Key result
En bloc excision and radiation yield no 6-month recurrence in rare right ovarian vein leiomyosarcoma.
Why the study?
Primary leiomyosarcoma of vascular origin is rare and has poorer prognosis than other LMS origins, with ovarian vein LMS being extremely rare and only 15 cases reported.
Case Report (n=1)
No
Vascular leiomyosarcoma originating from the ovarian vein is extremely rare and can be managed with en bloc excision and adjuvant radiation therapy, though careful follow-up is required due to generally poor prognosis.
En bloc excision with radiation may offer short-term control in rare ovarian vein leiomyosarcoma; leaves open durable outcomes and protocols given Level 5 evidence.
Primary leiomyosarcoma (LMS) of vascular origin is a rare lesion, and patients with LMS of vascular origin have poorer prognoses than patients with LMS of other origins. The inferior vena cava is the most commonly affected vessel and accounts for 60% of all vascular cases. However, LMS originating from the ovarian vein is extremely rare, and we are only aware of 15 reported cases. Therefore, we report our experience with a case of LMS originating from the right ovarian vein and review the related literature. A 71-year-old Japanese woman with no symptoms was admitted to our hospital because of abnormal findings in a routine abdominal ultrasonography check-up. Contrast-enhanced computed tomography of the abdomen revealed a well-defined, lobulated solid mass with a diameter of 5.5 cm in the right retroperitoneal space. The mass exhibited relatively low uptake during 18 F-fluorodeoxyglucose positron emission tomography. Based on these findings, the differential diagnosis included a retroperitoneal tumor, such as a desmoid tumor, leiomyoma, LMS, and malignant mesothelioma. Operative findings confirmed that the mass had originated from the right ovarian vessels, and en bloc excision was performed for the mass and the right ovarian vessels. The final pathological diagnosis was LMS originating from the right ovarian vein, and the surgical resection margins were free from tumor cells. After histological findings confirmed the LMS diagnosis, the patient underwent adjuvant radiation therapy and has not exhibited signs of local recurrence or metastasis in the 6 months after surgery. We encountered a 71-year-old woman with LMS originating from her right ovarian vein. The prognosis of vascular LMS is generally poor. Therefore, careful follow-up will be required for our patient.
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Hirano et al. (2019) conducted a case report in Vascular leiomyosarcoma originating from the right ovarian vein (n=1). En bloc excision and adjuvant radiation therapy was evaluated on Local recurrence or metastasis. En bloc excision and adjuvant radiation therapy successfully treated a rare right ovarian vein leiomyosarcoma, with no local recurrence or metastasis observed at 6 months post-surgery.
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