Leiomyosarcoma with synchronous clear cell ovarian carcinoma

Area of Science:

• Gynecologic Oncology
• Pathology
• Oncology

Background:

• Uterine leiomyomas are common benign tumors, but can recur post-treatment.
• Disease recurrence can occur years after initial management.
• Malignant transformation of leiomyomas is rare but possible.

Observation:

• A 55-year-old woman presented with a complex mass 20 years after uterine leiomyoma treatment.
• Surgery revealed a 16 cm ovarian mass and a synchronous leiomyosarcoma.
• The leiomyosarcoma appeared to originate from a prior uterine leiomyoma.

Findings:

• The coexistence of ovarian mass and leiomyosarcoma is exceedingly rare.
• Leiomyosarcoma development from a uterine leiomyoma is suspected.
• Differential diagnoses include leiomyomatosis peritonealis disseminata.

Implications:

• This case underscores the importance of long-term surveillance for uterine leiomyoma patients.
• It highlights the potential for late malignant transformation of benign gynecologic lesions.
• Further research into the mechanisms of leiomyoma transformation is warranted.