Myxoid Leiomyosarcoma of the Uterus in a Fertile Woman

A 37 year old woman (G1P1 spontaneous delivery) was admitted to our university hospital for menometrorrhagia. The case history showed the patient had menometrorrhagia for six months; moreover, during the abdominal examination we found a mass occupying the hypogastric and mesogastric area. The consistence was hard and the mass reached the level of the umbilicus. The combined vaginal-abdominal examination confirmed the presence of the mass on the anterior wall and, in addition, multiple myomata were felt; the uterus was found enlarged in size (equivalent to 18 pregnancy weeks); both ovaries and Fallopian tubes were regular. During surgery multiple myomata were visualized. The largest, 10 centimeter diameter, was soft in consistence with a gelatinous structure. Total abdominal hysterectomy with preservation of adnexa was performed.