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Year : 2020  |  Volume : 9  |  Issue : 4  |  Page : 237-240

A case of unsuspected low-grade endometrial stromal sarcoma successfully treated with two minimally invasive surgeries

Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan

Correspondence Address:
Dr. Akira Nakabayashi
8-1 Kawada-Cho, Shinjuku-Ku, Tokyo 162-8666
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/GMIT.GMIT_67_19

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It is relatively uncommon to treat patients with a preoperative diagnosis of benign leiomyoma that is then unexpectedly rediagnosed as malignant in postoperative histology. We report the case of a 55-year-old woman with low-grade endometrial stromal sarcoma who had been diagnosed as having uterine leiomyoma with myxoid degeneration by preoperative magnetic resonance imaging (MRI). She underwent a laparoscopic hysterectomy. The uterus, after being placed in a retrieval bag, was transvaginally morcellated to prevent spillage of the contents, as the MRI image appeared somewhat atypical. A retrospective survey of MRI findings affirmed that the muscle tissue had the appearance of a low-intensity band-like structure: bag of worms appearance. She underwent a laparoscopic bilateral salpingo-oophorectomy and remains recurrence-free. With somewhat atypical preoperative MRI, it is essential to prevent the spillage of the tumor content as no definitive preoperative exclusion of unsuspected mesenchymal malignancies is feasible.

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