49-year-old woman

Presented for a 2nd opinion after hysterectomy was recommended due to the risk of malignancy.


Symptoms

  • She reported minimal symptoms, not affecting her quality of life.

Ultrasound

  • Multiple large fibroids

Examination

  • 20-week size uterus filling the pelvis up to her umbilicus

Recommendations

  • The patient was educated of the rarity of leiomyosarcoma. Given minimal effect on her QOL and proximity to menopause, no treatment (expectant management) was recommended. Other options discussed were UFE, myomectomy, and hysterectomy.

Treatment

  • She elected no treatment with no increase in her symptoms. Following menopause, her uterus decreased in size by 50%.