Metastatic Uterine Leiomyosarcoma Involving Bilateral Ovarian Stroma without Capsular Involvement Implies a Local Route of Hematogenous Dissemination

Table 1

Summary of the literature review of uLMS cases with ovarian metastasis.

Report	Patient; age	Description	Lung; metastasis?	Possible route of metastasis
Alvarado Gay and Vega Silva, 2005 [5]	33	10 cm uLMS of right lateral uterine wall involving fallopian tube, ovary, and ipsilateral parametrium plus 2 neoplasms in omentum.	no	Direct extension +/− hematogenous dissemination
Bharambe et al., 2014 [6]	65	Enlarged and lobulated uterus due to uLMS. Right ovary enlarged to 11 cm and multinodular. Left ovary unremarkable.	n/a	Direct extension, lymphatic dissemination, or hematogenous dissemination
Dai and Song, 2010 [7]	n/a	uLMS with ovarian and lymph node metastasis.	n/a	Lymphatic +/− hematogenous or direct extension
Vasiljevic et al., 2008 [8]	28	uLMS of posterior uterine wall with metastasis to capsule and cortex of right ovary. Omentum, pelvic, and para-aorta lymph nodes were negative for malignancy.	no	Direct extension
Young and Scully, 1990 [9]	35	uLMS extended from endometrium to serosa. 14 months later, ovaries enlarged and lobulated with metastatic disease plus extensive spread in abdomen.	n/a	Direct extension
Young and Scully, 1990 [9]	44	Lower uterine segment mass deemed inoperable. Seven months later debulking of uLMS involved lower uterine segment, endocervix, and paracervical soft tissue. Right ovary enlarged to 4 cm with metastatic uLMS.	n/a	Direct extension, lymphatic dissemination, or hematogenous dissemination
Young and Scully, 1990 [9]	49	uLMS creating a “rock hard” cervix, vaginal cuff, and lower uterine segment. Despite grossly unremarkable ovaries, dissection revealed one ovary with 3 discrete nodules in hilus and medulla. Parametrial and para-aortic lymph nodes metastasis was also present.	n/a	Lymphatic +/− hematogenous