Uterine Leiomyosarcoma Diagnosed at Caesarean Myomectomy: A Case Report

A 33-year-old patient had a history of a uterine leiomyoma that was first diagnosed incidentally on a dating scan in a previous pregnancy. This was further confirmed on different ultrasound scans after birth, and her main symptom was abnormal uterine bleeding. When she was due for further imaging and hysteroscopy, she was already eight weeks pregnant. Throughout pregnancy, the leiomyoma was growing on serial ultrasound scans, but she was not symptomatic. During her elective caesarean section (CS), a pedunculated leiomyoma was protruding from the posterior wall of the lower uterine segment and was excised and sent for histopathology. This was reported as a uterine leiomyosarcoma (ULMS), and she was referred to gynaecological oncology for management. Following this, she had staging investigations, which showed no metastasis. She proceeded to have a hysterectomy, and the histology confirmed complete treatment.