Development of primary leiomyosarcoma of the sternum postirradiation: Report of a case

(Received for publication on July 22, 1997; accepted on Mar. 10, 1998)     

Giant leiomyosarcoma of the remnant stomach: Report of a case

(Received for publication on Mar. 6, 1997; accepted on Nov. 6, 1997)     

Primary leiomyosarcoma arising in the lesser sac: Report of a case

We describe herein a very rare case of leiomyosarcoma arising in the lesser sac. A 58-year-old man with a psychiatric disorder was admitted to our department for the investigation of epigastralgia and nausea which he had been suffering since the previous month. A laparatomy revealed that the abdominal mass, found on physical examination, was a primary lesser omental tumor, histological examinations of which confirmed a diagnosis of leiomyosarcoma. The tumor cells showed a DNA diploid pattern. Leiomyosarcoma of the lesser sac is extremely unusual and it is important that it be distinguished from an extraluminal tumor of the abdomen.     

Primary leiomyosarcoma of the seminal vesicle

A case of leiomyosarcoma of the seminal vesicle detected as a prerectal mass on routine per-rectal examination is described in a 37-year-old man. Computed tomography scan confirmed it to be arising from the right seminal vesicle. Per-rectal trucut biopsy showed malignant cells. Radical cystoprostatectomy with bilateral pelvic lymphadenectomy with anterior resection of rectum and urinary diversion with ileal conduit was performed. Microscopic examination of the resected specimen showed moderately differentiated leiomyosarcoma from the seminal vesicle. The patient received adjuvant chemotherapy and sandwiched radiotherapy. He is well and free of tumor 20 months after surgery.     

Primary leiomyosarcoma of the breast: a case report with review of the literature

Breast sarcomas account for about 1% of all malignant breast cancers. Leiomyosarcoma (LMS), one of the rarest, was first described 20 years ago, and yet few published reports exist. A case of primary LMS in a 25-year-old woman is presented and is only the 18th well-documented case in the literature. The clinical presentation, diagnosis, therapy, and pathologic features are reviewed.     

Primary leiomyosarcoma of the breast

Sarcomas of the breast are rare, accounting for about 1% of all malignant breast tumors. Leiomyosarcoma of the breast was an almost unknown tumor until some 20 years ago, and the few previously published cases lacked detailed information. Only 11 well-documented cases of leiomyosarcoma of the breast had been reported in the literature up to February 1992. The clinical features, diagnosis, therapy, and prognosis are discussed here in the light of the previously published literature.     

Primary hepatic leiomyosarcoma in a woman after renal transplantation: report of a case

In contrast to malignant lymphomas or skin cancer, smooth muscle tumors including leiomyosarcoma are rarely associated with transplant recipients. We herein present a 33-year-old woman with end-stage renal disease who received a transplant at 27 years of age. Four years after the transplantation, at age 31, she underwent a mastectomy because of primary right breast cancer, which was found to be a 5-mm-sized mucinous carcinoma with no regional lymph node metastasis. Six years after the transplantation, a liver tumor was unexpectedly discovered. An explorative laparotomy revealed a well-encapsulated tumor occupying the posterior portion of the right lobe of the liver. The patient underwent a posterior segmentectomy. Histologically, the tumor possessed intermingling fascicles of spindle cells with eosinophilic cytoplasm and elongated nuclei. Based on an immunohistochemical examination, the tumor cells were positive for the muscle-associated antibody. In addition, RNA probes for Epstein-Barr virus were negative based on in situ hybridization. The histologic, immunohistochemical findings were considered to be diagnostic for leiomyosarcoma, which is a low-grade malignancy. Two years after surgery, the patient is doing well with no recurrence of liver tumors or breast cancer. Received: April 16, 2001 / Accepted: September 11, 2001     

Primary leiomyosarcoma of the breast: report of a case

We describe herein a case of primary leiomyosarcoma of the breast in a 59-year-old woman. Preoperative clinical examination and cytology findings indicated a benign breast tumor, but intraoperative histopathological examination of the tumor revealed malignant spindle cells, and a modified radical mastectomy was performed. Immunohistochemical analysis subsequently confirmed a diagnosis of leiomyosarcoma. Primary leiomyosarcoma of the breast is extremely rare and difficult to diagnose before surgery because of the need for mitotic figures and immunohistochemical staining to confirm the diagnosis. When pre- and intraoperative examinations indicate the possibility of a leiomyosarcoma, an extended excision with sufficient margins should be performed to remove all of the affected tissue. A review of the literature on this unusual tumor of the breast is presented. Received: May 21, 2001 / Accepted: November 20, 2001     

A primary extraskeletal osteosarcoma of the mesentery: a case report

Extraskeletal osteosarcoma is a rare and invasive malignancy, typically located in the soft tissue without attachment to the skeleton. The present study reports a case of a primary mesenteric extraskeletal osteosarcoma of a 71-year-old woman. The patient complained of an incomplete defecation. Colonoscopy showed an ulcer with impression of external compression of the sigmoid. An additional abdominal computed tomography (CT) scan revealed a large, almost completely calcified, mass in the left lower abdomen causing hydronephrosis of the left kidney. The patient underwent surgery and the mass was resected completely. The histopathological diagnosis was a primary abdominal extraskeletal osteosarcoma arising from the mesocolon with local invasion of the sigmoid. She was in follow-up without adjuvant chemo- or radiotherapy. Five months after initial surgery the tumor recurred with widespread peritoneal metastasis.     

Primary leiomyosarcoma of the lesser sac

A case of leiomyosarcoma arising in the lesser sac in a 64-year-old man is presented. A second operation was required because of local recurrence 6 years following the first operation. A review of the literature revealed that only eight cases of leiomyosarcoma arising in the lesser sac, including our case, were reported. Almost all of these patients had symptoms of abdominal pain or distension. The tumor tended to grow to a large size and about 90 percent were over 10 cm in the maximal diameter. The prognosis of these series was poor and our own patient seems to be the second 5 year survivor. Presented at the Kyushu Regional meeting of the Japan Surgical Society, Oita, July 2–3, 1983     

Primary leiomyosarcoma of the greater omentum: a case report

IntroductionGreater omentum leiomyosarcomas are rare tumors with only a few cases reported in literature.Presentation of caseWe report the case of a 68-year-old man who consulted complaining of diffuse abdominal pain without a palpable mass at physical examination. Imaging studies revealed a solid-cystic lesion in the right lower quadrant. Surgical resection was performed and the tumor was diagnosed as a leiomyoscarcoma by histological and immunohistochemical examinations.DiscussionSurgical resection of all lesions seems to be a reasonable therapeutic approach if resection is feasible. Chemotherapy may be used in selected cases.ConclusionMore cases are needed to define the best treatment approach of this disease.     

肾原发性平滑肌肉瘤3例病理分析

目的探讨原发于肾脏的平滑肌肉瘤的临床病理学特点、诊断、鉴别诊断、治疗及组织发生。方珐对3例肾平滑肌肉瘤进行常规HE、组织化学及免疫组织化学染色观察。焙杲3例显微镜下表现、组织化学及免疫组织化学染色均显示平滑肌源性肿瘤的特点。由病理确诊，术前无1例怀疑平滑肌肉瘤。2例分别于术后2个月、38个月后死亡，1例术后至今无复发（42月）。结论肾原发性平滑肌肉瘤罕见，临床诊断较困难，但依靠肾切除标本的病理检查，结合组织化学染色和免疫组织化学染色可确诊。该肿瘤恶性度高，预后较差。     

A case of leiomyosarcoma of the penis

A case of leiomyosarcoma of the penis is reported. A 27-year-old-man presented to our department with a mass at the root of the penis. Biopsy of the tumor showed that the tumor was leiomyosarcoma. The tumor was clinically and pathologically categorized into the deep type. Despite total penectomy and adjuvant chemotherapy, the patient died from disseminated disease 14 months after surgery. This is the 45th case of penile leiomyosarcoma.     

Primary great saphenous vein leiomyosarcoma: Report of a case

Leiomyosarcomas rarely arise in primary veins, especially the great saphenous vein. We have found only 20 case reports of leiomyosarcoma arising in the great saphenous vein, most of which manifested as nonspecific symptoms of advanced disease, such as a palpable mass, swelling, and back or abdominal pain. We report the case of greater saphenous vein leiomyosarcoma diagnosed in a 48-year-old man with a 4-month history of an inguinal mass. Ultrasonography and computed tomography showed a 6-cm mass attached to the right superficial femoral vein. Fine-needle aspiration biopsy confirmed that it was a vascular sarcoma. At the time of surgery there was no evidence of distant metastasis; therefore, we removed the tumor en bloc along with the sartorius muscle, inguinal lymph nodes, and 10 cm of the common femoral vein, and replaced the femoral vein with a polytetrafluoroethylene graft. A pathological examination revealed poorly differentiated leiomyosarcoma of the great saphenous vein, involving the deep femoral vein, without lymph node involvement. During follow-up, a thrombosis of the prosthesis developed, followed by proximal stenosis, which was treated successfully with percutaneous transluminal angioplasty. The patient was found to have lung metastases 25 months after surgery and he died about 5 months later.     

Primary superficial femoral vein leiomyosarcoma: Report of a case

The majority of leiomyosarcomas occur in the muscular layers of the gastrointestinal tract and uterus. Primary leiomyosarcomas rarely arise in the veins of the lower extremities. Primary leiomyosarcoma of the superficial femoral vein is extremely uncommon. We herein present a case of a 69-year-old man with a primary leiomyosarcoma of the superficial femoral vein of his left thigh, which manifested as an anteromedial palpable painless mass in the middle third of his left thigh. Duplex ultrasonography revealed a 4 × 8-cm mass attached to the left superficial femoral vein. The mass was removed surgically en bloc. Histological examination showed a low-grade leiomyosarcoma. Seven months after the resection, a local recurrence of the tumor was observed, and the patient underwent another surgery. Five years after the second operation the patient remains free of illness.     

Primary carcinoma of the cystic duct associated with sarcoid reactions: Report of a case

We report on an extremely unusual case of primary carcinoma of the cystic duct associated with sarcoid reactions. Although sarcoid reactions are known to occur occasionally with malignant tumors, primary carcinoma of the cystic duct is very rare, and to our knowledge, this is the first documentation of surgical treatment being performed for primary carcinoma of the cystic duct associated with sarcoid reactions. A 69-year-old woman with a mass in the right upper quadrant underwent cholecystectomy and hepaticocholedochal resection with dissection of the regional lymph nodes under the macroscopic operative diagnosis of primary carcinoma of the cystic duct. Microscopic examination of the resected lymph nodes disclosed sarcoid granulomas. According to our research of the literature, this is the 23rd surgically treated case of primary carcinoma of the cystic duct in Japan. The features of all 23 cases are reviewed following this case report.     

A Chylous Cyst of the Mesentery: Report of a Case

(Received for publication on Oct. 21, 1998; accepted on July 13, 1999)     

A malignant rhabdoid tumor of the kidney occcurring concurrently with a brain tumor: Report of a case

(Received for publication on Dec. 24, 1998; accepted on Sept. 17, 1999)     

Primary leiomyosarcoma of the thyroid gland

Primary leiomyosarcoma of the thyroid gland is extremely rare, and to the best of our knowledge only five well-documented cases have been reported in the world literature. We herein report a 58-year-old female patient with primary leiomyosarcoma of the thyroid who was successfully treated by total thyroidectomy with a modified neck dissection. Immunohistochemically, the tumor cells showed positive reactivity to α-smooth muscle actin and vimentin. Radical surgery was thus considered to be essential in the treatment of this rare but rather aggressive malignancy.