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Jila Agah [1] and Sedighe Karimzadeh [2] and Fateme Moharrer Ahmadi [2]
Academic Editor: Jeanine M. Buchanich
1, Department of Obstetrics and Gynecology, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran, medsab.ac.ir
2, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran, medsab.ac.ir
Received Apr 9, 2017; Accepted Jun 15, 2017
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
Pelvic masses are common findings in general gynecology [1]. Benign leiomyomas are the most uterine neoplastic mass which manifest clinically in about 30% of women older than 35 years [2]. Uterine sarcomas include 8% of all uterine malignancies with an incidence of about 0.4 per 100,000 women where leiomyosarcoma (LMS) consists 40% of them [3]. It occurs mostly in the 45–55 years of age. Leiomyosarcomas usually arise de novo from uterine smooth muscles; however rarely they may appear in a preexisting leiomyoma (0.2% of the cases) [4]. The gold standard of treatment for LMS is hysterectomy [5, 6]. Most leiomyosarcomas are accompanied with pain, sensation of pressure, and abnormal uterine bleeding or present only as a rapidly enlarging mass [7]. However, many imaging modalities are available and easy to accelerate the diagnosis; still some gigantic tumors are going to be neglected. Moreover, sometimes these tumors are erroneously reported as ovarian masses on imaging follow-up which can induce severe challenges for surgeon during operation. Herein we represent a huge uterine leiomyosarcoma mismanaged with incorrect diagnosis of dyspepsia for over two months and afterwards operated as misdiagnosis of ovarian mass reported in images.
2. Case Presentation
A 41-year-old woman (G3P2L2Ab1) was referred to gynecology clinic with chief complaints of abdominal distension and localized abdominal pruritus for three months. To rule out gastrointestinal disorders, she had visited a general physician given her symptoms. But she found no response to the drugs in spite of a long-term usage and was referred to our clinic after taking ultrasonography. Her past history showed menorrhagia but not menstrual irregularity and dysmenorrhea for several months. Laboratory tests including hemoglobin at 8 g/dl, hematocrit at 28,7%, ferritin at 6 ng/ml, and...