Uterine myxoid leiomyosarcoma with an underlying haematological disorder – case report and review of literature

Uterine myxoid leiomyosarcoma is an exceptionally unusual variant of leiomyosarcoma with only 34 cases having been reported in the literature. The authors describe a case of myxoid leiomyosaroma with an underlying haematological profile that has not been described previously. A 38-year-old Caucasian woman with a known uterine fibroid discovered during pregnancy presented to the emergency department with heavy per vaginal bleeding. On examination, she had a large abdominal mass. She had a haemoglobin level of 5.2, platelets of 16 and a low white cell count. She received multiple blood and platelet transfusions, despite which her haemoglobin and platelet count levels remained low. She underwent two bone marrow biopsies, which were inconclusive. She underwent laparotomy for abdominal hysterectomy, bilateral salphingo-oohphorectomy, omentectomy and appendicectomy. Histological examination showed uterine myxoid leiomyosarcoma (International Federation of Gynaecology and Obstetrics stage IIIA). Her haematological profile improved significantly following surgical resection of the tumour, reappearing with the recurrence of the disease. The authors hence, consider that pancytopaenia in this patient was a manifestation of paraneoplastic syndrome.