Metastatic uterine leiomyosarcoma and eosinophilia.
BACKGROUND
Uterine sarcomas account for approximately 3% to 7% of all uterine malignancies. Distinguishing benign and malignant myomas based on physical examination and imaging alone is challenging.


METHODS
A postmenopausal woman with a history of leiomyomas presented to the Emergency Department with chest pain and a right upper lobe lung mass. Blood tests demonstrated profound eosinophilia (58,000/mm). Positron emission tomography-computed tomography scan to exclude distant disease as work-up for presumed lung cancer revealed increased tracer uptake in the lung mass and a pelvic mass. The patient died from complications of hypereosinophilia, and a postmortem diagnosis of metastatic uterine leiomyosarcoma was made.


CONCLUSIONS
Significant blood eosinophilia is uncommon in leiomyomas and should raise suspicion of malignant etiology for a pelvic mass.
From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Doran
D
Ksienski
Winson Y
WY
Cheung
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides; D004417:Dyspnea / Q000175:diagnosis; D004802:Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D000068877:Imatinib Mesylate; D007890:Leiomyosarcoma / Q000150:complications / Q000556:secondary*; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D013160:Splenic Neoplasms / Q000556:secondary; D014594:Uterine Neoplasms / Q000150:complications / Q000473:pathology*
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011241:Prednisone; D006918:Hydroxyurea
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