Uterine leiomyosarcoma is an uncommon tumour  accounting for 1% of all uterine malignancies These are aggressive tumors with common sites of metastasis as peritoneal cavity, omentum, lung, pelvic lymph nodes, etc .Here we report a rare case of metastasis of uterine leiomyosarcoma to the anterior abdominal wall. A 36 year old patient with a history of supra-vaginal hysterectomy for uterine leiomyosarcoma 10 years back, presented with a lump in lower abdomen since 4 months. CECT pelvis suggested 7.7 *6.1 cm neoplastic mass in the anterior abdominal wall involving rectus abdominis and adjacent abdominal muscles. Tru-cut biopsy confirmed leiomyosarcoma. Repeat CECT after chemotherapy showed marginal reduction in the size. She underwent wide local excision of mass with a resulting defect of 20 x 15cm & abdominal wall reconstruction with a composite mesh & tensor fascia lata flap on 17/7/18.Final histopathology report confirmed the diagnosis. PET CT done on 21/9/18 revealed no residual disease.

Keywords: leiomyosarcoma, metastasis to abdominal wall, soft tissue sarcoma.

1. Gynecol Oncol. 2017 Apr;145(1):208-216. doi: 10.1016/j.ygyno.2017.02.019. Epub 2017 Feb 13. Uterine leiomyosarcoma: Epidemiology, contemporary treatment strategies and the impact of uterine morcellation. Ricci S1, Stone RL2, Fader AN3.
2. Survival Rates for Uterine Sarcoma, by Stage- American Cancer Society https://www.cancer.org/cancer/uterine-sarcoma/detection-diagnosis-staging/survival-rates.html Nov 13, 2017
3. 1989 Mar 1;63(5):935-8. Patterns of metastasis in uterine sarcoma. An autopsy study. Rose PG1, Piver MS, Tsukada Y, Lau T. [pubmed]
4. Salazar OM, Dunne ME. The role of radiation therapy in the man­agement of uterine sarcomas. Int J Radiat Oncol Biol Phys 1980; 6: 899-902
5. Güngör T, Akbay S, Aksüt H, Yılmaz B. Rectus abdominalis muscle metastasis from uterine leiomyosarcoma: An unusual case and review of the literature. Journal of the Turkish German Gynaecological Association. 2014;15(2):122-124. doi:10.5152/jtgga.2014.53533.
6. O’Brien JM, Brennan DD, Taylor DH, Holloway DP, Hurson B, O’Keane JC, Eustace SJ. Skeletal muscle metastasis from uterine leiomyosarcoma. Skeletal Radiol 2004; 33: 655-9.
7. Nusrath MA, Kendall CH, Avery CM. Metastatic uterine leiomyosar­coma masquerading as a primary lesion of the masseter muscle. Int J Oral Maxillofac Surg 2006; 35: 466-8.
8. Aslan E, Kuzeyli K, Cakir E, Reis A. Temporalis muscle metastasis of the uterine leiomyosarcoma: A case report. Turk Neurosurg 2008; 18: 215-8.
9. Courtney MW, Levine EA. Uterine leiomyosarcoma metastatic to soft tissue of the flank following a ten-year disease-free interval. South Med J 2009; 102: 325-6.
10. Recurrent uterine leiomyosarcoma: an atypical location. Köse M, Çelik F, Köse SK, Arıöz DT, Yılmazer M, Tokyol Ç. J Exp Ther Oncol. 2016 Nov;11(4):315-318
11. Eur J Gynaecol Oncol. 2014;35(4):449-51. Rectus abdominis muscle resection and fascial reconstruction for the treatment of uterine leiomyosarcoma invading the abdominal wall: a case report. Yoon BS, Seong SJ, Song T, Kim ML, Kim MK.

Ishita Katyal

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