Primary ovarian leiomyosarcoma

Background: Primary ovarian leiomyosarcoma is an extremely rare subtype of ovarian sarcomas. It most commonly occurs in postmenopausal women and has unfavorable prognosis. Case: The patient, a 58-year-old postmenopausal woman, presented with a complaint of abdominal pain. Preoperative examination revealed an intraabdominal mass 25 x 17 x 14 cm in the right adnexa. She underwent bilateral salpingo-oophorectomy, total omentectomy, appendectomy and bilateral pelvic lymphadenectomy. The histopathology revealed leiomyosarcoma of the right ovary Stage la. She did not receive any postoperative adjuvant therapy. Follow-up 21 months after initial surgery, showed no evidence of recurrence. Conclusion: Additional studies are needed to understand more about the nature, clinical behavior and treatment of this very rare tumor.

Primary ovarian leiomyosarcoma; Treatment; Surgery; Radiotherapy; Chemotherapy; Prognosis

[1] Shakfeh S.M., Woodruff J.D.: “Primary ovarian sarcomas: report of 46 cases and review of the literature”. Obstet. Gynecol. Surv., 1987, 42, 331.

[2] Friedman H.D., Mazur M.T.: “Primary ovarian leiomyosarcoma. An immunohistochemical and ultrastructural study”. Arch. Pathol. Lab. Med., 1991, 115, 941.

[3] Sood A.K., Sorosky J.I., Gelder M.S., Buller R.E., Anderson B., Wilkinson E.J. et al.: “Primary ovarian sarcoma: analysis of prognostic variables and the role of surgical cytoreduction”. Cancer, 1998, 82, 1731.

[4] Piura B., Rabinovich A., Yanai-Inbar I., Cohen Y., Glezerman M.: “Primary sarcoma of the ovary: report of five cases and review of the literature”. Eur. J. Gynaecol Oncol., 1998, 19, 257.

[5] Rasmussen C.C., Skilling J.S., Sorosky J.I., Lager D.J., Buller R.E.: “Stage IIIC ovarian leiomyosarcoma in a premenopausal woman with multiple recurrences: prolonged survival with surgical therapy”. Gynecol. Oncol., 1997, 66, 519.

[6] Arslan O.S., Sumer C., Cihangiroglu G., Kanat-Pektas M., Gungor T.: “A rare tumor of the female genital tract: primary ovarian leiomyosarcoma”. Arch. Gynecol. Obstet., 2011, 283 (suppl. 1), 83.

[7] Monk B.J., Nieberg R., Berek J.S.: “Primary leiomyosarcoma of the ovary in a perimenarchal female”. Gynecol. Oncol., 1993, 48, 389.

[8] Tas¸kin S., Tas¸kin E.A., Uzüm N., Ataog˘lu O., Ortaç F.: “Primary ovarian leiomyosarcoma: a review of the clinical and immunohistochemical features of the rare tumor”. Obstet. Gynecol. Surv., 2007, 62, 480.

[9] Bodner K., Bodner-Adler B., Czerwenka K., Hudelist G., Kimberger O., Leodolter S. et al.: “Bcl-2 expression in a primary leiomyosarcoma of the ovary: a case report”. Wien Klin Wochenschr., 2003, 115, 191.

[10] Nicòtina P.A., Antico F., Caruso C., Triolo O.: “Primary ovarian leiomyosarcoma. Proliferation rate and survival”. Eur. J. Gynaecol. Oncol., 2004, 25, 515.

[11] Balaton A., Vaury P., Imbert M.C., Mussy M.A.: “Primary leiomyosarcoma of the ovary: a histological and immunocytochemical study”. Gynecol. Oncol., 1987, 28, 116.

[12] Bouie S.M., Cracchiolo B., Heller D.: “Epithelioid leiomyosarcoma of the ovary”. Gynecol. Oncol., 2005, 97, 697.

[13] Dixit S., Singhal S., Baboo H.A., Vyas R.K., Neema J.P., Murthy R. et al.: “Leiomyosarcoma of the ovary”. J. Postgrad. Med., 1993, 39, 151.

[14] O’Sullivan S.G., Das Narla L., Ferraro E.: “Primary ovarian leiomyosarcoma in an adolescent following radiation for medulloblastoma”. Pediatr. Radiol., 1998, 28, 468.

[15] Nasu M., Inoue J., Matsui M., Minoura S., Matsubara O.: “Ovarian leiomyosarcoma: an autopsy case report”. Pathol. Int., 2000, 50, 162.

[16] Dobbs S.P., Brown L.J., Hollingworth J., Ireland D.: “Surgical treatment of recurrent primary ovarian leiomyosarcoma. A case report”. Eur. J. Gynaecol. Oncol., 1999, 20, 172.

[17] Inoue J., Gomibuchi H., Minoura S.: “A case of a primary ovarian leiomyosarcoma”. J. Obstet. Gynaecol Res., 2000, 26, 401.

[18] Rampaul R.S., Barrow S., Naraynsingh V.: “A primary ovarian leiomyosarcoma with micro-invasive features (Stage I): is surgical excision enough?”. Gynecol. Oncol., 1999, 73, 464.