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Advanced gastric leiomyosarcoma.

This is a retrospective review of twenty-two patients surgically treated for leiomyosarcoma. All but two patients had an advanced tumor of at least 8 cm size or involving contiguous structures. The most commonly performed operation was subtotal gastrectomy. The gastric resection required en bloc resection of contiguous structures in 10 patients. Fifteen patients with curative resection had a three year survival of 58 per cent. The overall group had a three year survival of 35 per cent. Advanced gastric leiomyosarcomas present a surgical challenge to complete resection, but when the procedure is accomplished the patient has a reasonable curative potential.

Adult↗

[Association of leiomyosarcoma and bladder papillomatosis].

The authors report one case of leiomyosarcoma associated with the papillomatosis of the bladder. After reviewing the literature, in which the exceptional nature of such tumoral associations is underlined, as are the infrequency and marked malignancy of leiomyosarcomas of the bladder, the authors illustrate the pathological and clinical characteristics of this neoplastic disease and discuss the pathogenic theories concerning this association.

Female↗

[A case report of leiomyosarcoma of the rectum].

A case of leiomyosarcoma of the rectum and a review of the relevant Japanese literature is reported. A 33-year-old man, suspected of having a rectal tumor was admitted to out hospital for though examination. The tumor was located at the anterior wall of the rectum behind the prostatic gland. A preoperative perineal biopsy was done and the pathological diameters was a leiomyosarcoma. The abdominoperineal resection was performed but the nerve was able to be preserved. The postoperative quality of life has been good. The difficulties in arriving at a histological differentiation of a simple tumors of the rectum from a malignant smooth muscle tumor of the rectum is discussed.

Adult↗

Leiomyosarcoma of a lower limb presenting with multiple cranial nerve palsies.

Leiomyosarcoma is a relatively uncommon soft tissue sarcoma usually presenting as a mass at the primary site. It arises in the retroperitoneal region, in the cutaneous or subcutaneous tissue of the extremities or, less commonly, from a large vein. A case is described where a patient presented with unilateral third, fourth, and sixth cranial, and ophthalmic division of trigeminal nerve palsies in whom biopsy of a longstanding lower limb mass demonstrated leiomyosarcoma. The presentation of this type of pathology has not been described previously.

Abducens Nerve↗

[Successful CYVADIC combination chemotherapy of metastatic pulmonary lesions involving a mediastinal leiomyosarcoma--a case report].

Discussed is a 34-year-old man who hospitalized for manifesting the superior vena cava syndrome. Chest radiograph and chest CT scan revealed a gross tumor shadow in the superior mediastinum and a tiny shadow in the right lung. Superior vena cavography showed intimal stenosis, irregularities, and stiffness of the superior vena cava. Thus, radiotherapy applied to primary lesion of the mediastinum was provided to relieve his complaints. One year later, predominant metastatic pulmonary lesions and skin lesions developed. Light and electron microscopic findings of a biopsied specimen of the skin lesion were consistent with leiomyosarcoma. CYVADIC combination chemotherapy reduced the pulmonary metastatic lesions dramatically. The literature of mediastinal leiomyosarcoma is reviewed and the origin of this tumor is discussed.

Adult↗

Surgical management of unresectable retroperitoneal leiomyosarcomas.

Retroperitoneal leiomyosarcomas are rare tumors with a poor prognosis. These tumors are often deemed unresectable because of their large size when diagnosed. This study presents two recent patients who show that retroperitoneal leiomyosarcomas can be resected successfully. Adjuvant radiotherapy is useful in treatment of patients with residual disease. Although the contribution of chemotherapy in prophylaxis and treatment of these tumors remains undefined, various chemotherapeutic regimens are currently under investigation.

Aged↗

[Primary leiomyosarcoma of the pulmonary artery. Apropos of a case].

A case of leiomyosarcoma of the pulmonary artery in a 64-year old man without previous cardiovascular disease is reported. The clinical picture, which comprised episodes of paroxysmal dyspnoea associated with acute cor pulmonale, suggested pulmonary embolism. Radioisotope perfusion study and pulmonary angiography seemed to confirm this diagnosis, but no improvement was obtained with a prolonged thrombolytic treatment. The presence of a median mass at CT led to exploratory thoracotomy and to the finding of a tumour in the pulmonary artery, which turned out to be a leiomyosarcoma. The disease rapidly took an unfavourable course. Comparison of this case with data from the literature showed that primary tumours of the pulmonary artery are extremely rare, that they are diagnosed with difficulty and often at a late stage and that their prognosis is usually very sombre.

Humans↗

Primary leiomyosarcoma of bone. A case report and review of the literature.

A 62-year-old female with primary leiomyosarcoma of the left femur is reported with a review of 21 cases reported in the literature. The resected specimen showed that the tumor extended from the femoral head to the diaphysis for 13 cm in length. The tumor showed mainly intramedullary proliferation, but extraosseous growth was also noted at the great trochanter. Microscopic examination revealed well differentiated leiomyosarcoma characterized by interlacing bundles of fusiform cells with eosinophilic cytoplasm and rod-shaped hyperchromatic nuclei. PAP stain of actin on the tumor cells was positive. On electron microscopy, microfilament of 6-8 nm in diameter, dense bodies, pinocytotic vesicles, marginal attachment plate, and basal lamina were noted. The patient died with pulmonary metastasis, 1 year and 7 months after the operation. An autopsy showed metastases in the right pelvic cavity and bilateral lungs, and confirmed the primary site to be the left femur.

Female↗

Gastric leiomyosarcoma. Comparative value of barium examinations, ultrasonography and CT scans.

The authors discuss four cases of gastric leiomyosarcoma explored by various imaging techniques (barium examinations, ultrasound, CT scans). Barium examinations were normal in two cases, abnormal but insufficient for diagnosis in one, and sufficient to allow topographic diagnosis in one. Ultrasonography gave abnormal findings insufficient for diagnosis in two cases and allowed topographic diagnosis in the other two cases. CT scans were abnormal but insufficient for diagnosis in one case, allowed topographic diagnosis in 3 cases, and in two of the cases permitted initial diagnosis of a connective tissue malignancy. Due to the frequently subserosal nature of leiomyosarcoma of the stomach and of the digestive tract in general, analysis by CT in mandatory. Analysis of tumor relations with the spleen, the left kidney and the pancreas is facilitated by ultrasonography.

Adult↗

Leiomyosarcoma in a budgerigar (Melopsittacus undulatus).

A tumor mass defined as a leiomyosarcoma was found in the thoracic cavity of a 3-year-old female budgerigar. Disseminated leiomyosarcomas were found in various body tissues, including bone marrow, spleen, and liver.

Animals↗

[Leiomyosarcoma of the anal canal].

Leiomyosarcoma originating in the anal canal internal sphincter is an extremely rare malignant tumor of often late diagnosis, since usually asymptomatic, and with malignancy criteria that are sometimes difficult to define. These tumors affect men and women with equal frequency, usually in the 6 th decade. Two cases are reported in patients aged 67 and 65 respectively in whom the tumor was revealed by a painful perianal mass shown on rectoscopy to be due to a submucous tumor projecting into anal canal, Prognosis and treatment of these tumors is discussed, diagnosis being confirmed only after excision biopsy. Tumoral extension was both local and regional by continuity but blood dissemination had occurred with metastases more frequently in liver (1 case) but also in lungs. Glandular extension was exceptional. Limited local exeresis of small tumors appears justified if sufficiently wide, since malignancy of leiomyosarcoma appears to remain circumscribed over long periods. However, this limited procedure runs the risk of local recurrence with the need for abdominoperineal amputation (the case in the 2 patients reported), although long-term results appear to be similar whether excision is or is not extensive, the abdominoperineal amputation failing to avoid the unfavorable course. Complementary radiotherapy or chemotherapy is ineffective, and prognosis is related more to the degree of tumoral differentiation than to the operative treatment itself.

Aged↗

[A case of leiomyosarcoma of the duodenum--histologic diagnostic criteria of borderline malignancy].

A case of a leiomyosarcoma of the duodenum is reported. A 52-year-old man with a duodenal submucosal tumor underwent a pancreatico-duodenectomy. Histologically, the resected tumor revealed moderate cellular atypism and moderate pleomorphism, but revealed no mitotic figures. The histological diagnosis was leiomyoma. Nine years after operation, the tumor showed a recurrence and metastasis in the liver. Thus, the patient underwent a lobectomy of the liver. The resected liver tumor showed similar histological features seen in the primary duodenal tumor but with high mitotic activity. Histologically, the patient was diagnosed as having a metastatic leiomyosarcoma. This history suggests that a smooth muscle tumor of potential malignancy, as seen in this case, should be followed continuously, even though mitoses may not be recognized.

Diagnosis, Differential↗

[Primary leiomyosarcoma of the pineal gland--a case report].

Primary sarcoma in the central nervous system is rare. From 1954 to 1986, 1417 neoplasms of the central nervous system were treated in our hospital and only one case of primary leiomyosarcoma of the pineal gland was seen. The patient, a forty-seven year old man, had diplopia for 2 months, headache and ataxia for 2 weeks before admission. The CT scan showed a space occupying lesion in the pineal gland. During operation, a mass, 3 x 2.5 x 2 cm in size, was found in the pineal and subtotal resection was performed. The pathological diagnosis of primary leiomyosarcoma of the pineal gland was established. The patient died the next year of the operation. Finally, the histogenesis, clinical manifestations, diagnosis and differential diagnosis are discussed with a review of literature.

Brain↗

[Cutaneous leiomyosarcoma (description of a case)].

Cutaneous leiomyosarcoma is a rare tumour arising in dermis or subcutaneous tissue. Diagnosis is usually made by microscopic examination on the basis of marked cellular atypia and mitoses. We report one case of leiomyosarcoma of the gluteus with precocious lung metastases in a 65-year-old female.

Aged↗

Primary leiomyosarcoma of gallbladder seen on computed tomography and ultrasound.

Neoplasms of the gallbladder are relatively rare and their preoperative diagnosis that much rarer; leiomyosarcoma of the gallbladder is one of the most infrequent types. The authors had the opportunity to diagnose such a neoplasm preoperatively (although the histological diagnosis was not made). The ultrasound and computed tomographic appearance has not been published before. Leiomyosarcoma showed a dilated gallbladder with an irregularly thickened wall and a polypoid protrusion into the lumen.

Aged↗

[Abdominopelvic recurrence of leiomyosarcoma. Echographic aspects apropos of 19 cases].

The recurrence rate after initial surgery of pelvis and abdominal leiomyosarcomas is significant. Quick but silent growth of these tumors requires a regular and frequent follow-up in order to improve the prognosis. Ultrasonography is the simplest way for such a follow-up. We present our experience about 23 operated cases of leiomyosarcomas followed by ultrason; 19 of them recurred with 1 to 6 abdominal and/or pelvic masses. The echographic patterns of recurrences are detailed.

Abdominal Neoplasms↗

Primary leiomyosarcoma in the breast.

The case is presented of a 62-year-old woman having a well-circumscribed, painless breast lump which led to the discovery of pure mammary leiomyosarcoma. There are only a few documented cases of primary leiomyosarcoma in the breast, and a brief review of the literature on the diagnostic findings and histogenesis of a smooth muscle malignant neoplasm in this site is, therefore, provided. As far as the histogenesis is concerned, ultrastructural features of the present case suggest a tumor of pluripotent mesenchymal cell nature rather than of vascular smooth muscle cell origin.

Breast Neoplasms↗