ABORTED LEIOMYOSARCOMA AFTER TREATMENT WITH LEUPROLIDE ACETATE

Background: Leuprolide acetate has been used to decrease uterine size and shrink leiomyomata. In carefully selected patients, its treatment benefits are well recognized. However, if leuprolide acetate is inadve rtently given to a patient with an unsuspected leiomyosarcoma, complic ations may occur. Case: A patient presumed to have leiomyomata was tre ated with monthly injections of leuprolide acetate. In the third month of treatment, unusual manifestations, including increased bleeding, a borting mass, urinary retention, and severe pain, occurred suggesting a possible malignancy and requiring immediate operation. Conclusion: T he use of leuprolide acetate can delay the diagnosis and treatment of leiomyosarcoma and thus may increase the risk of morbidity and affect the treatment outcome of patients with leiomyosarcoma. The histologic changes ascribed to leuprolide acetate treatment in leiomyomata also w ere seen in this leiomyosarcoma. (Obstet Gynecol 1998;92:664-6. (C) 19 98 by The American College of Obstetricians and Gynecologists.)