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1.
Clin Nucl Med ; 46(12): e594-e597, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34735413

RESUMO

ABSTRACT: A 56-year-old woman presented with abdominal pain and vomiting. Her abdominal CT revealed an retroperitoneal mass in the left upper quadrant of the abdomen. 18F-FDG PET/CT performed for metabolic characterization showed low to moderate heterogenous FDG uptake. 68Ga-fibroblast activation protein-specific inhibitor (FAPI)-04 PET/CT performed according to a research carried out in our department showed high heterogenous radiopharmaceutical uptake. The patient was diagnosed with leiomyosarcoma after R0 tumor resection. This case showed that 68Ga-FAPI-04 PET/CT could be a promising radiopharmaceutical in the evaluation of leiomyosarcomas.


Assuntos
Leiomiossarcoma , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Abdome , Feminino , Fluordesoxiglucose F18 , Humanos , Leiomiossarcoma/diagnóstico por imagem , Pessoa de Meia-Idade , Quinolinas
2.
BMJ Case Rep ; 14(11)2021 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-34799385

RESUMO

Soft tissue sarcomas (STSs) are rare and may often be misdiagnosed, resulting in delays in treatment. A 67-year-old cisgender woman with type 2 diabetes mellitus and obesity presented to her primary care physician with a mass on her left proximal arm. The clinical opinion of the attending physician was that of an insulin injection site reaction. After further evaluation from the physician, the patient was diagnosed with a lipoma without confirmatory histology. The patient continued to present with an enlarging mass, decline in health status and continued with local wound care. The patient underwent a confirmatory biopsy following which, the patient was diagnosed with leiomyosarcoma. This case report highlights the case of a person with a low or moderate income with a self-reported low health literacy living in a rural community and how STS may be misdiagnosed in medically underserved. The patient's primary or oncology care team are not involved in the production or review of this case report.


Assuntos
Diabetes Mellitus Tipo 2 , Leiomiossarcoma , Neoplasias Cutâneas , Idoso , Feminino , Humanos , Reação no Local da Injeção , Insulina , Leiomiossarcoma/diagnóstico
3.
J Med Case Rep ; 15(1): 559, 2021 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-34782012

RESUMO

BACKGROUND: Carney's triad is a rare syndrome comprising gastrointestinal stromal tumor, extra-adrenal paraganglioma, and pulmonary chondroma along with newer additions of adrenal adenoma and esophageal leiomyoma. The triad is completely manifest in only 25-30% cases, with most patients presenting with two out of three parts of the syndrome. Wild-type succinate-dehydrogenase-deficient gastric gastrointestinal stromal tumor forms the most common component of Carney's triad and is usually multicentric and multifocal. It usually demonstrates indolent behavior and resistance to imatinib; hence, the management remains predominantly surgical. Pulmonary chondromas are commonly unilateral and multiple with slow-growing nature, which allows for conservative management. Adrenocortical adenomas are found in 20% of patients and are usually detected as incidentalomas. CASE PRESENTATION: A 49-year-old Asian male presented with upper gastrointestinal bleed and was diagnosed with multiple gastric succinate-dehydrogenase-deficient gastrointestinal stromal tumors. On evaluation, he was found to have left pulmonary chondroma and non-secretory adrenal adenoma, thus completing the Carney's triad. He underwent surgery with sleeve gastrectomy and excision of the antral tumor nodule, while the adrenal and pulmonary tumors have been under close follow-up. CONCLUSION: Literature regarding Carney's triad is scarce, especially from the Indian setting. Our report aims to highlight the various manifestations of this syndrome with emphasis on management of wild-type succinate-dehydrogenase-deficient gastrointestinal stromal tumor. Radical gastric surgeries do not offer a survival advantage in this condition; hence, more conservative modalities of resection can be adopted.


Assuntos
Condroma , Leiomiossarcoma , Neoplasias Pulmonares , Neoplasias Primárias Múltiplas , Paraganglioma Extrassuprarrenal , Neoplasias Gástricas , Adulto , Condroma/diagnóstico por imagem , Condroma/cirurgia , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Paraganglioma Extrassuprarrenal/diagnóstico , Paraganglioma Extrassuprarrenal/cirurgia , Centros de Atenção Terciária
4.
Maturitas ; 154: 1-6, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34736574

RESUMO

OBJECTIVE: Gynecologic Sarcomas are rare, aggressive tumors. The aim of this study was to explore the incidence and outcomes of gynecologic sarcomas in a large national data registry and to compare them with reports from other countries. STUDY DESIGN: Records of gynecologic sarcomas diagnosed in Israel (1980-2014) were extracted from the National Cancer Registry and classified according to International Classification of Diseases for Oncology-3 and characterized according to anatomical site, morphology and demographics. Age-standardized incidence rates and 1, 3, 5 and 10-year relative survival rates were calculated for 3 time periods (1980-1994, 1995-2001 and 2005-2014) according to patient age, stage and years of diagnosis. RESULTS: During 1980-2014, 1271 new gynecologic sarcomas were diagnosed in Israel, with incidence slightly increasing in 1980-2004, to an age-standardized incidence rate of 13 per million women. The most common histologic diagnosis was leiomyosarcoma (48%) and the most common anatomical site was the uterus (89%). The age-standardized incidence rate for uterine sarcoma is higher in Israel (10.55 per million) than in England (7.4 per million) and Germany (5.8 per million) respectively. The 5-year overall survival was significantly poorer in patients >70-years, as compared to younger patients (p<0.001) and in those with leiomyosarcoma compared to endometrial stromal sarcoma (p<0.001). The survival rate of patients with leiomyosarcoma in Israel are comparable to survival rates reported by other studies, although substantially lower regarding endometrial stromal sarcoma. CONCLUSIONS: Uterine leiomyosarcoma was the most common gynecologic sarcoma found in the Israeli, European and American registries. Older patients and those with leiomyosarcoma have the worst prognoses. Histological and anatomical variations in Israel are comparable with global statistics, but the incidence in Israel seems higher than in Europe.


Assuntos
Leiomiossarcoma/epidemiologia , Sarcoma/epidemiologia , Neoplasias Uterinas/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Israel/epidemiologia , Leiomiossarcoma/etnologia , Pessoa de Meia-Idade , Sistema de Registros , Sarcoma/etnologia , Estados Unidos/epidemiologia , Neoplasias Uterinas/etnologia , Adulto Jovem
5.
Am J Case Rep ; 22: e933267, 2021 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-34695070

RESUMO

BACKGROUND Leiomyosarcoma frequently occurs in patients who are on immunosuppressive therapy. It is the second most common sarcoma in this population and is often associated with Epstein-Barr virus (EBV) infection. We present a case of advanced leiomyosarcoma of the retroperitoneal space in a kidney transplant recipient and discuss additional risk factors for oncogenesis. CASE REPORT A 44-year-old woman with a history of peritoneal dialysis and kidney transplantation was diagnosed with multiple liver lesions. PET-CT scanning showed a metabolically active tumor in the left lumbar region with numerous liver focal lesions. The histological examination of the liver lesion biopsy identified advanced retroperitoneal leiomyosarcoma with a high proliferative index and liver involvement. Unexpectedly, the relation with EBV infection was not proven. The patient was treated with first-line doxorubicin, with the simultaneous reduction of immunosuppression. Owing to disease progression after 6 cycles, the patient received second-line chemotherapy based on gemcitabine and docetaxel, which was terminated owing to unacceptable toxicity, despite an observed response. Third-line trabectedin-based therapy with good tolerance and stabilization of disease after 20 months was being maintained at the time of this report. CONCLUSIONS The increased cancer mortality in solid-organ transplant recipients requires an individualized approach and increased post-transplantation screening according to additional specific cancer risk factors. A further consideration is the hypothetical relevance of long-term peritoneal membrane irritation in peritoneal dialysis patients.


Assuntos
Infecções por Vírus Epstein-Barr , Transplante de Rim , Leiomiossarcoma , Diálise Peritoneal , Adulto , Feminino , Herpesvirus Humano 4 , Humanos , Transplante de Rim/efeitos adversos , Leiomiossarcoma/complicações , Diálise Peritoneal/efeitos adversos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Espaço Retroperitoneal
6.
Eur J Obstet Gynecol Reprod Biol ; 266: 119-124, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34624740

RESUMO

Ki67 labeling index (LI) has been proposed as a prognostic factor in uterine leiomyosarcoma (uLMS), although the evidence in this field is still unclear. We aimed to assess the prognostic value of ki67 LI in uLMS. A systematic review was performed by searching electronic databases from their inception to August 2020 for all studies assessing the prognostic value of ki67 LI in uLMS. Ki67 LI was assessed to the nearest 10% to define the most prognostically accurate threshold. Cox regression survival analysis with calculation of hazard ratio (HR) of death was performed; a p-value < 0.05 was considered significant. Ten studies were included in the qualitative review, out of which 6 were suitable for quantitative review. The absolute risk of death was 0.29 for a ki67 LI < 10%, remained stable at 0.49 in the 10%-39% LI range and increased to 0.65 for a LI ≥ 40%. On univariate analysis, both 10% and 40% thresholds were significantly associated with the hazard of death, with HRs of 3.349 (p = 0.007) and 3.172 (p = 0.001), respectively. On multivariate analysis, only the 10% threshold was significantly associated with the hazard of death (HR = 2.712; p = 0.028). In conclusion, a Ki67 LI ≥ 10% is a significant prognostic factor in uLMS.


Assuntos
Leiomiossarcoma , Neoplasias Uterinas , Biomarcadores Tumorais , Feminino , Humanos , Antígeno Ki-67 , Prognóstico , Modelos de Riscos Proporcionais
7.
Ann Ital Chir ; 102021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34569472

RESUMO

AIM: Sarcomas are rare tumors representing 0.7% of all cancer cases in adults, and approximately 15-20% of those occur in the retroperitoneum. Diagnosis is usually late. Liposarcoma and leiomyosarcoma are the most frequent forms. Liposarcomas have high local recurrence rates (35-60%) and a high metastasis rate only if dedifferentiated (30%), whereas leiomyosarcoma has a high distant metastasis rate (60%) and a low local recurrence rate (20%). CASE REPORT: A case report of multifocal synchronous well-differentiated liposarcoma is presented. The patient underwent a surgical excision of all the masses. The postoperative period was uneventful, with a postoperative hospital stay of 9 days. The patient underwent systemic chemotherapy and clinical and instrumental follow-up. A relapse of the disease was observed 24 months after surgery: a 25 mm mass was diagnosed close to the pancreatic stump, as well as a 24 mm mass in the left upper abdominal quadrant. The patient underwent a second laparotomy: recurrent lesions were identified and excised en-bloc with the body of the pancreas. CONCLUSION: Surgery is the gold standard of therapy. The best chance for curative resection is at the time of the first diagnosis of the disease. Compartmental surgery is a macroscopically complete resection through en bloc excision of adjacent structures, even if not clearly infiltrated. Many controversies still exist in the treatment of retroperitoneal liposarcoma, such as the extent of primary and secondary resections, the benefit of chemotherapy and radiation therapy, and when these treatments should be delivered. KEY WORDS: Compartmental surgery, Liposarcoma, Surgery, Retroperitoneal sarcoma.


Assuntos
Leiomiossarcoma , Lipossarcoma , Neoplasias Retroperitoneais , Adulto , Humanos , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia
8.
BMJ Case Rep ; 14(9)2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34518183

RESUMO

Small bowel malignant tumours make only 2% of all gastrointestinal (GI) malignancies. Small bowel leiomyosarcoma (LMS) is further rare, accounts for only 0.1%-3% fraction of these tumours. These cases can present as asymptomatic intra-abdominal mass, anaemia due to GI bleed or acute abdomen such as perforation peritonitis, intussusception and bowel ischaemia. Standard of care is surgical resection. Our case presented as large lobulated exophytic ileal LMS measuring 10.8×11×14.7 cm involving multiple small bowel loops and abutting right iliac vessels and uterus. Patient's clinical course was complicated with COVID-19 positivity, deep vein thrombosis and pulmonary thromboembolism. She was managed by preoperative anticoagulation followed by resection of the tumour with end ileostomy.


Assuntos
COVID-19 , Tumores do Estroma Gastrointestinal , Neoplasias Intestinais , Leiomiossarcoma , Adulto , Feminino , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Neoplasias Intestinais/diagnóstico , Neoplasias Intestinais/cirurgia , Intestino Delgado/diagnóstico por imagem , Intestino Delgado/cirurgia , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/cirurgia , SARS-CoV-2
9.
Clin Med (Lond) ; 21(5): e533-e534, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34507941

RESUMO

We present a rare case of pulmonary artery pseudoaneurysm formation in leiomyosarcoma metastases with evidence of acute bleeding and subsequent interventional radiological management.


Assuntos
Falso Aneurisma , Leiomiossarcoma , Neoplasias Uterinas , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Artéria Pulmonar/diagnóstico por imagem
10.
J Med Case Rep ; 15(1): 465, 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34544483

RESUMO

BACKGROUND: Up to 30% of all scrotal masses are sarcomas. Leiomyosarcoma of the scrotal wall is rare, and its clinical significance and prognosis have not been well defined, since the most reported cases have little or no follow-up. CASE PRESENTATION: We report a 45-year-old Caucasian man who was admitted with a firm, nontender, mobile scrotal wall mass from 15 months ago. Laboratory data including testicular tumor markers were within normal range, and transscrotal ultrasonography revealed an oval-shaped, hypoechogenic, solid mass with blood flow and well-defined border. Histopathologic examination and immunohistochemistry staining, following surgical excision, were in favor of malignant leiomyosarcoma. CONCLUSION: Here we describe the morphological features and immunohistochemical presentations of the tumor and the patient's relatively long-term follow-up.


Assuntos
Neoplasias dos Genitais Masculinos , Leiomiossarcoma , Neoplasias dos Genitais Masculinos/diagnóstico por imagem , Neoplasias dos Genitais Masculinos/cirurgia , Humanos , Imuno-Histoquímica , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/cirurgia , Masculino , Pessoa de Meia-Idade , Escroto/diagnóstico por imagem , Escroto/cirurgia , Ultrassonografia
11.
Acta Cytol ; 65(6): 541-548, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34569497

RESUMO

Myxoid leiomyosarcoma (MLS) is a rare variant of leiomyosarcoma, with most cases occurring in the uterus. A case of MLS arising in the periosteal region of the tibia, mimicking extraskeletal myxoid chondrosarcoma (EMC), is described. The evaluation included histological and cytological comparison with EMC. The patient was a 77-year-old man with a palpable mass at the anterior aspect of the right lower leg. After diagnosis by cytopathology and biopsy examination, a wide resection was performed. The resulting cytological smears were composed primarily of spindle-shaped tumor cells in a myxoid and hemorrhagic background. Histologically, the tumor showed abundant myxoid matrix and tumor cells proliferating in a cord-like to reticular pattern, exhibiting a lace-like arrangement that mimicked EMC. Although immunohistochemical findings suggested leiomyosarcoma, a diagnosis of EMC eventually was excluded by the lack of a split signal when assessed for a rearrangement of NR4A3 by chromogenic in situ hybridization. Despite histological similarity to EMC, characteristic cytological findings of EMC such as epithelioid structures with a cord-like pattern and chondroblast-like lacunar structures were not observed in the smears of this patient's MLS. We propose that cytopathological examination of bone and soft tissue lesions is useful as a diagnostic tool in similar cases. A total diagnostic workup, including clinical, radiographic, cytopathological, histopathological, and molecular findings, is needed to ensure an accurate final diagnosis and to reduce diagnostic error.


Assuntos
Neoplasias Ósseas/patologia , Condrossarcoma/patologia , Leiomiossarcoma/patologia , Neoplasias de Tecido Conjuntivo e de Tecidos Moles/patologia , Tíbia/patologia , Idoso , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/genética , Neoplasias Ósseas/química , Neoplasias Ósseas/genética , Neoplasias Ósseas/cirurgia , Condrossarcoma/química , Condrossarcoma/genética , Proteínas de Ligação a DNA/genética , Diagnóstico Diferencial , Rearranjo Gênico , Humanos , Imuno-Histoquímica , Hibridização In Situ , Leiomiossarcoma/química , Leiomiossarcoma/genética , Leiomiossarcoma/cirurgia , Masculino , Neoplasias de Tecido Conjuntivo e de Tecidos Moles/química , Neoplasias de Tecido Conjuntivo e de Tecidos Moles/genética , Valor Preditivo dos Testes , Receptores de Esteroides/genética , Receptores dos Hormônios Tireóideos/genética , Tíbia/química , Tíbia/cirurgia
12.
Clin J Gastroenterol ; 14(6): 1779-1784, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34558055

RESUMO

A 77-year-old female patient consulted our hospital for an abnormal shadow observed on chest X-ray. Computed tomography revealed the shadow of a mass in the right lower lung lobe and two shadows of masses in the pancreatic head and body. 18F-fluorodeoxyglucose-positron emission tomography showed an intense uptake only in the fields corresponding to these three masses. Each mass was diagnosed as leiomyosarcoma by transcutaneous needle biopsy of the pulmonary mass and endoscopic ultrasound-guided fine-needle aspiration of the pancreatic masses. The primary site was the lung because the pulmonary lesion was solitary, and no tumor was found in other organs. In English language literature, a case of primary pulmonary leiomyosarcoma with metastasis solely to the pancreas has not yet been reported to the best of our knowledge.


Assuntos
Leiomiossarcoma , Neoplasias Pancreáticas , Idoso , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Feminino , Humanos , Leiomiossarcoma/diagnóstico por imagem , Pulmão , Pâncreas/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem
13.
Ann Ital Chir ; 92: 419-423, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34524112

RESUMO

AIM: Sarcomas are rare tumors representing 0.7% of all cancer cases in adults, and approximately 15-20% of those occur in the retroperitoneum. Diagnosis is usually late. Liposarcoma and leiomyosarcoma are the most frequent forms. Liposarcomas have high local recurrence rates (35-60%) and a high metastasis rate only if dedifferentiated (30%), whereas leiomyosarcoma has a high distant metastasis rate (60%) and a low local recurrence rate (20%). CASE REPORT: A case report of multifocal synchronous well-differentiated liposarcoma is presented. The patient underwent a surgical excision of all the masses. The postoperative period was uneventful, with a postoperative hospital stay of 9 days. The patient underwent systemic chemotherapy and clinical and instrumental follow-up. A relapse of the disease was observed 24 months after surgery: a 25 mm mass was diagnosed close to the pancreatic stump, as well as a 24 mm mass in the left upper abdominal quadrant. The patient underwent a second laparotomy: recurrent lesions were identified and excised en-bloc with the body of the pancreas. CONCLUSION: Surgery is the gold standard of therapy. The best chance for curative resection is at the time of the first diagnosis of the disease. Compartmental surgery is a macroscopically complete resection through en bloc excision of adjacent structures, even if not clearly infiltrated. Many controversies still exist in the treatment of retroperitoneal liposarcoma, such as the extent of primary and secondary resections, the benefit of chemotherapy and radiation therapy, and when these treatments should be delivered. KEY WORDS: Compartmental surgery, Liposarcoma, Surgery, Retroperitoneal sarcoma.


Assuntos
Leiomiossarcoma , Lipossarcoma , Neoplasias Retroperitoneais , Adulto , Humanos , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia
14.
Vet Surg ; 50(7): 1434-1442, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34347882

RESUMO

OBJECTIVES: The primary objective of this study was to describe the clinical management and surgical treatment of production size pigs (PrdP) with uterine neoplasia. A secondary objective was to compare tumor diagnoses as well as short- and long-term survival between PrdP and a published report of pot-bellied pigs (PBP) following surgical intervention. STUDY DESIGN: Retrospective clinical study. ANIMALS OR SAMPLE POPULATION: Client-owned PrdP (n = 13) treated with exploratory celiotomy ±ovariohysterectomy for uterine neoplasia. METHODS: Medical records from a university hospital were reviewed for historical treatment, presenting complaint, clinical signs, diagnostics, surgical intervention, pathology, and outcome. An online owner survey was performed for follow-up. The novel PrdP cohort was compared to a previously published PBP cohort for differences in tumor diagnoses, surgical complications, and survival. Descriptive statistics, Fischer's exact tests and odds ratios were reported. RESULTS: PrdP were affected by uterine leiomyoma (4/11), leiomyosarcoma (2/11), adenoma (1/11), adenocarcinoma (3/11), and carcinosarcoma (1/11) with no difference in tumor types between PrdP and PBP. PrdP surviving to hospital discharge (6/13) survived at least 1 year postoperatively, with median follow-up of 16 months (14-60 months). PrdP were less likely than PBP to survive in the short-term despite similar frequencies of marked intraoperative hemorrhage. PrdP and PBP had comparable rates of long-term survival following hospital discharge. CONCLUSION: PrdP are afflicted by similar uterine neoplasia diagnoses as PBP, but they have lower rates of short-term survival to hospital discharge with surgical treatment. CLINICAL SIGNIFICANCE/IMPACT: PrdP have a guarded prognosis for survival to hospital discharge when operated for uterine neoplasia.


Assuntos
Leiomiossarcoma , Doenças dos Suínos , Animais , Feminino , Hemorragia/veterinária , Histerectomia/veterinária , Leiomiossarcoma/veterinária , Estudos Retrospectivos , Suínos , Doenças dos Suínos/cirurgia
15.
Biomed Res Int ; 2021: 2106972, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34395610

RESUMO

Leiomyosarcoma is an uncommon soft tissue sarcoma that composed of malignant mesenchymal cells with distinct features of the smooth muscle lineage. Typically affects the uterus and gastrointestinal tract, it can rarely be seen in large blood vessels, lymphatic and glandular duts, the mesentery, the omentum, retroperitoneum, and limbs. Occurrence is particularly rare in the limb region. Retrospective study based on patient records and postoperative pathological histological features. Four patients with limb leiomyosarcoma that were operated between 2016 and 2020 were included, three of them arising in the subcutis of the thigh region and one in cubitus. Extend resection with satisfactory outcomes is reported. Pathological examination showed that masses were composed of a fascicular arrangement of hyperchromatic spindle-shaped cells, characterized by the proliferation of epithelioid cells with eosinophilic cytoplasm for epithelioid leiomyosarcoma. Leiomyosarcomas that arise in the soft tissue, although rare, should be differentiated from other lesions, such as neurilemoma, neurofibroma, liomyoma,lipomyoma, synoviosarcoma, rhabdomyosarcoma, malignant fibrous histiotoma, and malignant neurinoma.


Assuntos
Extremidades/patologia , Leiomiossarcoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Adulto , Idoso , Extremidades/diagnóstico por imagem , Extremidades/cirurgia , Feminino , Humanos , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/patologia , Resultado do Tratamento , Adulto Jovem
16.
J Equine Vet Sci ; 104: 103718, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34416982

RESUMO

A 10 year-old endurance Arabian mare was presented with an invasive, firm, multilobulated mass at the left ventral face of the tongue. The mare had a history of four months of ptyalism, dysphagia, severe halitosis, and dysmastication. The Evaluation of the horse included physical and oral examination, complete blood count and serum biochemistry profile, computed tomography evaluation of the head, and histopathology of the mass. The computerized tomography (CT) head scan showed the homogeneous mass in the oral cavity confirming the degree of invasion on the tongue, as well as a small mineral focus at the left dorsal mandibular border and increased density of the submandibular lymph nodes. At necropsy, gross findings in the oral cavity revealed an irregular, nodular and partially ulcerated mass at the level of the body of the tongue in the ventral aspect, with a size of approximately 10 × 15 × 8 cm. Histologically, the tongue revealed a neoplastic process of mesenchymal muscle origin. The tumor cells showed distinctive morphological and architectural patterns in some areas. An immunohistochemistry panel was done yielding a positive reaction for Calponin and Desmin, confirming diagnostics of as a soft tissue leiomyosarcoma in the tongue. Immunohistochemistry results, in combination with histopathologic morphology, were suggestive of a leiomyosarcoma originating in the perivascular wall tissue. Oral leiomyosarcoma are very rare in veterinary medicine, and to the authors' knowledge, this is the first case report to utilize histopathology, immunohistochemistry and imaginology to describe oral leiomyosarcoma in a horse.


Assuntos
Doenças dos Cavalos , Leiomiossarcoma , Neoplasias da Língua , Animais , Feminino , Doenças dos Cavalos/diagnóstico , Cavalos , Imuno-Histoquímica , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/veterinária , Tomografia Computadorizada por Raios X/veterinária , Língua/diagnóstico por imagem , Neoplasias da Língua/diagnóstico , Neoplasias da Língua/veterinária
17.
Abdom Radiol (NY) ; 46(11): 5284-5296, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34415408

RESUMO

Primary leiomyosarcoma of the inferior vena cava (IVC) is a rare soft tissue sarcoma associated with poor prognosis. Patients are often asymptomatic or present with nonspecific abdominal symptoms, which delays initial diagnosis and contributes to poor oncologic outcome. Key imaging modalities include ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI). Characteristic imaging features include imperceptible caval lumen, dilation of the IVC, heterogeneous enhancement of the tumor, and development of extensive collateral circulation. Surgical resection is the mainstay of treatment, while chemotherapy and/or radiation may serve as therapy adjuncts. This article reviews the pathology, clinical findings, imaging features and management of IVC leiomyosarcoma.


Assuntos
Leiomiossarcoma , Sarcoma , Humanos , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/cirurgia , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Veia Cava Inferior/diagnóstico por imagem
18.
BMC Surg ; 21(1): 326, 2021 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-34392834

RESUMO

BACKGROUND: Retroperitoneal vascular leiomyosarcoma (RVLMS) is an extremely rare disease in clinical practice, and it has poor prognosis. This article is to explore the diagnosis and treatment of RVLMS and present our experience. METHODS: Data of RVLMS patients were continuously collected in our hospital from August 2018 to February 2020: two males and two females with a median age of 56 (min-max = 33-61) years were included. Patients in whom paraganglioma could not be excluded were asked to take phenoxybenzamine before surgery. A multi-disciplinary team (MDT) meeting had been held and surgery was recommended. The operation procedures varied based on the tumor location, shape, and stage, and the core steps were "exposure of the retroperitoneum and tumor, identification of vital blood vessels, blocking the bloodstream, complete removal of the tumor and tumor thrombus, and release of blood flow". A Satinsky clamp was used to partially block the blood vessels. Follow-up was conveyed by revisits and phone calls. RESULTS: One patient underwent open surgery, and three patients underwent laparoscopic surgery, one of whom underwent conversion to open surgery. The procedures were finished successfully, with a median operative time of 314.5 (min-max = 224-467) mins. The median amount of intraoperative bleeding was 550 (min-max = 200-1500) ml, and three patients had transfusion during the operation. The mass was irregular in shape, with a median maximum size of 7.45 (min-max = 4.2-10.7) cm, and the pathological examination confirmed RVLMS, which has spindle-shape, high mitotic activity and atypia. One week after the operation, the median serum creatinine level was 85 (min-max = 70-99) µmol/L. The median follow-up time was 16 (min-max = 13-21) months, and 1 case reported asymptomatic recurrence. CONCLUSION: Uncharacteristic manifestations and imaging features contribute to the problematic diagnosis of RVLMS. Comprehensive preoperative evaluation and careful surgical planning are essential. Multicenter research is needed in the future to reach a dominant consensus.


Assuntos
Laparoscopia , Leiomiossarcoma , Neoplasias Retroperitoneais , Adulto , Feminino , Humanos , Leiomiossarcoma/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Espaço Retroperitoneal , Estudos Retrospectivos
19.
Artigo em Inglês | MEDLINE | ID: mdl-34360112

RESUMO

Carcinosarcoma, leiomyosarcoma, melanoma and carcinoid as primary tumors in the ovary are extremely rare. In this paper, the authors reviewed the literature from 2010 to 2021, based on specific criteria, to analyze the treatment of these rare ovarian neoplasms. We also aimed to verify whether modern therapies have been found in recent years. For this article, 80 papers were finally selected. The vast majority of the articles were clinical case reports. Despite single mentions of new potential pharmacological treatments, surgery (radical or fertility-sparing) is definitely the mainstay of treatment. There are currently no treatment guidelines for these tumors. A review of the literature has revealed the use of various adjuvant treatments. We, therefore, believe that a more detailed understanding of the biology of these tumors is necessary in order to find new target points for treatment. We would like to emphasize the importance of creating an international database of rare ovarian tumors which would make it possible to gather data from various oncological centers and enable further research into these neoplasms.


Assuntos
Tumor Carcinoide , Carcinossarcoma , Leiomiossarcoma , Melanoma , Neoplasias Ovarianas , Carcinossarcoma/terapia , Feminino , Humanos , Leiomiossarcoma/terapia , Melanoma/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico
20.
BMJ Case Rep ; 14(8)2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34433536

RESUMO

Leiomyosarcoma is a rare aggressive malignant mesenchymal tumour, accounting for 1% of all uterine malignancies. It spreads rapidly through the intraperitoneal and haematogenous pathways. It is often diagnosed postoperatively following myomectomy, hysterectomy or supracervical hysterectomy for presumed benign disease. It has a predilection for perimenopausal women with a median age of 50 years. Individuals may describe symptoms of vaginal or abdominal pressure. Physical examination may reveal a large palpable pelvic mass, which may haemorrhage. Surgery remains the mainstay of treatment. Hysterectomy and a bilateral salpingo-oophorectomy may be considered, depending on the individual's menopausal status. Ovarian preservation can be considered in young patients. Adjuvant systemic treatment and radiotherapy are of no benefit. Gemcitabine/docetaxel and doxorubicin have shown benefit in the treatment of advanced or recurrent disease. The authors present the case of a 44-year-old woman with lower abdominal pain, vaginal bleeding and a uterine fibroid. Laboratory investigations confirmed a leucocytosis, neutrophilia and a thrombocythaemia. Further investigation with an MRI pelvis showed a very large, heterogeneous, malignant appearing pelvic mass compressing the right ureter and it appeared uterine in nature. Her staging CT showed multiple lung metastases. The diagnosis of uterine leiomyosarcoma was subsequently established. Due to the aggressive behaviour of this sarcoma subtype, novel early detection strategies and targeted therapies are required.


Assuntos
Leiomioma , Leiomiossarcoma , Neoplasias Pélvicas , Miomectomia Uterina , Neoplasias Uterinas , Adulto , Feminino , Humanos , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/terapia , Pessoa de Meia-Idade , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/terapia
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