Case report, case study
https://doi.org/10.3325/cmj.2024.65.51
Breast lump as the initial presentation of metastatic uterine leiomyosarcoma: a case report and comprehensive literature review
Nermina Ibisevic
; Department of Pathology, University of Sarajevo Clinical Center, Sarajevo, Bosnia and Herzegovina
Kresimir Tomic
; Department of Oncology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Alen Humackic
; Department of Radiology, Cantonal Hospital Dr. Safet Mujic, Mostar, Bosnia and Herzegovina
Zlatko Guzin
; Department of Surgery, Cantonal Hospital Dr. Safet Mujic, Mostar, Bosnia and Herzegovina
Blanka Lukic
; Department of Oncology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
Semir Vranic
orcid.org/0000-0001-9743-7265
; College of Medicine, QU Health, Qatar University, Doha, Qatar
*
* Corresponding author.
Abstract
Uterine leiomyosarcoma (uLMS) is a rare but aggressive
cancer with a high metastatic potential and an unfavorable prognosis. A 54-year-old woman with a history of
uterine fibroids clinically presented with a painless, palpable left breast mass measuring 20 mm. A core biopsy of
the breast mass demonstrated a cellular spindle cell neoplasm (a potentially malignant smooth muscle neoplasm;
B4). A wide local breast-mass excision was performed, revealing grade-2 leiomyosarcoma. A re-review of the uterine fibroids revealed that the largest one (200×130 mm),
initially diagnosed as symplastic leiomyoma, was morphologically identical to the breast lesion. Additional diagnostic work-up revealed multiple liver and pulmonary metastases with a suspected metastatic sclerotic lesion in the
L3 projection. The patient was subsequently treated with
chemotherapy protocol for metastatic uLMS. The latest follow-up in September 2023 confirmed stable disease. This
case highlights the importance of considering unusual
metastatic patterns when evaluating breast masses, particularly in patients with a history of non-specific uterine
conditions. Comprehensive diagnostic work-up, including
imaging and histopathologic examinations, is crucial for an
accurate diagnosis of uLMS and appropriate treatment selection. Further studies are needed to better understand
the underlying mechanisms and optimal management
strategies for metastatic uLMS.
Keywords
Hrčak ID:
331935
URI
Publication date:
22.2.2024.
Visits: 416 *