grade endometrial stromal sarcoma who had been diagnosed as having uterine leiomyoma with myxoid degeneration by preoperative magnetic resonance imaging (MRI). She underwent a laparoscopic hysterectomy. The uterus, after being placed in a retrieval bag, was transvaginally morcellated to prevent spillage of the contents, as the MRI image appeared somewhat atypical. A retrospective survey of MRI findings affirmed that the muscle tissue had the appearance of a low-intensity band-like structure: bag of worms appearance. She underwent a laparoscopic bilateral salpingo-oophorectomy and remains recurrence-free. With somewhat atypical preoperative MRI, it is essential to prevent the spillage of the tumor content as no definitive preoperative exclusion of unsuspected mesenchymal malignancies is feasible.