Cervical leiomyosarcoma treated by radical laparoscopic approach: a case report

Cervical sarcomas are extremely rare neoplasms associated with younger age, advanced stage, and poorer prognosis relative to cervical carcinomas. Carcinosarcoma is the most frequently observed cervical sarcoma subtype, while leiomyosarcomas are exceedingly rare subtypes, with only a small number of cases reported in the English language literature. Cervical leiomyosarcoma patients present most commonly with abnormal vaginal bleeding, discharge, and/or abdominal and pelvic pain. Due to their rarity, data regarding these tumors typically come from case reports and small case series, and treatment strategies are often adapted from data for uterine sarcomas. Here the authors report the clinical findings from a case of unusual asymptomatic leiomyosarcoma arising in the uterine cervix and treated with a laparoscopic approach.

Cervical neoplasm; Laparoscopy; Leiomyosarcoma; Radical hysterectomy; Sentinel node.

[1] Wright J.D., Rosenblum K., Huettner P., Mutch D.G., Rader J.S., Powell M.A., Gibb R.K.: ‘Cervical sarcoma: an analysis of incidence and outcome”. Gynecol. Oncol., 2005, 99, 348.

[2] Bansal S., Lewin S., Burke W.M., Deutsch I., Sun X., Herzog T.J., Wright J.D.: ‘Sarcoma of the cervix: Natural history and outcomes”. Gynecol. Oncol., 2010, 118, 134.

[3] Hanley K.Z., Birdsong G.G., Mosunjec M.B.: “Recent developments in surgical pathology of the uterine corpus”. Arch. Pathol Lab Med.,2017, 141, 528.

[4] Liang Y., Zhang X., Chen X., Lü W.: “Diagnostic value of proges-terone receptor, p16, p53 and pHH3 expression in uterine atypical leiomyoma”. Int. J. Clin. Exp. Pathol., 2015, 8, 7196.

[5] Giuntoli R.L., Metyinger D.S., DiMarco C.A., Cha S.S., Sloan J.A., Keeney G.L., Gostout B.S.: “Retrospective review of 208 patients with leiomyosarcomaof the uterus: prognostic indicators, surgical management, and adjuvant therapy”. Gynecol. Oncol., 2003, 89, 460.

[6] Khosla D., Gupta R., Srinivasan R., Patel F., Rajwanshi A.: “Sarco-mas of uterine cervix: Clinicopathological features, treatment, and outcome”. Int. J. Gynecol Cancer, 2012, 22, 1026.

[7] Irvin W., Presley A., Andersen W., Taylor P., Rice L.: “Leiomyosar-coma of the cervix”. Gynecol. Oncol., 2003, 91, 636.

[8] Abdul-Karim F.W., Bazi T.M., Sorensen K., Nasr M.F.: “Sarcoma of the cervix: Clinicopathologic findings in three cases”. Gynecol. Oncol., 1987, 26, 103.

[9] Major F.J., Blessing J.A., Silverberg S.G., Morrow C.P., Creasman W.T., Currie J.L., et al.: “Prognostic factors in early-stage uterine sarcoma”. Cancer, 1993, 71, 1702.

[10] Cibula D.,Abu-Rustum N.R., Dusek L., Slama J., Zikan M., Zaal A., et al.: “Bilateral ultrastaging of sentinel lymph node in cervical can-cer: Lowering the false-negative rate and improving the detection of micrometastasis”. Gynecol. Oncol., 2012, 127, 462.