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Case Reports in Obstetrics and Gynecology
Volume 2015 (2015), Article ID 316262, 5 pages
http://dx.doi.org/10.1155/2015/316262
Case Report

Uterine Myxoid Leiomyosarcoma with Tumor Embolism Extending into the Right Atrium

1Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan
2Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima 890-8520, Japan
3Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-0054, Japan

Received 27 October 2014; Revised 22 January 2015; Accepted 22 January 2015

Academic Editor: Maria Grazia Porpora

Copyright © 2015 Hiromi Imai et al. 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.

Abstract

Uterine myxoid leiomyosarcoma (MLMS) is an extremely rare variant of uterine leiomyosarcoma; only 56 cases were reported from 1982 to 2013. Uterine MLMS is characterized by a myxoid appearance and highly malignant behavior. We herein report a case involving a 65-year-old woman with uterine MLMS with a large tumor embolism that reached the right atrium. A total abdominal hysterectomy, bilateral salpingooophorectomy, and tumor embolism resection with the use of a heart-lung machine were performed. Epirubicin-ifosfamide chemotherapy in the adjuvant setting led to reductions in both the tumor emboli and peritoneal dissemination. The patient retained a good quality of life for 10 months after the initial surgery. She then developed progressive disease despite treatment with pazopanib. She died of her disease 14 months after the initial surgery. Although complete surgical resection of the tumor is desirable, tumor reduction surgery followed by adjuvant chemotherapy might help to retain a good quality of life. This is the first reported case of a primary uterine MLMS with tumor emboli.