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1.
BMJ Case Rep ; 16(1)2023 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-36639199

RESUMO

Pulmonary artery sarcoma is a rare disease with only a handful of cases reported. It is histologically classified as leiomyosarcoma, spindle cell sarcoma, fibrous histiocytoma or undifferentiated sarcoma. The disease is mostly misdiagnosed as pulmonary thromboembolism and carries a grim prognosis with an average survival of only a few months. Misdiagnosis often results in patients being treated inappropriately and diagnosed in later stages of the disease. This delay in diagnosis can be associated with significant mortality in the setting of an already poor prognosis. Early aggressive surgery targeting complete surgical resection is the standard treatment. Chemotherapy and radiation therapy have been tried with variable outcomes. Given the aggressive nature of pulmonary artery sarcoma, regular post-surgery follow-up is indicated.


Assuntos
Leiomiossarcoma , Neoplasias Pulmonares , Embolia Pulmonar , Sarcoma , Neoplasias Vasculares , Humanos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/patologia , Neoplasias Vasculares/patologia , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/patologia , Sarcoma/patologia , Leiomiossarcoma/patologia , Neoplasias Pulmonares/patologia
2.
Kyobu Geka ; 75(13): 1125-1129, 2022 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-36539230

RESUMO

A 70-year-old man was referred for an abnormal chest shadow. Enhanced computed tomography (CT) revealed a well-circumscribed lung tumor of 53 mm in diameter in the left upper lobe with slight enhancement. Positron emission tomography-CT showed a high maximum standardized uptake value for the tumor but no metastasis in the lymph nodes or other organs. Although a definitive diagnosis could not be made by transbronchial biopsy, the tumor was highly suspected to be malignant based on the radiological findings, and a left upper lobectomy with mediastinal lymph nodes dissection was performed for definitive diagnosis and treatment. A pathological examination showed the tumor to be composed of mitotic spindle-shaped cells, which were positive for α-smooth muscle actin, desmin, and caldesmon. The MIB-1 labelling index was 60~70%. According to these pathologic findings, the tumor was identified as a leiomyosarcoma. Metastases to the skin of chest and hilar lymph nodes were noted six months after the surgery for which radiotherapy was performed.


Assuntos
Leiomiossarcoma , Neoplasias Pulmonares , Masculino , Humanos , Idoso , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/cirurgia , Leiomiossarcoma/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/patologia , Pulmão/patologia , Mediastino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
3.
Cells ; 11(23)2022 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-36497061

RESUMO

Uterine leiomyosarcoma (uLMS) is the most frequent subtype of uterine sarcoma that presents a poor prognosis, high rates of recurrence, and metastasis. Currently, the molecular mechanism of the origin and development of uLMS is unknown. Class I histone deacetylases (including HDAC1, 2, 3, and 8) are one of the major classes of the HDAC family and catalyze the removal of acetyl groups from lysine residues in histones and cellular proteins. Class I HDACs exhibit distinct cellular and subcellular expression patterns and are involved in many biological processes and diseases through diverse signaling pathways. However, the link between class I HDACs and uLMS is still being determined. In this study, we assessed the expression panel of Class I HDACs in uLMS and characterized the role and mechanism of class I HDACs in the pathogenesis of uLMS. Immunohistochemistry analysis revealed that HDAC1, 2, and 3 are aberrantly upregulated in uLMS tissues compared to adjacent myometrium. Immunoblot analysis demonstrated that the expression levels of HDAC 1, 2, and 3 exhibited a graded increase from normal and benign to malignant uterine tumor cells. Furthermore, inhibition of HDACs with Class I HDACs inhibitor (Tucidinostat) decreased the uLMS proliferation in a dose-dependent manner. Notably, gene set enrichment analysis of differentially expressed genes (DEGs) revealed that inhibition of HDACs with Tucidinostat altered several critical pathways. Moreover, multiple epigenetic analyses suggested that Tucidinostat may alter the transcriptome via reprogramming the oncogenic epigenome and inducing the changes in microRNA-target interaction in uLMS cells. In the parallel study, we also determined the effect of DL-sulforaphane on the uLMS. Our study demonstrated the relevance of class I HDACs proteins in the pathogenesis of malignant uLMS. Further understanding the role and mechanism of HDACs in uLMS may provide a promising and novel strategy for treating patients with this aggressive uterine cancer.


Assuntos
Leiomiossarcoma , Neoplasias Uterinas , Feminino , Humanos , Histona Desacetilases/metabolismo , Leiomiossarcoma/tratamento farmacológico , Leiomiossarcoma/genética , Leiomiossarcoma/patologia , Neoplasias Uterinas/tratamento farmacológico , Neoplasias Uterinas/genética , Neoplasias Uterinas/patologia , Inibidores de Histona Desacetilases/farmacologia , Inibidores de Histona Desacetilases/uso terapêutico , Miométrio/metabolismo
4.
Taiwan J Obstet Gynecol ; 61(6): 935-940, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36427995

RESUMO

Uterine smooth muscle tumor of uncertain malignant potential is a subtype of uterine smooth muscle neoplasms. It is characterized by distinct pathologic findings with morphologic features intermediate between those of benign leiomyoma and malignant leiomyosarcoma. Clinically, STUMP is rare and its clinical picture is comparable to that of leiomyoma, with diagnosis typically being made postoperatively. Most patients with STUMP are uneventful after tumor resection. However, a small portion of patients may experience recurrence that may even lead to mortality. Given the uncommon occurrence of STUMP and the low frequency of malignant potential, currently there is still no standard guideline in treating patients with this disease and this can be challenging for physicians. Moreover, because cases are rarely available for study, investigating this tumor is difficult. Thus, matters such as the pathologic diagnostic criteria, strategy of clinical management, identification of prognostic factors, and the pathogenesis of this disease remain to be clarified. We collected and analyzed recently published case series studies of STUMP to obtain up-to-date clinical information. The current status of research in various basic and clinical aspects of this tumor was also reviewed.


Assuntos
Leiomioma , Leiomiossarcoma , Tumor de Músculo Liso , Neoplasias Uterinas , Feminino , Humanos , Tumor de Músculo Liso/diagnóstico , Tumor de Músculo Liso/cirurgia , Neoplasias Uterinas/patologia , Leiomioma/cirurgia , Leiomioma/patologia , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/cirurgia , Leiomiossarcoma/patologia , Útero/patologia
5.
J Cardiovasc Surg (Torino) ; 63(6): 649-663, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36239928

RESUMO

INTRODUCTION: Primary malignancies of the inferior vena cava comprise a heterogeneous group of histologic types that generally have a poor prognosis. Their rarity limits the data available in literature. There is no doubt that surgery is the mainstay treatment, but several questions about the best surgical strategy and multidisciplinary approach remain. The present review covers the surgical technique including the various reconstructive modalities and the available evidence about treatments and outcomes. EVIDENCE ACQUISITION: From literature research, we identified 15 case series of patients with primary inferior vena cava tumors, who underwent surgery from 2000 onwards. Details on resection and reconstruction, focusing on both oncologic and surgical issues, were analyzed and summarized. EVIDENCE SYNTHESIS: Inferior vena cava malignancies can be either primary or secondary. The main primary tumor is leiomyosarcoma, while retroperitoneal liposarcomas and renal carcinomas are the main causes of secondary invasion. The outcomes of primary inferior vena cava leiomyosarcoma are linked to its metastatic risk. However, long-term survivors do exist. The factors that determine the surgical strategy include extent of the disease, which segment is involved, additional organ resection needed, presence of collateral venous circulation. After a partial resection, the wall defect can be repaired primarily or by patch interposition. After a circumferential resection, the first decision is whether to reconstruct the vascular continuity. There are several options, including prosthetic (polytetrafluoroethylene and Dacron) or biological materials (from autologous venous grafts to cryopreserved aortic grafts). CONCLUSIONS: Tumors involving inferior vena cava are rare and challenging. A specific expertise is required to select the most appropriate surgical resection and reconstruction for the single patients in order to maximize the chance of cure alongside the quality of life.


Assuntos
Leiomiossarcoma , Neoplasias Retroperitoneais , Humanos , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/cirurgia , Veia Cava Inferior/patologia , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/cirurgia , Leiomiossarcoma/patologia , Qualidade de Vida , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Neoplasias Retroperitoneais/patologia , Veias
6.
JCO Precis Oncol ; 6: e2200087, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36240470

RESUMO

PURPOSE: Radiation-associated sarcomas (RAS) are rare but aggressive malignancies. We sought to characterize the histology-specific presentation and behavior of soft tissue RAS to improve individualized prognostication. METHODS: A single-institutional prospectively maintained database was queried for all patients with primary, nonmetastatic RAS treated with surgical resection from 1982 to 2019. Patients presenting with the five most common RAS histologies were propensity-matched to those with sporadic tumors of the same histology. Incidence of disease-specific death (DSD) was modeled using cumulative incidence analyses. RESULTS: Among 259 patients with RAS, the five most common histologies were malignant peripheral nerve sheath tumor (MPNST; n = 19), myxofibrosarcoma (n = 20), leiomyosarcoma (n = 24), undifferentiated pleomorphic sarcoma (UPS; n = 55), and angiosarcoma (AS; n = 62). DSD varied significantly by histology (P = .002), with RAS MPNST and UPS having the highest DSD. In unadjusted analysis, RAS MPNST was associated with increased DSD compared with sporadic MPNST (75% v 38% 5-year DSD, P = .002), as was RAS UPS compared with sporadic UPS (49% v 28% 5-year DSD, P = .004). Unadjusted DSD was similar among patients with RAS AS, leiomyosarcoma, or myxofibrosarcoma and sporadic sarcoma of the same histology. After matching RAS to sporadic patients within each histology, DSD only differed between RAS and sporadic MPNST (83% v 46% 5-year DSD, P = .013). Patients with RAS AS presented in such a distinct manner to those with sporadic AS that a successful match was not possible. CONCLUSION: The aggressive presentation of RAS is histology-specific, and DSD is driven by RAS MPNST and UPS histologies. Despite the aggressive presentation, standard prognostic factors can be used to estimate risk of DSD among most RAS. In MPNST, radiation association should be considered to independently associate with markedly higher risk of DSD.


Assuntos
Fibrossarcoma , Histiocitoma Fibroso Maligno , Leiomiossarcoma , Neurofibrossarcoma , Sarcoma , Neoplasias de Tecidos Moles , Adulto , Histiocitoma Fibroso Maligno/patologia , Humanos , Leiomiossarcoma/patologia , Sarcoma/patologia
7.
J Vet Med Sci ; 84(12): 1579-1584, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36261364

RESUMO

A 12-year-old female Himalayan cat underwent an ovariohysterectomy to remove an intra-abdominal mass. Histologic examination using immunohistochemical staining revealed that the mass was comprised of epithelial and mesenchymal components. Within the lesion, multinucleated giant cells (MGCs) were observed diffusely. MGCs were positive for vimentin and Iba-1 and negative for cytokeratin AE1/AE3 and CD204. In addition, MGCs were negative for Ki-67, indicating nonneoplastic cells. Osteoclast-like MGC (OLMGC) phenotype with tartrate-resistant acid phosphatase positivity was also seen. These findings suggested that the uterine tumor was carcinosarcoma with OLMGCs. Uterine tumors in humans, such as leiomyosarcoma and carcinosarcoma, with OLMGC infiltration, are well-known pathologic entities; however, they are rare in animals and to our knowledge, have not been previously reported in cats.


Assuntos
Carcinossarcoma , Doenças do Gato , Leiomiossarcoma , Neoplasias Uterinas , Animais , Gatos , Feminino , Carcinossarcoma/veterinária , Carcinossarcoma/patologia , Doenças do Gato/cirurgia , Doenças do Gato/patologia , Células Gigantes/patologia , Leiomiossarcoma/patologia , Leiomiossarcoma/veterinária , Osteoclastos , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/veterinária , Neoplasias Uterinas/patologia
8.
Am J Case Rep ; 23: e937317, 2022 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-36219592

RESUMO

BACKGROUND Leiomyosarcoma is a common tumor found in soft tissue. In relation to the vascular system, leiomyosarcoma appears as the most common malignancy characterized by poor prognosis. Leiomyosarcomas of the leg large vessels often occur late, and their appearance can imitate vein thrombosis with symptoms such as soft tissue swelling or mild pain, and can be misdiagnosed. Peripheral vascular leiomyosarcomas are rare. Especially leiomyosarcomas of the great saphenous vein are uncommon. The tumors develop on the media basis and grow from endovascular to exovascular order. Distant metastasis can be identified and worsen prognosis. CASE REPORT We present a case of a 61-year-old female patient with varicose vein disease complicated by recurrent superficial vein thrombosis. After 2 months of conservative treatment, while waiting for admission to the department of surgery, she developed additional symptoms. Clinical examination on the day of admission revealed several tumors along and near the great saphenous vein on the left limb below the knee. The diagnosis of leiomyosarcoma was confirmed after the surgery, involving excision of the saphenous vein, including tumors formed on its course. Preoperative clinical and ultrasound findings did not suggest malignancy. CONCLUSIONS Leiomyosarcoma of the great saphenous vein is an extraordinarily rare tumor originating from the middle layer of the vessel, mimicking unspecific symptoms and complicating and delaying diagnosis. In every case of vascular or perivascular lesions, a detailed examination and diagnosis it is required, and even unlikely clinical scenarios should be considered.


Assuntos
Leiomiossarcoma , Neoplasias de Tecidos Moles , Neoplasias Vasculares , Trombose Venosa , Feminino , Humanos , Perna (Membro)/patologia , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/patologia , Leiomiossarcoma/cirurgia , Pessoa de Meia-Idade , Neoplasias de Tecidos Moles/complicações , Neoplasias Vasculares/patologia , Trombose Venosa/diagnóstico , Trombose Venosa/etiologia
9.
BMC Cancer ; 22(1): 1050, 2022 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-36207687

RESUMO

BACKGROUND: Uterine sarcomas are rare and aggressive gynaecologic malignancies, characterized by a relatively high recurrence rate and poor prognosis. The aim of this study was to investigate the clinicopathological features and explore the prognostic factors of these malignancies. METHODS: This was a single-institution, retrospective study. We reviewed the medical records of 155 patients with pathologically confirmed uterine sarcomas including uterine leiomyosarcoma (ULMS), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), undifferentiated uterine sarcoma (UUS) and adenosarcoma (AS) between 2006 and 2022. A total of 112 patients who underwent surgery between January 2006 and April 2019 were included in the survival analysis. The current study recorded the clinicopathological, treatment and outcome data to determine clinical characteristics and survival. RESULTS: The most common histopathological type was ULMS (63/155, 40.64%), followed by LG-ESS (56/155, 36.13%) and HG-ESS (16/155, 10.32%). The mean age at diagnosis of all patients was 49.27±48.50 years and 32.90% (51/155) of patients were postmenopausal. Fifteen patients underwent fast-frozen sectioning, 63(54.78%) were diagnosed with malignancy, 29(25.22%) were highly suspected of malignancy that needed further clarification and 23(14.84%) were diagnosed with benign disease. A total of 124(80%) patients underwent total hysterectomy (TH) and salpingo-oophorectomy. Multivariate analyses showed that histological type and tumour size were independent prognostic factors both for overall survival (OS) (p<0.001 and P=0.017, respectively) and progression-free survival (PFS) (p<0.001 and P=0.018, respectively). Tumour stage was only significantly associated with PFS (P=0.002). Elevated preoperative NLR, PLR and postmenopausal status were significantly correlated with shorter PFS and OS in univariate analysis, but no statistically significant difference was found in multivariate analysis. CONCLUSIONS: In patients with uterine sarcoma, in comparison to LMS and LG-ESS, UUS and HG-ESS tend to present as more aggressive tumour with poorer outcomes. Furthermore, larger tumour (>7.5 cm) were an important predictor of shorter PFS and OS.


Assuntos
Neoplasias do Endométrio , Tumores do Estroma Endometrial , Leiomiossarcoma , Neoplasias Pélvicas , Sarcoma do Estroma Endometrial , Sarcoma , Neoplasias de Tecidos Moles , Neoplasias Uterinas , Neoplasias do Endométrio/patologia , Feminino , Humanos , Leiomiossarcoma/patologia , Prognóstico , Estudos Retrospectivos , Sarcoma/diagnóstico , Sarcoma/cirurgia , Sarcoma do Estroma Endometrial/diagnóstico , Sarcoma do Estroma Endometrial/cirurgia , Neoplasias Uterinas/patologia
10.
Indian J Pathol Microbiol ; 65(4): 938-941, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36308213

RESUMO

Primary leiomyosarcoma (PLMS) of the ovary is extremely rare tumors comprising 1% of ovarian tumors. About 3% of all ovarian malignancies are primary ovarian sarcomas. Only 72 cases have been reported till date. A 57-year-old postmenopausal female presented with abdominal pain for the last 6 months. Ultrasonography and MRI revealed a heterogeneously enhancing solid lobulated mass in the left adnexa abutting the fundus of the uterus and bowel loops. The endometrial cavity was normal. Ovarian markers CA 125, CEA, CA 19.9, and all hematological parameters were within normal limits. LDH was near normal (284 IU/ml). The specimen was sent for frozen section and a diagnosis of malignant spindle cell lesion of ovary was rendered. Histopathology of the ovarian mass revealed intersecting fascicles of tumor cells consisting of ovoid to spindle-shaped cells having a moderate amount of cytoplasm. Bizarre and atypical cells were seen singly dispersed and in small aggregates along with the brisk mitotic activity. Focal areas of necrosis and hemorrhage were also noted. Immunohistochemistry showed strong positivity for smooth muscle actin and Caldesmon while focal positivity for Desmin and Epithelial Membrane Antigen (EMA) was noted. The lesion was negative for Inhibin, Calretinin, and CD 117 and S100. The final diagnosis of primary ovarian Leiomyosarcoma was given based on histopathology and Immunohistochemistry. PLMS of the ovary are rare incidental findings in postmenopausal women. These are highly malignant tumors and carry a poor prognosis. Hence, early diagnosis and surgical treatment with cytoreduction improve patient survival.


Assuntos
Leiomiossarcoma , Neoplasias Ovarianas , Feminino , Humanos , Pessoa de Meia-Idade , Leiomiossarcoma/patologia , Achados Incidentais , Imuno-Histoquímica , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/patologia
11.
Eur J Obstet Gynecol Reprod Biol ; 279: 94-101, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36308940

RESUMO

The clinical value of lymph node dissection remains controversial. This study aimed to evaluate the impact of lymphadenectomy on the prognosis of patients with uterine leiomyosarcomas (uLMS) or endometrial stromal sarcomas (ESS). PubMed, EMBASE and the Cochrane Library were searched for studies describing the prognostic significance of lymphadenectomy in uLMS or ESS. Quality assessments were performed using the Newcastle-Ottawa Scale, relative hazard ratios and a random-effects model. Thirty-two retrospective cohort studies that included 26,693 patients in total were enrolled. Patients with uLMS or low-grade ESS (LG-ESS) had no survival benefits from lymphadenectomy. However, patients with high-grade ESS (HG-ESS), did show survival benefits of lymphadenectomy, with no heterogeneity. No significant evidence of publication bias was found. Lymphadenectomy had little prognostic effect on patients with early-stage uLMS or LG-ESS. The best treatment for HG-ESS is early, comprehensive hysterectomy with lymph node dissection.


Assuntos
Neoplasias do Endométrio , Leiomiossarcoma , Neoplasias Pélvicas , Sarcoma do Estroma Endometrial , Neoplasias Uterinas , Feminino , Humanos , Sarcoma do Estroma Endometrial/cirurgia , Sarcoma do Estroma Endometrial/patologia , Leiomiossarcoma/cirurgia , Leiomiossarcoma/patologia , Prognóstico , Estudos Retrospectivos , Neoplasias do Endométrio/patologia , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/patologia , Excisão de Linfonodo , Neoplasias Pélvicas/cirurgia
12.
Future Oncol ; 18(29s): 3-11, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36189762

RESUMO

An international collaborative project set up as a 'priority setting partnership' used a questionnaire to capture the views of patients, carers and clinicians about the sarcoma research agenda. Responses from 25 patients with leiomyosarcoma (LMS) in eight countries provided useful insight from the patient's perspective. Unmet needs identified by patients were in the areas of: LMS-specific trial design; exploring new therapeutic avenues; avoiding morcellation; exploring the immune system in LMS; investigating circulating tumor DNA; implementing molecular characterization of LMS; conducting basic research and a translational pipeline; evaluating imaging modalities; improving early diagnosis; identifying patient-reported outcomes; improving communication, information and support; and addressing survivorship and end-of-life care. Each of the unmet needs is described in more detail.


Assuntos
DNA Tumoral Circulante , Leiomiossarcoma , Feminino , Humanos , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/terapia , Leiomiossarcoma/patologia , Ensaios Clínicos como Assunto , Projetos de Pesquisa
13.
Head Neck ; 44(12): 2886-2903, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36069494

RESUMO

We investigated the clinical features, treatment, and prognosis of laryngeal leiomyosarcoma (LLMS) and Epstein-Barr virus-associated (EBV-associated) LMS. We report a case of EBV-associated LLMS in an adult patient with HIV infection. We also conducted a review of the English-language literature on LLMS and EBV-associated leiomyosarcoma. To the best of our knowledge, 62 cases of LLMS and EBV-associated leiomyosarcoma have been reported to date. Of patients with LLS, 18.9% had distant metastases and 17.0% had local recurrence. The overall 5-year survival rate was 64.0%. Distant metastases affected the survival of patients with LLMS (p = 0.04). EBV-positive patients had a low survival rate (p = 0.01). Among patients with EBV-associated LMS, 8.2% had distant metastases and recurrence and the overall 5-year survival rate was 50.0%. EBV-associated LLMS is rare. The EBV infection might be a poor prognostic factor of LLMS.


Assuntos
Infecções por Vírus Epstein-Barr , Infecções por HIV , Laringe , Leiomiossarcoma , Adulto , Humanos , Herpesvirus Humano 4 , Infecções por Vírus Epstein-Barr/complicações , Leiomiossarcoma/terapia , Leiomiossarcoma/patologia , Infecções por HIV/complicações , Laringe/patologia
14.
J Obstet Gynaecol Res ; 48(12): 3242-3251, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36114691

RESUMO

AIM: Histopathologic diagnosis of a subset of uterine smooth muscle tumors is challenging. We report a critical review regarding the clinicopathological point of view of 62 cases of subsequently recurred or metastasized leiomyoma. METHODS: Medical records and glass slides of 62 cases of uterine smooth muscle tumor diagnosed as leiomyoma, which subsequently recurred or metastasized, were critically reviewed by pathologists specializing in gynecologic pathology and oncology. RESULTS: In 47 (75.8%) of 62 cases, the diagnosis of leiomyoma was confirmed, including 11 intravascular leiomyomatosis (IVL) and benign metastasizing leiomyoma (BML). In 29 cases (46.8%) laparoscopic surgery was performed, of which morcellator without a bag was employed in 23 cases. Fifteen cases (24.2%) appeared to be underestimated and were re-classified as smooth muscle tumor of uncertain malignant potential (STUMP), leiomyosarcoma, or other malignant mesenchymal tumors. Recurrences in seven cases (11.3%) were interpreted to be a malignant transformation, and one STUMP recurred as STUMP. CONCLUSION: The recurrence or metastasis in cases of "leiomyoma" is attributed to iatrogenic or under-evaluation of primary tumors, although a subset of cases is a rare example of biological progression.


Assuntos
Leiomiomatose , Leiomiossarcoma , Mesenquimoma , Tumor de Músculo Liso , Neoplasias Uterinas , Feminino , Humanos , Tumor de Músculo Liso/patologia , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/patologia , Leiomiossarcoma/patologia , Leiomiomatose/cirurgia , Leiomiomatose/patologia , Estudos Multicêntricos como Assunto
15.
J Coll Physicians Surg Pak ; 32(9): 1205-1208, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36089722

RESUMO

Leiomyosarcoma malignant tumours arise from the smooth muscle cells. They are rapidly growing tumours with aggressive behaviour and poor prognosis. Although relatively rare, they pose a diagnostic challenge as they comprise a large spectrum of diagnostic entities. Herein, we describe three cases of leiomyosarcoma developing at unusual sites and posing diagnostic challenges. Our first case is a leiomyosarcoma developing at the post-burn scar site; the second case is of primary pulmonary leiomyosarcoma, and the third is retroperitoneal leiomyosarcoma. Histopathological examination is not sufficient all the time for making the diagnosis of leiomyosarcoma because there is a morphologic overlap with other malignancies. Immunohistochemistry acts as an adjunct to arrive at a definite diagnosis and hence, proves to be the most important ancillary technique in the diagnosis of such tumours. Though these tumours arise most commonly from the uterine smooth muscle, but rarely encountered at unusual sites posing diagnostic difficulties. Key Words: Leiomyosarcoma, Retroperitoneal, Pulmonary, Post-burn scar.


Assuntos
Leiomiossarcoma , Neoplasias Retroperitoneais , Cicatriz/patologia , Feminino , Humanos , Imuno-Histoquímica , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/patologia , Leiomiossarcoma/cirurgia , Músculo Liso , Neoplasias Retroperitoneais/patologia
16.
Pan Afr Med J ; 42: 135, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36060845

RESUMO

Coexisting primary pulmonary leiomyosarcoma (PPL) with pulmonary Aspergillosis in immunocompetent patients is a rare occurrence. Here, we presented a 54-year-old woman presented with a dry cough for two months. Bronchoscopy revealed pulmonary aspergillosis. The patient was treated with antifungal therapy for one month without improvement. To evaluate further, a chest computed tomography (CT) scan showed a large heterogeneous enhancing mass in the lower lobe of the left lung with left atrium thrombosis. Computed tomography-guided biopsy was performed, and histopathology demonstrated the diagnosis of PPL. The metastasis workup staging showed multiple metastases in vertebrae, scapula, rib, and liver. The patient was treated with chemotherapy followed by tumor bed radiotherapy. Unfortunately, her general condition worsened, and she passed away with overall survival of fourteen months. In conclusion, clinicians should be alert to underlying malignant disease if airway Aspergillus infection is suspicious in patients without strong risk factors for invasive fungal infection.


Assuntos
Aspergilose , Leiomiossarcoma , Neoplasias Pulmonares , Aspergilose Pulmonar , Aspergilose/diagnóstico , Feminino , Humanos , Leiomiossarcoma/complicações , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/patologia , Pulmão/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Pessoa de Meia-Idade , Aspergilose Pulmonar/complicações , Aspergilose Pulmonar/diagnóstico , Aspergilose Pulmonar/patologia
17.
Curr Oncol ; 29(9): 6400-6418, 2022 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-36135073

RESUMO

Retroperitoneal tumors are extremely rare. More than 70% of primary retroperitoneal soft tissue tumors are malignant. The most common sarcomas in the retroperitoneum include liposarcomas and leiomyosarcoma, however other sarcomas, along with benign mesenchymal tumors, can occur. Sarcomas are a heterogenous group of tumors with overlapping microscopic features, posing a diagnostic challenge for the pathologist. Correct tumor classification has become important for prognostication and the evolving targeted therapies for sarcoma subtypes. In this review, the pathology of retroperitoneal soft tissue sarcomas is discussed, which is important to the surgical oncologist. In addition, less common sarcomas and benign mesenchymal tumors of the retroperitoneum, which may mimic sarcoma clinically and pathologically, are also discussed.


Assuntos
Leiomiossarcoma , Lipossarcoma , Neoplasias Retroperitoneais , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Leiomiossarcoma/patologia , Lipossarcoma/patologia , Neoplasias Retroperitoneais/patologia , Sarcoma/patologia
18.
Rev Fac Cien Med Univ Nac Cordoba ; 79(3): 294-297, 2022 09 16.
Artigo em Espanhol | MEDLINE | ID: mdl-36149076

RESUMO

Introduction: Primary skin leiomyosarcomas are infrequent neoplasms. They correspond to 2-3% of skin sarcomas and are most frequently located on the lower extremities, trunk and genitals. Methods: We present a case of a 73-year-old man with a 4-month evolution of foreskin leiomyosarcoma. The lesion was biopsied for histopathological study with HE and immunohistochemistry with smooth muscle actin, specific muscle actin, CD34, p63 and S-100 (-). Results: We observed a leiomyosarcoma of high histological grade and mitotic count. It was positive by immunohistochemistry for smooth muscle actin, while the other markers were negative. Surgical limits were compromised so a reoperation with wide margins of healthy tissue was necessary. Conclusion: The skin lesions should be removed all, without exception, since they can be neoplasms of variable biological behavior. The histological study must be complemented with immunohistochemistry to differentiate them from other neoplasms. For the prognosis, the histological grade, size, location and the possibility of resection with wide margins must be taken into account.


Introducción: Los leiomiosarcomas primarios de piel son neoplasias infrecuentes. Corresponden al 2-3 % de los sarcomas cutáneos y se localizan con mayor frecuencia en las extremidades inferiores, tronco y genitales. Método: Presentamos un caso de un varón de 73 años con un leiomiosarcoma en prepucio de 4 meses de evolución. Se le practicó biopsia excisional de la lesión para estudio histopatológico con HE e inmunohistoquímica con actina de músculo liso, actina muscular específica, CD34, p63 y S-100 (-). Resultados: Observamos un leiomiosarcoma de alto grado histológico y recuento mitótico. Presentó positividad por inmunohistoquímica para actina de músculo liso, en tanto que los otros marcadores fueron negativos. Los límites quirúrgicos estuvieron comprometidos por lo que fue necesaria una reintervención con amplios márgenes de tejido sano. Conclusión: Las lesiones de piel deben extirparse todas, sin excepción, ya que pueden tratarse de neoplasias de conducta biológica variable. El estudio histológico debe complementarse con inmunohistoquímica para diferenciarlas de otras neoplasias. Para el pronóstico se debe tener en cuenta el grado histológico, el tamaño, la localización y la posibilidad de resección con amplios márgenes.


Assuntos
Leiomiossarcoma , Actinas , Idoso , Prepúcio do Pênis/patologia , Humanos , Imuno-Histoquímica , Leiomiossarcoma/patologia , Leiomiossarcoma/cirurgia , Masculino , Prognóstico
19.
J Cancer Res Ther ; 18(4): 1186-1188, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36149185

RESUMO

Primary leiomyosarcoma kidney is a rare tumor with an aggressive nature. Leiomyosarcoma is one of the common histologic types of the sarcomas, comprising 60% of all sarcomas. Sarcomatoid renal cell carcinoma is a close differential of renal leiomyosarcoma as both tumors have spindle-shaped cells. The former has a more pleomorphic character with nuclear grade four, which can be differentiated on the basis of immunohistochemistry. Hence, the diagnosis of primary renal leiomyosarcoma poses a diagnostic challenge. One such case of renal leiomyosarcoma in a 45-year-old male is being discussed here.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Leiomiossarcoma , Sarcoma , Carcinoma de Células Renais/patologia , Diagnóstico Diferencial , Humanos , Rim/patologia , Neoplasias Renais/diagnóstico , Neoplasias Renais/patologia , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/patologia , Masculino , Pessoa de Meia-Idade , Sarcoma/patologia
20.
J Cancer Res Ther ; 18(4): 1205-1207, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36149191

RESUMO

Genitourinary system lymphomas comprise a small part of extra-nodal lymphomas (ENLs). ENLs of uterine origin are extremely rare and are often confused with gynecological malignancies. We present an 80-year-old female patient diagnosed with diffuse large B-cell lymphoma (DLBCL) with a single focus of the uterus. The patient's only complaint was abnormal uterine bleeding. Magnetic resonance imaging revealed an intramural-subserous-submucous multiple mass lesion with minimal contrast enhancement mimicking leiomyosarcoma. Diffuse pathological 18F-fluorodeoxyglucose uptake was detected in the entire uterus corpus and cervix on positron emission tomography/computed tomography (PET/CT) scanning. The pathology of the endocervical and endometrial curettage material obtained was DLBCL; the patient was diagnosed with ENL, and a single focus was the uterus. ENLs should be considered in the differential diagnosis of gynecological malignancies in patients with abnormal uterine bleeding. PET/CT is crucial in showing metabolically active spread areas in these patients.


Assuntos
Leiomiossarcoma , Linfoma Difuso de Grandes Células B , Linfoma não Hodgkin , Neoplasias Pélvicas , Neoplasias Uterinas , Idoso de 80 Anos ou mais , Feminino , Fluordesoxiglucose F18 , Humanos , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/patologia , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/patologia , Linfoma não Hodgkin/diagnóstico por imagem , Linfoma não Hodgkin/patologia , Neoplasias Pélvicas/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons/métodos , Compostos Radiofarmacêuticos , Hemorragia Uterina , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/patologia , Útero/patologia
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