Misdiagnosis of a Giant Uterine Leiomyosarcoma:Clinic and Image Challenges

A41-year-oldwoman(G3P2L2Ab1) was referred to gynecology clinic with chief complaints of abdominal distension and localizedabdominal wall pruritus for three months. She was misdiagnosed with gastrointestinal disorder and ultimately had undergoneimaging. Ultrasonography and computed tomography (CT) scan disclosed a huge solid-cystic mass originating from the ovary. Onclinical examination the patient had no pain or tenderness and no gynecologic complaints. Laboratory tests showed normal tumormarkers and hemoglobin at 8 g/dl. Laparotomy was carried out as diagnosis of ovarian serous cyst adenoma, but a huge tumorwith attachment to uterus and ovaries and extension to pelvic floor, peripheral tissues of ureter, and upper abdomen was found.Hysterectomy with bilateral salpingooophorectomy was done. Pathology report demonstrated uterine leiomyosarcoma measuring40 centimeters and weighing 10 kilograms. In conclusion, as pelvic masses even in a large size may present unspecific symptomsmisdiagnosis may occur which lead to overgrowth, local invasion, or other complications. So, it is rather to suggest ultrasonographyin patients with persistent abdominal or pelvic symptoms and if needed, more exact diagnostic modalities like magnetic resonanceimaging (MRI) could be offered to avoid misdiagnosis and mismanagement