A Rare Case of Leiomyosarcoma with Hemoperitoneum in Pregnancy
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 5
Abstract
Uterine leiomyosarcoma during pregnancy is an extremely rare event. We report a retrospectively diagnosed case of a ruptured primary uterine leiomyosarcoma with hemoperitoneum diagnosed during pregnancy. The patient came to the emergency room (unbooked with us, taking treatment at the other hospital) with G4P1A2L0 with GDM + pregnancy-induced hypertension (PIH) and ultrasonography (USG) diagnosed large fibroid with degeneration (19 cm × 13.2 cm × 13.2 cm) at 30.5 weeks of gestation, breech presentation with complaints of pain in abdomen and vomiting. An initial conservative treatment was started considering prematurity with fibroid degeneration. Due to severe pain in abdomen and history of PIH, USG was repeated after 2 days of admission which showed hemoperitoneum, so the decision for emergency preterm LSCS was taken. During cesarean section, a ruptured sessile uterine fibroid was removed and hemoperitoneum was drained. Histopathological diagnosis of the tumor revealed a poorly differentiated uterine leiomyosarcoma. The patient underwent laparotomy after weeks with radical hysterectomy and received adjuvant chemotherapy. The diagnosis and suspicion for leiomyosarcoma during pregnancy at young age stand difficult, and the treatment options seem to be reduced in pregnant women and are mainly dependent on the patient’s condition as well as the gestational age at the time of presentation.
Authors and Affiliations
Ragini Agrawal, Pallavi Vasal, Bijal Bhati, Charu Dutt Arora
Keywords
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