Introduction Uterine sarcoma is a rare and aggressive malignancy arising from the smooth muscle or connective tissue of the uterus. Due to its rarity, there is limited information available on the clinical presentation, treatment, and prognosis of this disease. The aim of this study is to report the clinical and pathological features, as well as treatment outcomes of 16 cases of uterine sarcoma.

Methods We conducted a retrospective analysis of 16 patients diagnosed with uterine sarcoma between 2015 and 2021 at our tertiary care hospital. Clinical data, including age, presenting symptoms, tumor characteristics, treatment modalities, and survival outcomes were collected from medical records.

Results The mean age of the patients was 53 years (range: 35–72). The most common presenting symptom was abnormal uterine bleeding (n=11, 68.75%). The majority of the tumors were leiomyosarcoma (n=14, 87.5%). The mean tumor size was 7.4 cm (range: 4–15 cm). The most common treatment modality was surgery (n=14, 87.5%), with adjuvant therapy administered in some cases.12 patients were treated with an initial hysterectomy with bilateral adnexectomy due to the strong preoperative suspicion of uterine sarcoma on radiological data. The overall 5-year survival rate was 43.8%. 4 patients had an initial myomectomy and then a complement by hysterectomy and bilateral adnexectomy was performed after the final anatomopathological examination.

Conclusion/Implications Uterine sarcoma is a rare malignancy with a poor prognosis. The most common presenting symptom is abnormal uterine bleeding. Surgery is the mainstay of treatment, and adjuvant therapy may be considered in selected cases.