A Rare Case of Leiomyosarcoma in a Fourteen-Year-Old Female: Challenges in Treatment and Recurrence Management

Uterine sarcoma is rare and accounts for 1.7 per 100,000 cases annually. It most often occurs in postmenopausal women aged 44.6 to 58 years and is rarely observed in adolescents. The gold standard therapy is surgery; however, oophorectomy, adjuvant radiotherapy, and chemotherapy remain controversial. A 14-year-old girl presented with intermenstrual bleeding for a year. Ultrasonography revealed a solid tumor, and the biopsy result was endometrial sarcoma. The patient was diagnosed with uterine sarcoma grade I-II. The tumor was inoperable on surgical resection planning, and the patient underwent chemoradiotherapy. An abdominal computed tomography (CT) scan post-chemoradiotherapy showed a solid mass with lymphadenopathy in the uterus. The patient underwent a second course of chemoradiotherapy and showed a good response, although recurrence still occurred. Leiomyosarcoma has a poor prognosis and low survival rate, even in the early stages, despite undergoing surgery with adjuvant chemoradiotherapy. In our case, the patient was an adolescent who presented challenges in management, particularly regarding the necessity of oophorectomy and the role of adjuvant radiotherapy and chemotherapy in young women. J Clin Gynecol Obstet. 2024;13(3):95-100 doi: https://doi.org/10.14740/jcgo994