Primary leiomyosarcoma of bone

Primary leiomyosarcoma of bone is rare. We present the clinicopathological features of a case, the first documented from the Caribbean, seen recently at our institution. (AU)

Uterine leiomyosarcoma with intracerebral metastasis: a case report

A case of a 36-year-old woman with a past history of uterine leiomyosarcoma and an an intracerebral metastasis is reported. The patient presented with a 24-hour history of severe headache with coma, and the CT findings were consistent with a metastatic lesion. Pathological examination of the operative specimen showed features of a leiomyosarcoma. Uterine leiomyosarcoma is an uncommon tumor and metastasis to the brain is rare (AU)

Uterine sarcoma in Jamaican women

A review of 55 cases of uterine sarcoma recorded in the Jamaican Cancer Registry for the period 1958-1973 showed an annual incidence of 0.45 cases per 100,000 population, representing a 2.9 percent tumour incidence among all female genital cancers. Clinicopathological studies of 34 cases revealed that these tumours in the Negro population showed little difference from reports elsewhere in their epidemiological, clinical, pathological and prognostic aspects. The only difference was in cases of leiomyosarcoma in the young premenopausal women with rapidly growing uterine masses together with a high mitotic count, who had a poorer prognosis compared with older patients with this tumour. Surgical treatment of patients with leiomyosarcoma was hysterectomy and bilateral salpingo-oophorectomy, while mesenchymal sarcomas were treated with extended hysterectomy. Both groups of patients had postoperative radiotherapy. The 5-year survival was 30 percent in the former and 10 percent in the latter group. Postoperative radiotherapy in both groups failed to improve this poor prognosis but adjunctive immunotherapy may have a role in future treatment schedules (AU)

Leiomyosarcoma of the rectum

The only case of leimyosarcoma of the rectum seen at the University Hospital of the West Indies is reported. The natural history and pathology of this tumour are similar to those of smooth muscle tumours occurring elsewhere in the gut. When rectal leimyosarcoma invades adjacent organs such as the vagina and bladder, it may give rise to considerable morbidity. In addition, widespread metastases may occur. Aggressive surgical therapy is therefore warranted for early lesions if therapy is expected to be curative (AU)

Leiomyosarcoma of the duodenum

Only two cases of leimyosarcoma of the duodenum have been documented by the Jamaica Cancer Registry to date. One patient presented with obstructive jaundice which is an unusual presentation of this tumour. He died on the ninth post-operative day due to necrotising entero-colitis. The other patient presented with rectal bleeding, anaemia and an abdominal mass. The lesion was treated with pancreatico-duodenectomy and he is alive, but with recurrence up to the date of reporting. Neither of the two cases was diagnosed pre-operatively. Surgeons should be aware of this lesion while operating for upper-intestinal bleeding or on patients with obstructive jaundice (AU)

Malignant mesenchymal tumours of the corpus uteri

Fourteen cases of malignant mesenchymal tumours of the uterine bidy, observed over a 13 year period (1953-1966), have been reviewed. There were 9 examples of leiomyosarcoma, 1 endometrial stromal sarcoma and 4 malignant mixed mesodermal tumours. These tumours are uncommon in that they accounted for only 3 percent of uterine malignancies, and 0.6 percent of all female cancers in Jamaica. Seven of the 9 cases of leiomyosarcoma arose in previously benign fibroids, making the incidence of malignant transformation in benign fibroids 0.42 percent. Mixed mesodermal tumours constituted 0.72 percent of all uterine malignancies and 8 percent of the corporeal cancers. The prognosis was uniformly poor (AU)