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Profound blood eosinophilia in a patient with a pelvic mass was associated with a postmortem diagnosis of metastatic uterine leiomyosarcoma, suggesting it should raise suspicion of malignancy.
Case Report (n=1)
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Significant blood eosinophilia in a patient with a pelvic mass should raise suspicion for a malignant etiology such as leiomyosarcoma.
BACKGROUND: Uterine sarcomas account for approximately 3% to 7% of all uterine malignancies. Distinguishing benign and malignant myomas based on physical examination and imaging alone is challenging. CASE: A postmenopausal woman with a history of leiomyomas presented to the Emergency Department with chest pain and a right upper lobe lung mass. Blood tests demonstrated profound eosinophilia (58,000/mm). Positron emission tomography-computed tomography scan to exclude distant disease as work-up for presumed lung cancer revealed increased tracer uptake in the lung mass and a pelvic mass. The patient died from complications of hypereosinophilia, and a postmortem diagnosis of metastatic uterine leiomyosarcoma was made. CONCLUSION: Significant blood eosinophilia is uncommon in leiomyomas and should raise suspicion of malignant etiology for a pelvic mass.
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Ksienski et al. (2011) conducted a case report in Metastatic Uterine Leiomyosarcoma (n=1). Eosinophilia was evaluated on Diagnosis of metastatic uterine leiomyosarcoma. Profound blood eosinophilia in a patient with a pelvic mass was associated with a postmortem diagnosis of metastatic uterine leiomyosarcoma, suggesting it should raise suspicion of malignancy.
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