Uterine leiomyosarcoma: A ten-year review in a referral hospital in Peru, 2005 – 2014

Objective: To describe general characteristics, clinical features, moment of diagnosis and treatment of patients with uterine leiomyosarcoma (LMS). Methods: From 2005 to 2014, clinical files of patients diagnosed with a uterine LMS at Hospital Nacional Edgardo Rebagliati Martins in Peru were reviewed. Results: Eleven cases with complete information were identified; mean age at diagnosis was 45.36 years (range, 27 - 61 years); most frequent symptom reported was pelvic pain in 6/11 (54%) patients. 8/11 (72%) patients were diagnosed after any surgical intervention. The most frequent clinical stage was IB in 10/11 (90%) cases. Initial treatment was total abdominal hysterectomy (TAH) + bilateral salpingo-oophorectomy (BSO) in 7/11 (62%) cases. Prevalence of undiagnosed uterine LMS in hysterectomies and myomectomies done for presumed leiomyomas was 0.24% and 0.22%, respectively. Conclusion: Clinical presentation of uterine LMS do not differ from usual leiomyoma. Most of the cases are diagnosed incidentally after surgical specimen analysis. Most accepted initial management to date is still en bloc TAH + BSO. Follow-up strategies should be implemented and be the goal of any long term program.