UNSUSPECTED UTERINE LEIOMYOSARCOMA DISCOVERED DURING TREATMENT WITH AGONADOTROPIN-RELEASING-HORMONE ANALOG - A CASE-REPORT AND LITERATURE-REVIEW

We report a case of a 37-year-old woman who had received five courses of gonadotropin-releasing hormone (GnRH) agonist (Decapeptyl) for pres umed uterine leiomyomata associated with episodes of uterine bleeding. Submucous myoma (histologically proven) was partially removed on the first visit. After a period of significant reduction in the tumor size and cessation of uterine bleeding, the symptoms recurred along with r apid re-growth of the uterus. Total abdominal hysterectomy was perform ed and the pathologic evaluation revealed leiomyosarcoma with a high m itotic rate. This case and the literature review emphasize the problem s encountered with the early diagnosis of uterine leiomyosarcoma durin g GnRH agonist therapy. (C) 1998 Elsevier Science Ireland Ltd.