Misdiagnosis of leiomyosarcoma after radiofrequency ablation of uterine fibroids.

BACKGROUND: Minimally invasive therapies to treat symptoms of uterine fibroids can be effective alternatives to major surgery. Such modalities include pharmacologic agents, uterine artery embolization (UAE), MR guided focused ultrasound, and laparoscopic radiofrequency ablation (Acessa procedure). Acessa is being used to treat women with symptomatic fibroids and was approved by the FDA in 2012.

CASE: This case describes a patient who underwent Acessa and subsequently required hysterectomy for refractory symptoms. Pathology of her tumor was initially classified as epithelioid leiomyosarcoma, but on subsequent review was classified as benign.

CONCLUSION: This report highlights the challenges of accurate histologic diagnosis in the setting of using new therapeutic modalities. Clinicians should report such interventions to pathologists at the time of surgery to allow for accurate diagnosis.