Uterine malignant mesenchymoma, arising in a leiomyoma, with pulmonary metastases

An unusual case of an osteosarcoma arising in a leiomyoma of the uterus

Leiomyoma is the most common uterine neoplasm. It has several histological variants such as atypical, cellular, myxoid, and epithelioid. Leiomyoma with heterologous elements is a rare variant of leiomyoma, which may contain heterologous elements such as fat, skeletal muscle, and chondroid and osseous tissues. The heterologous sarcomatous differentiation is also rarely seen. We report on a 53-year-old woman who was admitted with abnormal vaginal bleeding and symptoms related to an abdominal mass. She had a huge uterine leiomyoma that contained osteosarcomatous differentiation in several foci. Although malignant progression for leiomyoma is exceedingly rare, when it occurs it may result not only in a leiomyosarcoma but also in a heterologous sarcomatous differention. We have reported histopathological, immunohistochemical, and clinical features of this rare case and reviewed the published studies.

Carcinosarcoma arising in a uterine leiomyoma: report of a unique neoplasm

Malignant transformation of a uterine leiomyoma is an exceedingly rare phenomenon. Previous reported examples of malignant neoplasms to arise so include leiomyosarcoma, angiosarcoma, and malignant mesenchymoma. We report an intramural carcinosarcoma arising in a uterine leiomyoma in a 38-year-old woman. This case is unique in being the first recorded carcinosarcoma arising within a uterine leiomyoma and the first example of an epithelial neoplasm to do so. We discuss the differential diagnosis and possible pathogenesis of the tumor that has likely arisen secondary to epitheliogenesis in a mesenchymal neoplasm.

Malignant mesenchymal tumor with leiomyosarcoma, rhabdomyosarcoma, chondrosarcoma, and osteosarcoma differentiation: case report and literature review

A case of malignant mesenchymoma of the bladder containing leiomyosarcoma, rhabdomyosarcoma, chondrosarcoma, osteosarcoma, and myxomatous components is described. The primary pedunculated tumor measuring 14 × 13 × 7 cm and weighing 343 g arose from the left trigone of the bladder and was treated by total cystectomy. The histogenesis of malignant mesenchymomas and their optimal management strategy and prognosis remain uncertain. Herein, we present the fifth case of malignant mesenchymoma of the urinary bladder to be reported in the literature, which presented five unrelated differentiated tissues more than did previously reported cases.

Osteosarcoma Arising in a Long-Standing Uterine Leiomyoma: A Case Report and Literature Review

The authors present the first case of a pure osteosarcoma arising in a long-standing uterine leiomyoma along with a literature review of all heterologous sarcomas arising in uterine leiomyoma. Most cases present with abnormal vaginal bleeding and symptoms related to a rapidly enlarged pelvic mass in postmenopausal women with a long-standing history of uterine leiomyoma. The histological finding of the case in this study revealed a relatively well-circumscribed tumor with a peripheral ring of leiomyoma and a central osteosarcoma. The case in this study further supported a possible pathogenesis involving the p53 gene. The prognosis may be better with low-stage tumor; however, cases with advanced stages, larger tumor size at presentation, and histological type of epithelioid angiosarcoma had poorer prognosis despite aggressive therapy.