Spindle cell variant of leiomyoma exhibiting myxoid change and calcification: a rare case report

Abstract

Uterine leiomyomas, commonly referred to as fibroids, are the most prevalent benign tumors found in women of reproductive age, characterised by the proliferation of smooth muscle cells within the uterus. While the vast majority of leiomyomas are benign, a small percentage (approximately 1%) can undergo malignant transformation into leiomyosarcoma, complicating management and prognosis. Here we report a case of 51-year-old P1L1 presented to the outpatient department (OPD) with complaints of heavy menstrual bleeding for two years. Patient was examined and investigated. On clinical examination, a palpable pelvic mass of approximately 20×15 cm noted measuring about 24 weeks in size. On radiological examination, revealed a heterogeneously hyperechoic solid-cystic lesion measuring 12.5×10.5×7.6 cm with features suggestive of endometrial carcinoma. Total abdominal hysterectomy with bilateral salpingo - oophorectomy. Histopathological examination (HPE) report revealed endometrial hyperplasia without atypia. The myometrium reveals features of adenomyosis and leiomyoma. The subserosal fibroid consists of spindle cells in interlacing fascicles, with areas of calcification and focal myxoid change.