A RARE CASE, A GOOD RESPONSE OF CHEMORADIOTHERAPY ON TEENAGE LEIOMYOSARCOMA : CASE REPORT

Problem statement: Uterine sarcoma is rare case. It just 1.7 per 100.000 annually. It most often in the mean age 44.6 to 58 postmenopausal women, rare found in adolescents. Risk factors contribute are history of pelvic radiation, nulliparity, increasing age, obesity and tamoxifen exposure. The gold standard therapy is surgery while oophorectomy, adjuvant radiotherapy, and chemotherapy still controversy.

Methods : Case report

Results: A 14 years old girl came with having intermenstrual bleeding for a year. Her menarche was 12 years old. We found good assessment for her vital sign, anthropometry and physical examination. Ultrasonography imaging showed 7.11x6.06x5.28centimeters tumour. First biopsy result was endometrial cartilaginous metaplasia and second result was endometrial sarcoma. The patient diagnosed uterine sarcoma I-II then. The tumour found inoperable on surgical resection planning because it found easily bleeding and immobile, pressed the organs around like bladder and rectum. So that the patient underwent chemoradiotherapy. Evaluating first chemoradiotherapy through CT scan abdomen, it showed that it still had solid mass with lymphadenopathy. The patient underwent second schedule of chemoradiotherapy and showed good response yet recurrency still happened. It mentioned on literature that leiomyosarcoma is a rare case, found mostly on premenopausal women, but our case is a teenager. It mostly located in uterine as same as in this case. Those risk factors mentioned above were not found in our case. Clinical manifestations found on this case were not specific maybe due to it happened on a teenager. Numerous scoring scale were not match due to limited further examination. Leiomyosarcoma has poor prognosis and low of survival rate even in early stage who underwent surgical with chemoradiotherapy as adjuvant. Related to our case the patient was still a teenager, it helps to reach good prognosis seen from a good response of chemoradiotherapy.

Conclusion: Leiomyosarcoma is a rare case, in addition happened in adolescent or teenager. Early diagnosis and complete surgical resection confirmed as a gold treatment yet this case is an example of a good improvement of leiomyosarcoma on a teenager who underwent chemoradiotherapy due to inoperable case.

Keywords: Leiomyosarcoma, teenager, rare case, chemoradiotherapy