http://dx.doi.org/10.5455/2320-1770.ijrcog20140355 Volume 3 · Issue 1 Page 258 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Kaur J et al. Int J Reprod Contracept Obstet Gynecol. 2014 Mar;3(1):258-260 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Case Report Primary ovarian leiomyosarcoma: a case report with review Jasmeen Kaur 1 *, Megha Mishra 2 , Bharti Goel 1 INTRODUCTION Primary ovarian leiomyosarcoma is very rare ovarian tumor, with less than 50 cases in the literature. 1 Because of its extreme rarity; a standard treatment isn’t yet established. We present this case of ovarian neoplasm in a postmenopausal woman. Literature of primary leiomyosarcoma of the ovary is reviewed. CASE REPORT A 59 year old female, P 2 L 2 A 1 came with complains of post-menopausal bleeding since 1 week, it was mild in amount; there was no history of contact bleeding. No complains of pain abdomen or any urinary complains. On per abdomen examination, abdomen was soft, no guarding, rigidity or tenderness was present. On per speculum examination cervix appeared to be healthy, bleeding was seen through the os. On per vaginal examination multiparous anteverted uterus palpable, a 3 by 4cm mass was palpable in right fornix, left fornix was free and non-tender. Routine investigations were normal. CA-125 was 5.5U/ml. On ultrasonography, anteverted uterus with thick ET of 13mm was noted; a4 by 4 cm solid right adnexal mass was seen, likely to be of ovarian origin, normal left ovary seen. On MRI pelvis solid right ovarian mass likely neoplastic, showing internal cystic changes. Thick ET with poor definition of cervico vaginal junction, suggestive of endometrial hyperplasia/ endometrial carcinoma. No obvious ascites or deposits on serosal surface of pelvis, no enlarged lymph nodes noted. On Fractional Curettage findings were suggestive of simple endometrial hyperplasia along with chronic cervicitis. Ultrasound guided FNAC of the mass showed blood component with occasional cluster of epithelial cells having mild atypia, aspirate was inadequate for a definitive opinion. On laparotomy, TAH with BSO was done. On imprint cytology of right ovary, it was found to be benign ovarian tumor. On histopathology? Cellular fibroma? fibrosarcoma. On immunohistochemistry, intermediate grade leiomyosarcoma was diagnosed. Microscopic examination of left ovary revealed normal ovarian stoma. No leiomyoma were detected in sections taken from uterus and tubes. DISCUSSION Primary ovarian sarcoma are very rare tumors, comprising less than 2% of all ovarian malignancies. 1 They are a heterogeneous group of tumors, consisting of the fibrosarcomas, endometrial stromal sarcomas,rhabdomyosarcoma 3,4 and the rare leiomyosarcomas, ( less than 0.1%). 1 1 Department of Obstetrics & Gynecology, Government Medical College and Hospital, Chandigarh, Punjab, India 2 Department of Obstetrics & Gynecology, Consultant Patel Hospital, Jalandhar, Punjab, India Received: 18 December 2013 Accepted: 06 January 2014 *Correspondence: Dr. Jasmeen Kaur, E-mail: drjasmeen81@yahoo.in © 2014 Kaur J et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Primary ovarian leiomyosarcoma is a very rare tumor. Presenting a case report with review of literature. Keywords: Primary ovarian leiomyosarcoma, Leiomyosarcoma, Primary ovarian DOI: 10.5455/2320-1770.ijrcog20140355