Primary Uterine Leiomyosarcoma and Primary Atypical Meningioma Diagnosed during Pregnancy

Objective: Uterine leiomyosarcoma during pregnancy is an extremely rare event. The incidence of meningioma during pregnancy is comparable with that in nonpregnantwomenofthesameagegroup.Wereportacase ofboth-aprimaryuterineleiomyosarcomaandadditionally anatypicalmeningiomaofthebrainbothdiagnosedduring pregnancy. Case Report: The patient was admitted with generalised seizures at 31 weeks of gestation. A tumo ural mass was detected and initial conservative treatment was started. The patient delivered her infant via caesarean section,at34weeksofgestation.Duringcaesareansection a pedunculated uterine fibroid was removed and total gross resection due to the brain tumo ur was also performed. Histopathological diagnosis of both tumo urs revealed an atypical meningioma of the brain and a uterine leiomyosarcoma. The patient underwent laparatomy and receivedsixcyclesofadjuvantchemotherapy.Conclusion:We arethefirsttoreportacaseofawomanwithtwoseparate primary neoplasms both diagnosed during pregnancy. Treatment options seem to be reduced in pregnant women andmainlydependonthepatient'sconditionaswellasthe gestationalageatpresentation. Uterine leiomyosarcomas (LMS) are rare, highly malignant neoplasms that make up about 1% of all uterine malignancies (1). The risk of local recurrence and metastasis is high, with reported 5-year survival rates ranging between 12% and 25% . The median age for women with LMS is after childbearing age (between 43 and 53 years). Total abdominal hysterectomy and bilateral salpingo- oophorectomy are considered the standard therapy for LMS of the uterus (2, 3). The role of conservative fertility-sparing surgery in young women remains controversial (4). Uterine LMS associated with pregnancy is even rarer and only a few cases are reported in the literature (4, 5). The incidence of meningioma in pregnant women is comparable with that in nonpregnant women of the same age group (6). Here we report a case of a patient with both uterine LMS and atypical meningioma of the brain diagnosed during the second trimester of pregnancy. Case Report