Recurrent primary ovarian leiomyosarcoma preconception, pregnancy, delivery, and puerperal management: A case report and literature review.

Abstract

A primary ovarian leiomyosarcoma (POLMS) is a rare malignant tumor of the ovary. Herein, we report a patient with an early-stage POLMS who underwent unilateral adnexectomy in our department with a subsequent pregnancy, delivery, and tumor recurrence. In this case, the patient was a 29-year-old female with a complaint of abdominal distention who underwent a right adnexectomy for a solid tumor in the right ovary. The pathological diagnosis was a stage IA leiomyosarcoma of the right ovary. One month later, a recurrence in the left ovary tumor was diagnosed. The patient did not agree to further treatment. She subsequently achieved a spontaneous pregnancy and had an uneventful pregnancy and delivery at term. During the puerperium, she underwent radical surgery and chemotherapy with the recommended follow-up evaluation. The literature review shows the pathogenesis of POLMS has not been established. There are no specific tumor markers, and it is difficult to distinguish the nature and origin of the tumor with imaging modalities, thus, early diagnosis is difficult. The malignancy rate is high, and the prognosis of advanced tumors is poor. To properly counsel patients to optimize treatment, more reports of cases, the disease course, treatments, and outcomes are needed.