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PubMed2006

[Leiomyosarcoma of the spermatic cord].

Leiomyosarcomas of the spermatic cord are rare tumours. The authors report the case of a 65-year-old man presenting with painful mass of the left side of the scrotum with scrotal ulceration. Left transinguinal orchidectomy and left hemiscrotectomy were performed and histological examination of the operative specimen revealed leiomyosarcoma of the spermatic cord. No metastases were observed on thoracoabdominopelvic CT. One month after discharge from hospital, the patient presented with delayed healing and complementary scrotal resection and adjuvant radiotherapy were performed. Local and regional extension is frequently observed in leiomyosarcoma of the spermatic cord, justifying radical transinguinal orchidectomy with high ligation of the cord. Cases at greatest risk of recurrence (large tumour, early local recurrence, positive surgical margins) should be identified by multidisciplinary committees and may be eligible for adjuvant radiotherapy.

Aged↗

PubMed2006

Giant adrenal myelolipoma associated with small bowel leiomyosarcoma: a case report.

Adrenal myelolipoma is a rare, benign and biochemically inactive tumor. It is usually diagnosed incidentally by radiological methods and is known to be associated with obesity, hypertension, endocrinological disorders and some malignancies. We report herein the association of a myelolipoma with a gastrointestinal stromal tumor. To our knowledge this is the first report of such an association to date. A 67-year-old male patient admitted to our clinic with abdomimal pain and fever; he had a history of hypertension and diabetes mellitus. In physical examination, a mass involving the right quadrants was palpated. Computerized tomography revealed a right retroperitoneal mass, probably originating from the kidney or cecum. In laparotomy, the tumor (12 cm radius and 1500 g) localized on the superior of right kidney was excised. Abdomen exploration revealed another mass with 10 cm radius 100 cm distal to the ligamentum of Treitz and segmental jejunal resection and anastomosis were applied. The pathological diagnosis was reported as myelolipoma for the retroperitoneal mass and leiomyosarcoma for the jejunal mass. Myelolipoma is a benign tumor, involving mature fat and hematopoietic stem cells. Pathogenesis is still not clear and the microscopical characteristics are hematopoietic, lipoid, and reticuloid cells and megakaryocytes. Myelolipomas are reported to be associated with some other malignancies (especially renal), but this is the first report showing the association with a leiomyosarcoma. Therefore, leiomyosarcoma should also be one of the possible associations kept in mind by the physician in the diagnosis and treatment of myelolipomas.

Adrenal Gland Neoplasms↗

PubMed2006

Skull metastasis from uterine leiomyosarcoma: a case report.

Uterine leiomyosarcoma is a rare malignancy whose presenting symptoms usually are not specific for the disease. The clinical presentations include vaginal bleeding, pelvic pain or pressure, and awareness of an abdominal-pelvic mass. The diagnosis should be considered if rapid uterine enlargement occurs, especially in a post-menopausal woman. Local spreading of the tumor could involve the myometrium, pelvic blood vessels and lymphatics, contiguous pelvic structures, and then the abdominal organs, whereas distant metastasis most often involve the lungs. A 63-year-old female presented a rare uterine leiomyosarcoma metastasis to the skull with the manifestions of a bulging mass over her left occipito-parietal region. On admission, neurological examination revealed right hemiplegia. She underwent total resection of the tumor with the reconstruction of the dura, the skull plate and the scalp. Her post-operative course was smooth and the muscle power of her right limbs was improved from grade 1 to grade 3 after the procedure. The histological diagnosis is leiomyosarcoma. Aggressive management of the metastatic skull tumor is recommended in selected patients at least for a betterquality of life.

Female↗

PubMed2006

A unique case of pulmonary artery leiomyosarcoma.

Primary pulmonary artery leiomyosarcomas are rare, and the diagnosis is usually confused with other, more common, diseases, especially pulmonary embolism. A 52-year-old male, previously healthy, sustained a cardiac arrest. Chest CT-angiography diagnosed a "saddle embolus". Local thrombolysis was tried without any obvious success. At this point, the possibility of neoplasm was entertained. A cardiac MRI showed a nonhomogeneous mass in the proximal pulmonary artery. Successful surgery was performed, and histological examination of the resected mass was consistent with leiomyosarcoma. A follow-up cardiac MRI showed no residual mass. The dilemma associated with diagnosing pulmonary artery leiomyosarcomas will be discussed.

Diagnosis, Differential↗

PubMed1991

[Leiomyosarcoma of the esophagus associated with pulmonary edema by the compression of the left atrium].

Leiomyosarcoma of the esophagus is a rare neoplasm. We reported a very rare case of esophageal leiomyosarcoma associated with pulmonary edema by the compression of the left atrium. A 67-year-old man was admitted with a 3-month history of chest pain, exertional dyspnea and dysphagia. Chest X-ray computed tomography showed posterior mediastinal tumor. Esophageogastroscopy and fiberoptic bronchofiberscopy showed no direct invasion of the tumor. By echocardiography, the left atrium was found to be compressed by the tumor and pulmonary hypertension (58/25 mmHg) and increased pulmonary wedge pressure (25 mmHg) was present. Open biopsy specimen demonstrated elongated cells suggestive of sarcoma. At autopsy, the tumor was confirmed to be leiomyosarcoma and to be originated from the lower esophagus.

Aged↗

PubMed1991

[A case of leiomyosarcoma of the esophagus].

A 67-year-old woman was admitted on June 21, 1990 because of an abnormality on chest roentgenogram, a three-month history of palpitations on exertion, and a 2 kg weight loss. Chest roentgenogram revealed a huge mass in the posterior mediastinum. The results of needle aspiration cytology from the mass and celiac angiography were suggestive of leiomyosarcoma of the esophagus. The patient underwent tumor enucleation. The tumor originated from the lower-portion of the thoracic esophagus, measured 23 x 13 x 13 cm, and weighted 1110 g. The tumor was diagnosed as leiomyosarcoma histologically. Esophageal leiomyosarcoma is a very rare malignant tumor. The present case had no history of dysphagia in spite of the large tumor size.

Aged↗

PubMedDate not supplied

MR imaging of gastrointestinal leiomyosarcoma.

Two cases of leiomyosarcoma, one in the esophagus and the other in the small intestine, underwent magnetic resonance imaging (MRI). Spin echo T1-weighted images of both leiomyosarcomas showed almost the same intensity as muscle. Spin echo T2-weighted images showed the tumors to be hyperintense compared with fat; however, the esophageal tumor was more hyperintense than the small intestinal one. The jejunal leiomyosarcoma had a central cavity on MRI and CT, suggesting that it was malignant.

Angiography↗

PubMed1991

Primary ovarian leiomyosarcoma. An immunohistochemical and ultrastructural study.

Primary sarcoma of the ovary is rare, and only 16 reported examples of leiomyosarcoma are known to us. We encountered a primary ovarian leiomyosarcoma in a 58-year-old woman. The tumor was characterized by interlacing bundles of plump spindle cells that showed immunoreactivity for desmin, vimentin, and muscle-specific actin. Ultrastructural features included abundant smooth-muscle-type filaments, notched nuclei, pinocytotic vesicles, and extracellular collagen. This case illustrates the utility of ancillary techniques in the classification of pure ovarian sarcomas and leads us to propose ultrastructural and immunohistochemical criteria for primary ovarian leiomyosarcoma.

Female↗

PubMed1990

[Successful resection of mediastinal and abdominal recurrent tumors of esophageal leiomyosarcoma 12 years after surgery].

A 57-year-old woman admitted to our hospital in October, 1988 because of the tumor of the abdominal wall and abnormal shadows of right chest wall and right upper mediastinum. Her esophagus had been resected and reconstructed by the stomach roll because of the esophageal leiomyosarcoma in May, 1976. Clinical examinations revealed that the abdominal mass and chest shadows were the recurrence of the leiomyosarcoma. The abdominal tumor was resected on 17th October, 1988. On 14th December, 1988 right thoracotomy was performed. Chest wall tumor (40 x 30 x 20 mm) and mediastinal tumor (45 x 40 x 35 mm) were resected completely. The mediastinal tumor was adhered to the remnant esophageal muscle layer. Microscopic section of the tumor showed spindle cell sarcoma with fine calcification, and it was diagnosed as the metastatic leiomyosarcoma.

Abdominal Muscles↗

PubMed1990

[Two cases of pulmonary leiomyosarcoma].

Pulmonary sarcoma is a rare tumor of the lung. There are 81 cases in the literature for review, including our two cases. Our first case who was a thirty-seven year old male who was admitted to our hospital with complaints of left back pain. His chest X-ray showed an 11 X 14 cm tumor shadow in the lower left lung area. A left upper lobectomy was performed, and the histological diagnosis was leiomyosarcoma of the pulmonary vein. He died due to mediastinal recurrence 29 months later. Our other case was a fifty-six year old female. Her chest X-ray showed an abnormal shadow that was a tumor shadow in the right central lung area of 4 cm in diameter. As the diagnosis of the transcutaneous lung biopsy was benign tumor, partial resection of lung was performed. The histological diagnosis was leiomyosarcoma of the bronchus, and she is alive and well at 29 months after the operation. As the rate of diagnosis in leiomyosarcoma detected by transcutaneous lung biopsy is low, the most acceptable method of diagnosis is a total examination, including cytology of sputum, bronchoscopic findings, and roentgenoscopy. Probe thoracotomy would also be necessary if malignancy could not ruled out. The treatment of lobectomy should include lymph node resection.

Adult↗

PubMed1990

[Two cases of supposed metastasizing leiomyosarcoma of the uterus].

Case 1. A 57-year-old female had hysterectomy 10 years ago because of leiomyoma uteri. She was recently found to have a clear-cut round mass shadow in the right middle lung field on her chest X-ray film 3. The mass was resected and microscopically diagnosed as metastatic leiomyosarcoma. Re-examination of the pathological specimen of the uterine tumor resected 10 years ago revealed 5-9 mitosis per 10 high-powered fields (/10 HPF). Case 2. A 54-year-old female who had undergone hysterectomy for myoma uteri 9 years previously was found to have a well-defined oval shadow in the left lower lung field which was resected and pathologically diagnosed as metastatic leiomyosarcoma. Her uterus lesion microscopically revealed 1-2 mitosis/10 HPF. The relationship between metastatic leiomyosarcoma of the lung and mitotic activity of leiomyoma uteri was discussed.

Female↗

PubMed1990

[Clinicopathological analysis of leiomyosarcomas of the small intestine and a review of the Japanese literature].

An analysis has been made of 9 cases of a leiomyosarcoma of the small intestine that were treated from 1974 through 1989. In two patients (22.2%), a perforation was seen, and a case report of a 59-year-old woman is presented. Further, case reports of leiomyosarcomas in the Japanese literature from 1980 through 1989 were clinico-pathologically analyzed. The frequency of a perforation was found to be 8.6%, and the distribution of the perforated leiomyosarcomas was the same as for the non-perforated cases. The five-year postoperative survival rate was 41.2%. Of note is that 3 out of 10 patients that had survived for 5 years subsequently died of sarcomatosis.

Adult↗

PubMed1990

Radioimmunodetection in rhabdo- and leiomyosarcoma with 111In-anti-myosin monoclonal antibody complex.

In patients with rhabdo- and leiomyosarcoma a radioimmunodiagnostic study was performed with 111In labeled F(ab) fragments of a monoclonal antibody against myosin. Eight patients with rhabdomyosarcoma and 18 patients with leiomyosarcoma were studied. Scanning was performed at 4, 24, and 48 h after administration of 74 MBeq of the antibody complex. A high uptake with a tumor:background ratio of 10:1 was observed in several patients with rhabdomyosarcoma but the results were less accurate in leiomyosarcoma.

Adolescent↗

PubMed1990

A case of rapidly growing gastric leiomyosarcoma: observations over 18 months.

A gastric leiomyosarcoma in a 68-yr-old female was followed for 18 months by serial roentgenography. On initial x-ray, the lesion was diagnosed as a benign submucosal tumor. However, it rapidly increased in size, with doubling time subsequently calculated as 5 months. After 18 months' periodic observation, a gastrectomy was performed for a suspected malignancy. Histologic examination of the resected tumor revealed a leiomyosarcoma originating in the muscular layer of the stomach. It appears that the poor prognosis of leiomyosarcoma is related to its rapid growth; in addition, it is seldom detected at an early stage. Follow-up of the patient with a gastric submucosal tumor should be done first, 6 months after the initial examination, and thereafter, be done continuously according to the patient's condition. It is useful in differentiating a benign from a malignant myogenic tumor.

Aged↗

PubMed1987

Post-irradiation leiomyosarcoma. Case report with immunohistochemical studies.

We report here one case of post-irradiation leiomyosarcoma. The diagnosis of this was confirmed using anti-intermediate filament antibodies: tumor cells were positive for anti-vimentin and anti-desmin but negative for anti-prekeratin and anti-epithelial membrane antigen. The positive staining with anti-desmin clearly indicates a muscular origin although the tumor cells were not stained by two anti-actin antibodies, one directed against alpha-smooth muscle actin and the other against alpha-striated muscle actin. Irradiation was motivated by a wrong diagnosis of breast carcinoma when the patient was 13 year-old. The laps of time separating irradiation and the occurrence of the leiomyosarcoma was 13 years. The total dose was 6,000 rads. This is the ninth case of post-irradiation leiomyosarcomas reported in the literature.

Actin Cytoskeleton↗

PubMed1989

[A clinicopathological studies on gastrointestinal leiomyosarcomas, with special reference to prognosis].

Twenty-five cases of gastrointestinal leiomyosarcomas were subjected to clinico-pathological studies in an attempt to correlate the prognosis with tumor size, mitosis, cellularity and DNA ploidy pattern. Leiomyosarcomas greater than 5cm in diameter had poorer prognosis. Those with mitotic index larger than 3.0/mm2, cellularity larger than 3.0/0.0004mm2, DNA aneuploidy had poorer prognosis. By multiple regression analysis, mitotic index was useful for the prediction of tumor recurrence in earlier postoperative period, but cellularity, tumor size were useful for the prediction of recurrence in later postoperative period. As for the type of tumor recurrence, hematogenous metastasis was observed in 7 cases, peritoneal dissemination in 2 and local recurrence in 4. Four cases with local recurrence had all hematogenous metastasis. Two cases of gastric leiomyosarcomas developing local recurrence were greater than 10cm in diameter and gastric local resection was done for them. One case was diagnosed benign leiomyoma in the rectum histologically, but after trans-anal tumor resection local recurrence and metastasis to the lung occurred. We must pay attention to the surgical margin and the surface of tumor dissection during of the tumor, especially in larger tumors. Aggressive surgical resection is efficient for the treatment of recurrent tumors.

Cell Count↗

PubMed1989

[A case of leiomyosarcoma of the inferior vena cava].

Primary leiomyosarcoma of the inferior vena cava is rare and fatal. A 15-year-old female was admitted with the diagnosis of the right atrial myxoma associated with the Budd-Chiari syndrome. The tumor of the IVC was unresectable, although the right atrial tumor extended from the IVC was extirpated. Pathological examination of the tumor revealed a leiomyosarcoma. She was hemodynamically improved immediately after the operation. But she was expired due to the hepatic failure 9 days postoperatively. No autopsy was obtained. The literature regarding with leiomyosarcoma of the IVC was briefly reviewed.

Adolescent↗

PubMed1989

[A retroperitoneal leiomyosarcoma--a case of non-concurrent double cancers with kidney cancer].

A retroperitoneal leiomyosarcoma in a 50-year-old man is reported. A laparotomy was performed on Dec. 17, 1987 and the tumor, weighing 120 g, was completely excised. The patient was followed up and has stayed healthy (1 year after operation). Although CT ultrasonography and arteriography are helpful in the diagnosis of retroperitoneal tumors, it is felt that a histological examination is indispensable for a qualitative assessment of the lesion. Surgical excision constitutes the fundamental treatment for a retroperitoneal leiomyosarcoma. However, the prognosis is usually poor and depends on successful radical surgery. This case involved non-concurrent double cancers with a retroperitoneal leiomyosarcoma and a kidney cancer.

Humans↗