Uterine leiomyosarcoma with massive necrosis diagnosed during gonadotropin-releasing hormone analog therapy for presumed uterine fibroid

Hormonal therapy in uterine sarcomas

“…GnRH‐a was reported to reduce the volume of uLMY by suppressing the synthesis of special collagen . What's more, binding sites for GnRH‐a have also been described in uLMY . The first report of the use of GnRH‐a in uLMS was in 1990.…”

Chance finding of a leiomyosarcoma in hysteroscopic resection of a myoma

“…It can be concluded from the present case that leiomyosarcomas or endometrial stroma sarcomas may also occur in rare instances in younger patients (3)(4)(5)(7)(8)(9)(10)13). These can be detected early by hysteroscopic myoma resection when all resectates are carefully worked up histologically.…”

“…Leiomyosarcomas are a real rarity, especially when they are fortuitously diagnosed in younger patients in the context of an organ‐preserving procedure (2,5,8–10,13). Whereas clinical symptoms of relatively rapid uterine or myomal growth suggests a sarcoma (4,9), this could not be demonstrated in this case.…”

Steroidal Treatment of Myomas: Preoperative and Long-Term Medical Therapy

“…In addition to these sides effects of GnRH agonist treatment, another potential risk is the treatment of an unsuspected uterine malignancy with the potential for GnRH agonist treatment to delay the diagnosis and initiation of proper therapy Several cases have been reported in the literature of women with leiomyosarcomas who were presumed to have myomas and were treated with GnRH-agonist therapy. [75][76][77] A final concern with short-term preoperative GnRH agonist therapy before myomectomy is that myomas may decrease in size so that they are not visible or palpable at the time of surgery. This would be most likely to occur in cases where multiple small intramural and/or submucosal fibroids were present.…”