Dilemma in Diagnosis Surprise at Histopathology

A 65-year post-menopausal woman presented in the Gynaecology OPD of RD Gardi Medical College, Ujjain, with complaints of pain, a lump in her lower abdomen along with difficulty of micturition, defecation and vaginal bleeding for 4 years. She has had a known case of hypertension for 10 years and is taking treatment. Clinically diagnosed as 20 weeks size uterine fibroid, ultrasonography reported 11 to 14.5 cm fibroid, and MRI showed degenerating fibroid. The patient was managed by abdominal hysterectomy with bilateral salpingo-oophrectomy. The post-operative period was uneventful. Histopathology reported leiomyosarcoma. The patient was discharged and followed by chemotherapy.