Primary Leiomyosarcoma of Peritoneal Cavity
A 65-year-old female presented with lower abdominal lump and pain for 3 months. On local examination the mass was suprapubic, freely mobile, nontender and measured 10×10 cm in size. contrast enhanced computed tomography revealed well defined heterogenous hypo dense solid cystic mass approx. 12×10×8 cm in peritoneum with area of calcification, necrosis and multiple septation (). Tumor marker (CEA: 1.9 ng/mL, CA125: 6.064 U/mL) were within normal limits.\nThe mass was surgically excised out in its entirety and peroperative finding revealed unremarkable adnexa and soft tissue mass arising from the mesentery. Grossly globular grey white soft tissue received which measured 15×10×7 in size. The cut section was solid, cystic with large area of haemorrhage and necrosis. Multiple histopathological sections examined revealed spindle cells arranged in alternating fascicles having pleomorphic nuclei, indistinct margin, eosinophilic cytoplasm with foci of haemorrhage and necrosis. Mitotic figures were 5-6/HPF (). The tumor cells were immunoreactive with smooth muscle actin (), desmin and negative for S-100, CD-34 and c-kit. There was no evidence of lung, liver or nodal metastases and peritoneal seeding. Final diagnosis of primary leiomyosarcoma of peritoneal cavity was made. The postoperative course was uneventful; however the patient expired after six month of surgery.