Abstract:

Perivascular epithelioid cell tumor (PEComa) is a group of clinically rare mesenchymal tumors, mainly occuring in perimenopausal and postmenopausal women. The primary tumors are mostly located in uterus, retroperitoneum and other sites. PEComa of uterus mostly occurs in the uterine body subserous membrane, and a few patients occur in cervix and submucosa, and malignancy is rare. A case of cervical PEComa was reported due to abdominal pelvic space occupying and multiple bone metastases. The patient underwent CT of the sacroiliac joint in a local hospital due to repeated pain of the left knee joint, and was found that abdominal pelvic space occupying lesions and multiple high density lesions of the iliac bone and lumbosacral coccygeal bone. After admission in July 2023, combined with imaging examination and pelvic mass biopsy, malignant myoma was considered, and abdominal total hysterectomy, double adnexectomy, pelvic lymph node biopsy and pelvic adhesion lysis were performed under general anesthesia after exclusion of surgical contraindications. Postoperative pathology indicated cervical PEComa and lymphangioleiomyomatosis. Regular outpatient follow-up after discharge, no recurrence was found 5 months after surgery. The clinical and imaging manifestations of cervical PEComa are lack of specificity, and it is easy to be misdiagnosed and missed clinically. Pathological diagnosis is the gold standard, and the main treatment method at present is surgical resection of tumor tissue.

Key words: Perivascular epithelioid cell neoplasms, Mesenchymoma, Uterine cervical neoplasms, Immunohistochemistry, Case reports