title: An unusual case of pedunculated subserosal leiomyosarcoma of the uterus mimicking ovarian carcinoma.
abstract: BACKGROUND
  Leiomyosarcoma of the uterus is an extremely rare but highly aggressive tumor that accounts for only 1-2 % of uterine malignancies, and is usually associated with a dismal outcome.
  
  
  METHODS
  The authors present an unusual case of pedunculated subserosal leiomyosarcoma of the uterus mimicking ovarian carcinoma. A 57-year-old postmenopausal woman presented with progressive low abdominal pain and urinary frequency. Pelvic magnetic resonance imaging revealed a large adnexal mass with carcinomatosis peritonei. Laboratory examination revealed an elevated serum CA-125 level (398.4 U/ml). The patient underwent exploratory laparotomy under suspicion of ovarian malignancy. Frozen section indicated malignancy originating from the uterus, and thus, total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic and para-aortic lymph node dissection, and mass excision were performed. Subsequent histopathologic examination resulted in a final diagnosis of leiomyosarcoma of the uterus. The patient's postoperative course was uneventful, and gemcitabine and docetaxel adjuvant chemotherapy was administered.
  
  
  CONCLUSIONS
  The authors report an unusual case of pedunculated subserosal leiomyosarcoma of the uterus mimicking ovarian carcinoma.
authors: Department of Obstetrics and Gynecology, Pusan National University School of Medicine, 179, Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. dssuh@pusan.ac.kr.|Biomedical Research Institute and Pusan Cancer Center, Pusan National University Hospital, 179, Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. dssuh@pusan.ac.kr.
authors: Dong Soo
authors: DS
authors: Suh
authors: Department of Obstetrics and Gynecology, Pusan National University School of Medicine, 179, Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. una518@naver.com.
authors: Yoon Hwa
authors: YH
authors: Kim
authors: Department of Obstetrics and Gynecology, Pusan National University School of Medicine, 179, Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. tornasol@naver.com.
authors: Ka Yeong
authors: KY
authors: Yun
authors: Department of Radiology, Pusan National University School of Medicine, and Biomedical Research Institute, Busan, 602-739, Korea. leenk77@daum.net.
authors: Nam Kyung
authors: NK
authors: Lee
authors: Department of Pathology, Pusan National University School of Medicine, and Biomedical Research Institute, Busan, 602-739, Korea. kuchoi@pusan.ac.kr.
authors: Kyung Un
authors: KU
authors: Choi
authors: Department of Obstetrics and Gynecology, Pusan National University School of Medicine, 179, Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. ghkim@pusan.ac.kr.|Biomedical Research Institute and Pusan Cancer Center, Pusan National University Hospital, 179, Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. ghkim@pusan.ac.kr.
authors: Ki Hyung
authors: KH
authors: Kim
authors: Department of Obstetrics and Gynecology, Pusan National University School of Medicine, 179, Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. msyoon@pusan.ac.kr.|Biomedical Research Institute and Pusan Cancer Center, Pusan National University Hospital, 179, Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. msyoon@pusan.ac.kr.
authors: Man Soo
authors: MS
authors: Yoon
mesh_terms: D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy