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2022-RA-1575-ESGO Secondary bone localization from uterine sarcoma: a case series of a very rare condition
  1. Saida Sakhri,
  2. Takoua Chalouati,
  3. Malek Bouhani,
  4. Amani Jellali,
  5. Nouha Ben Ammar,
  6. Hanen Bouaziz and
  7. Khaled Rahal
  1. Surgical oncology department, Salah Azaiez institute, Tunis, Tunisia


Introduction/Background Uterine sarcomas are uncommon tumors that account for 3 to 5% of all malignant uterine tumors. They typically spread to the liver and lungs, and very rarely to the bones. These metastases worsen the prognosis. We report five cases of metastatic uterine sarcoma to the bone.

Methodology We retrospectively analyzed clinical data of five patients with uterine sarcomas metastatic to bone who were dignosed and treated in our institute.

Results We report five cases of uterine sarcoma treated in our institute. The median age was 51 years old. Vaginal bleeding and pelvic pain were the most common symptom at presentation. All cases had pelvic MRI. No distant metastases were detected. Hysterectomy and bilateral adnexectomy were performed on all patients. Four cases had leiomyosarcoma and one had an undetermined sarcoma. Adjuvant radiotherapy (54 Gy) was administered to only one patient. On average, bone metastases occurred 9.8 months following the initial cancer diagnosis. The clinical presentation was marked by bone pain. In four cases, the dorsal spine was the most common bone site. In one case, it was found in the femur. For all patients, analgesic and decompressive radiation were prescribed. Two patients required emergency surgery for spinal cord compression. Histological examination confirmed the metastatic nature of these lesions following laminectomy. In two cases, hepatic and adrenal metastases were also found. Three cases had chemotherapy. Respiratory and renal failure led to the deaths of three patients. There were two patients lost to follow-up.

Conclusion Uterine sarcomas are malignant tumors that have a dismal prognosis. Bone metastases are uncommon, but they worsen the outcome, so it is imperative not to ignore physical discomfort and bone pain.

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