Exploring a Unique Case of Uterine Leiomyosarcoma with Chronic Inversion: Insights and Implications

Abstract

Sarcomatous change in uterine fibroid is termed leiomyosarcoma. The tumor originates from smooth muscle 
cells and is rare, accounting for 2 to 5% of all uterine malignancies. The said patient had the history of irregular 
bleeding, but not typical menorrhagia, which is the usual presentation in this tumor. A 40 year old, P4+0 women of 
North Indian origin, was admitted with huge polypoidal fungating mass with bosselated surface and variegated 
mass protruding from introitus consistently. It was 12 ×10 cm in size with fundal cuping and cervical rim around 
the mass, which indicates inversion of the uterus. Total abdominal hysterectomy with bilateral 
salpingoophorectomy and bladder repair was done via abdomino-perineal route and the histopathology 
confirmed the diagnosis of leiomyosarcoma. Because of their rarity, uterine sarcomas are not recommended for 
routine screening. Surgery is the only treatment modality of leiomyosarcoma and prognosis depends upon the 
stage of the cancer.