Metastatic leiomyosarcoma of vault post – hysterectomy

Abstract

Fibroids/Leiomyomas are the most common benign mesenchymal neoplasms and consist of smooth muscle cells with variable amounts of fibrous stoma. Atypical leiomyomas are rare forms of myoma (fibroid uterus), of which recurrent atypical leiomyoma post hysterectomy is rarer and its converting into leiomyosarcoma rising from the vault is rarest. The tumor occurs most frequently in uterus, affecting 20-30% of women of reproductive age. We report a case of 51 years old P4L4A2 patient presented with complaints of PV bleeding for 4 days, hysterectomy was done 1 year back for chronic nonspecific cervicitis and cervical leiomyomatous polyp. In January 2022, polypoidal growth from vault for which Laparoscopic excision of the mass was performed, Sample has been sent for histopathology and suggestive of mitotically active leiomyoma. Radical vaginectomy and reconstruction was done, small bowel deposits was found and diagnosed as Metastatic Leiomyosarcoma. Hence, diagnosis of leiomyosarcoma should always kept in mind though the patient is hysterectomized.