Advanced Leiomyosarcoma Treated with Total Abdominal Hysterectomy-Bilateral Salphingo Oophorectomy, Low Anterior Resection, and Bilateral Double J Stent: A Case Report

Uterine leiomyosarcoma (ULMS) is a rare neoplasm that accounts for only 1-2% of uterine malignancy. Despite its shallow occurrence, uterine sarcoma has a poor prognosis, which depends on the extent of the disease and its mitotic index. We report a case of 45-year-old woman with a 6-month history of massive uterine mass. On gynecology physical and vaginal examination, a palpable solid fixed mass 15 cm in size was observed in the lower abdomen and normal portio. A Multidisciplinary Team (MDT) including a gynecologic oncologist, urologist, gastrointestinal surgeon, radiologist, and anatomical pathologist decided for re-laparotomy, Total abdominal Hysterectomy-bilateral salphingo oophorectomy, low anterior resection, and protective loop-ileostomy. The final diagnosis was stadium 3A leiomyosarcoma. This case underscores the importance of early detection, comprehensive imaging, multidisciplinary approach, and continued exploration of innovative therapeutic strategies for managing this rare and aggressive tumor.