ABSTRACT
OBJECTIVE: To evaluate the results of bloc resection and vascular reconstruction of leiomyosarcomas with involvement of main vessels in the lower extremities. MATERIAL AND METHODS: From January 1983 to December 2016, 42 patients with leiomyosarcomas were diagnosed. Six of these leiomyosarcomas affected main vessels of the lower extremities (called vascular). Epidemiological data, imaging studies, surgery performed, adjuvant treatments, complications, as well as recurrences and mortality were retrospectively recorded. RESULTS: All the patients were affected by high-grade leiomyosarcomas (ii-iii FNCLCC classification), with a larger tumour average diameter of 9.1cm(6-15) and a mean follow-up of 23 months (7-36). The average age was 64 years (29-84). The first symptom was a palpable tumour in 4 of them. The other 2 cases debuted with thromboembolic phenomena. In 5 cases the origin was the femoral vessels, while one case was at the popliteal level. Although all cases preserved the limb, in 3 cases (50%) they presented pulmonary dissemination,2 cases (33%) hepatic dissemination and one case had local recurrence. Two cases died at the end of the study and there was one case of loss to follow-up. DISCUSSION AND CONCLUSIONS: Vascular leiomyosarcomas are highly aggressive tumours with a low survival rate at 5 years. In our study, 50% of the patients remain in complete remission with a mean follow-up of 23 months. Their onset frequently associates the presence of tumour mass with thrombotic phenomena (33% of our cases). Tumour resection surgery usually compromises the main vascular structures, which implies resection and vascular reconstructive techniques to salvage the limb.
Subject(s)
Leiomyosarcoma/surgery , Lower Extremity/blood supply , Vascular Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Leiomyosarcoma/mortality , Lower Extremity/surgery , Male , Middle Aged , Plastic Surgery Procedures , Retrospective Studies , Survival Analysis , Treatment Outcome , Vascular Neoplasms/mortality , Vascular Surgical ProceduresABSTRACT
Neuroendocrine cells are frequently found in gastric tumours, although they rarely make up more than one third of the total number of tumour cells. When juxtapositioning of the two kinds of tumour cells occurs a "collision tumour" is formed. These have been described to occur with varying frequency throughout the digestive tract. They are uncommon in the stomach. We describe a case, of a gastric collision tumour in which an adenocarcinoma coexisted with a carcinoide tumour and there were zones of bony metaplasia in the transition area between the two tumors. Positive CEA, VIP, beta-HCG and TSH on inmunohistochemical analysis was found.