Research Day
OCCULT CERVICAL LEIOMYOSARCOMA FOUND ON HYSTERECTOMY FOR VAGINAL PROLAPSE
Document Type
Abstract
Date
2021
Abstract
Background: Cervical leiomyosarcoma is rare, accounting for less than 1% of all cervical cancers and typically more aggressive than squamous cell and adenocarcinomas. Often presenting with abnormal uterine bleeding and a palpable cervical mass, it is an unusual tumor to find incidentally at hysterectomy. The rarity of this cancer has led to a lack of knowledge on prognosis and optimal management for these patients.
Case History: We present a case of asymptomatic cervical leiomyosarcoma found incidentally at the time of vaginal hysterectomy performed for treatment of pelvic organ prolapse. Preoperatively, there was no history of abnormal vaginal bleeding, pelvic pain, or abnormal pap smear and no mass palpated on pelvic exam. The tumor was encountered at the time of posterior cul-de-sac entry. Hysterectomy and bilateral salpingo-oophorectomy were successful in removing the tumor, with no recurrence observed in 13 months of follow-up for this patient.
Discussion: Cervical leiomyosarcoma is an aggressive tumor with a 5-year survival of only 55.6%. Given the rarity of their incidental presentation at the time of hysterectomy for benign indications, treatment of these malignancies presents a challenge in determining intensity of intervention and timing of post-treatment surveillance. Careful documentation of treatment and outcomes is essential to improve future patient outcomes.