並列摘要
We herein reported a 41-year-old woman presenting with two weeks of lower abdominal mass and dull pain. She underwent total hysterectomy with bilateral salpingo-oophorectomy, and the pathology examination revealed uterine leiomyosarcoma. The patient had a surgical history of laparoscopic myomectomy with a pathologic diagnosis of atypical leiomyoma of the uterus two and a half years ago. The incidence of uterine leiomyosarcoma is very low. In the modern era, echography and computed tomography remain unable to clearly differentiate uterine leiomyosarcoma from leiomyoma, whereas MRI is a sensitive tool for diagnosis. Therefore, if a lower abdominal mass is more than 8 cm or rapidly growing, MRI, biopsy, or laparoscopic exploration, is strongly recommended. Moreover, while atypical leiomyoma of the uterus is mostly benign in nature, it has a high rate of recurrence and the potential of transformation into leiomyosarcoma. Hence, for early detection of recurrence, pelvic examination twice a year, annual chest X-ray, and pelvic imaging are recommended for at least 5 years postoperatively in these cases.