Uterine leiomyosarcomas are an extremely rare subtype of uterine malignancy. This is a case report of a 47-year-old woman whose underlying uterine leiomyosarcoma manifested as acute respiratory distress secondary to pulmonary metastases. We highlight that a combination of suggestive imaging features and elevated lactate dehydrogenase (LDH) may prompt its diagnosis, notwithstanding that histological examination of a tissue sample is mandatory for its confirmation. The diagnosis of this condition is arduous for a multitude of reasons, including the insidious clinical course, aggressive nature, and high propensity to metastasize, coupled with a lack of standardised guidelines for its preoperative work-up. These challenges are amplified where resources may be limited, such as in the Caribbean region, where radiographic imaging and treatment options may not always be readily available.
Keywords: caribbean; case report; immunohistochemistry; lactate dehydrogenase; leiomyoma; magnetic resonance imaging; pulmonary metastases; uterine leiomyosarcoma.
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