Recurrence and Metastasis of Uterine Myxoid Leiomyosarcoma After Surgery: A Case Report

Myxoid leiomyosarcoma (MLMS) is a rare subtype of uterine leiomyosarcoma, usually occurring in perimenopausal women. We report a 24-year-old female with postoperative recurrence and unusual subcutaneous metastasis of uterine MLMS. Four years prior, she underwent laparoscopic myomectomy for progressive dysmenorrhea, with pathology confirming MLMS. She was admitted for the 6th cycle of adjuvant chemotherapy with gemcitabine plus docetaxel, and imaging examinations suggested MLMS recurrence, followed by laparoscopic total hysterectomy with bilateral salpingo-oophorectomy (pathology confirmed recurrence). Eight months postoperatively, a right lower abdominal subcutaneous mass was found, and biopsy confirmed MLMS metastasis. This case highlights the rarity of MLMS in young women and its atypical subcutaneous metastasis, emphasizing the need for enhanced postoperative surface surveillance to facilitate early detection of recurrence and metastasis.