Case Report of an Unusual Combination of Perineal Leiomyosarcoma with Uterine Adenocarcinoma and Leiomyoma
Year: 2025
Type: article
Study design: Case Report
Abstract: two large intramural leiomyomas.Biopsy from the perineal mass suggested high-grade mesenchymal sarcoma [smooth muscle actin (SMA) positive and vimentin focally positive].Endometrial aspiration indicated high-grade adenocarcinoma.Differentials included endometrial carcinoma metastasis, Bartholin cyst, and primary soft-tissue tumor.A diagnosis of perineal leiomyosarcoma with synchronous endometrial adenocarcinoma was established. IntroductIonLeiomyosarcoma is the most common soft tissue sarcoma accounting for about 5-10% of all tumors.However, the perineum as the primary site is an extremely rare finding. 1 Synchronous uterine adenocarcinoma and leiomyosarcoma uteri have been reported in the available literature. 2 A perineal leiomyosarcoma in combination with other malignancies of different origin and at different sites seems to be a rare but not to be missed presentation, which is why it is vital to present this case. case descrIptIonA 70-year-old woman presented with an 8-month history of a painless, slowly enlarging perineal swelling.She had undergone local excision for a similar lesion 2 years earlier, with recurrence within 2 months.Past history included hypertension, diabetes, hypothyroidism, asymptomatic uterine fibroids, and uneventful obstetric history.On examination, vitals were stable.A 7 × 6 cm firm, nontender mass was noted in the left perineum on the left side of the vulva with normal overlying skin (Fig. 1).Per vaginam exam revealed an irregular retroverted uterus with a 6 × 5 cm fibroid; rectal exam was normal.Magnetic resonance imaging (MRI) showed a well-defined perineal mass abutting the rectum without invasion, multiple endometrial polypoidal lesions with myometrial extension, and 1,
Source: Journal of Medical Academics
Authors: Vibha Singh, Astha Nayyar, Anurag Mishra
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7116783372