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Metastatic leiomyosarcoma diagnosed after uterine artery embolization
H E Stohl Posy1, J C Elkas, A V Yemelyanova
1Department of Gynecology and Obstetrics, The Kelly Gynecologic Oncology Service, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
European Journal of Gynaecological Oncology
|June 2, 2009
Summary
Uterine artery embolization (UAE) can mask uterine leiomyosarcoma (LMS) diagnosis. This case highlights delayed LMS detection years after UAE, diagnosed via metastasis.
Area of Science:
- Gynecologic Oncology
- Interventional Radiology
- Surgical Pathology
Background:
- Uterine artery embolization (UAE) is a common treatment for uterine fibroids.
- UAE does not provide tissue for pathological diagnosis.
- Delayed diagnosis of uterine leiomyosarcoma (LMS) is a potential risk of UAE.
Observation:
- A 45-year-old woman presented with a substernal mass five years post-UAE.
- Pathology revealed LMS; she underwent radiation and subsequent hysterectomy.
- Hysterectomy confirmed uterine LMS, with no evidence of disease after treatment.
Findings:
- This case illustrates a significant delay in diagnosing uterine LMS.
- Diagnosis was established through a distant metastasis years after UAE.
- It underscores the challenge of detecting LMS when UAE is performed.
Implications:
- Consider LMS in patients with a history of UAE presenting with unexplained masses.
- UAE may obscure the diagnosis of uterine malignancies.
- Further research into diagnostic strategies post-UAE for suspected LMS is warranted.
