title: Metastatic leiomyosarcoma diagnosed after uterine artery embolization.
abstract: Uterine artery embolization (UAE) allows treatment of recalcitrant fibroids, but does not provide a surgical specimen. In the rare instance that a uterine mass represents a uterine leiomyosarcoma (LMS), UAE may delay diagnosis. We report a case of a 45-year-old woman who underwent resection of a substernal mass five years after UAE. Pathology demonstrated LMS. She received radiation therapy to the surgical site. Upon recovery, she underwent a hysterectomy and bilateral salpingo-oophorectomy. Pathology demonstrated uterine LMS. She was managed conservatively and is without evidence of disease over two years after excision of her substernal mass. Multiple case reports have described a delay in diagnosis of uterine LMS after UAE. The current case is unique in that it the diagnosis was made based on the presence of a distant metastasis, which occurred years after UAE.
authors.affiliation: Department of Gynecology and Obstetrics, The Kelly Gynecologic Oncology Service, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
authors.forename: H E Stohl
authors.initials: HE
authors.lastname: Posy
authors.forename: J C
authors.initials: JC
authors.lastname: Elkas
authors.forename: A V
authors.initials: AV
authors.lastname: Yemelyanova
authors.forename: T P
authors.initials: TP
authors.lastname: Diaz-Montes
authors.forename: R E
authors.initials: RE
authors.lastname: Bristow
authors.forename: R L
authors.initials: RL
authors.lastname: Giuntoli
mesh_terms: D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D007890:Leiomyosarcoma / Q000175:diagnosis; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D013899:Thoracic Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D035441:Thoracic Wall; D055357:Uterine Artery Embolization; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*