FEATURES OF THE LOW-SYMPTOMATIC COURSE OF LEIOMYOSARCOMA

The purpose of this study was to study the features of the low-symptomatic course of leiomyosarcoma based on the examination and treatment results of patient Ch., 61 years old in the gynecological department of the V.D.Seredavin State Medical University with a directional diagnosis: "Subserous - intermuscular uterine fibroids 12 weeks. Atresia of the cervical canal. Coronary artery disease. Hypertension, grade II, risk 4». The patient was examined at the prehospital stage according to the clinical recommendations of "Uterine fibroids". In this case, leiomyosarcoma was an intraoperative finding. The patient had a low–symptomatic course of an advanced case of cancer - leiomyosarcoma with the presence of distant lung metastases. The only clinical manifestation of the disease in this case was an increase in the size of the uterus with the definition of interstitial - subserous nodes. The presence of widespread lung metastases at the preoperative stage did not manifest itself clinically. No patholalia was detected during the lung X-ray performed during the preoperative examination. The lack of vivid clinical manifestations in this patient led to the fact that she was not prescribed a more informative examination of the pelvis, abdominal cavity and lungs in the preoperative period, which would have allowed her to suspect the diagnosis of uterine sarcoma earlier. At the same time, cito-diagnostics of the macropreparation during surgery, an intraoperative consultation with the head of the oncogynecology department made it possible to make the correct diagnosis and determine the optimal amount of surgical intervention. Joint and coordinated actions of surgeons, gynecologists, an anesthesiologist – resuscitator, as well as high surgical technique made it possible to perform intraoperative hemostasis, which causes significant difficulties in this pathology. The patient was carefully monitored in the postoperative period, and the patient was promptly transferred to the Department of anesthesiology and intensive care for examination and treatment, which further ensured the correct management tactics. The myocardial infarction was the result of exposure to decomposing leiomyosarcoma on the patient's body..In case of cardiac arrest, apnea, the stages of cardiopulmonary resuscitation (CPR) and subsequent therapy were carried out competently and in a timely manner, which allowed to obtain a positive effect at this stage of treatment even with such a serious condition of the patient. The clinical case is of undoubted interest from the standpoint of observing oncological alertness in patients with the presence of formations in the myometrium, even in cases of a low-symptomatic clinical picture.