PMC4899701_01
50-year-old woman with carcinoma in situ (20 and 16 years ago) and leiomyosarcoma on the left arm (19 years ago). She recently developed another leiomyosarcoma of the left abdominal wall. FDG-PET-CT shows intense uptake of the recurrent tumor on the abdominal wall muscle and inner side of the iliac wing (A: axial CT, PET on the first line, fused and maximum-intensitiy projection [MIP] on the second line). Histology confirmed a leiomyosarcoma with coagulative necrosis; H&E staining x200 (B) and x400 (C). The same FDG-PET-CT showed abnormal focal uptake in the uterine body (D: axial CT, PET on the first line, fused and MIP on the second line). Histology revealed a uterine atypical (bizarre) leiomyoma with bizarre single or multiple hyperchromatic nuclei; H&E x100 (E) and x400 (F).
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Fortuitously, another focal uptake on the uterus was found (Figs. 1A, D). The leiomyosarcoma was estrogen-receptor-negative (Figs. 1B, C). Diagnosis was atypical (bizarre/symplastic) leiomyoma of the uterus, a benign variant of uterine leiomyoma (Figs. 1E, F).