Cases reported "Leiomyosarcoma"

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1/17. Extraperitoneal pelvic leiomyosarcoma. MR findings in a case.

    The magnetic resonance imaging (MRI) of a patient with nongynecologic pelvic leiomyosarcoma is presented. A retroperitoneal mass appeared under the broad ligaments, in the right paravesical and parametrial, lateral pararectal site. The mass leaned on the uterus and vagina. On MRI, the mass had solid structure, isointense on T1-weighted images, inhomogeneously iperintense on T2-weighted images with central areas of increased intensity. Late after contrast agent administration, the mass appeared inhomogeneously ipointense with areas of fair late contrast enhancement. The morphology of the tumor, the retroperitoneal site, and MRI sequences make the differential diagnosis. These evidences were useful in treatment planning.
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keywords = gynecologic
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2/17. Primary jejunal leiomyosarcoma mimicking a gynecologic tumor.

    Alimentary leiomyosarcoma (LMS) is not uncommon; however, LMS which metastasizes to the ovary and uterine serosa is extremely rare. We present a case diagnosed as LMS due to the negative finding on the CD117 stain, which is the most specific criterion for the differential diagnosis of gastrointestinal stromal tumor and LMS. Despite the daunting reoperation which was performed within a short interval in this case, the patient made a rapid recovery from both procedures.
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keywords = gynecologic
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3/17. Pulmonary metastases from a low-grade endometrial stromal sarcoma confirmed by chromosome aberration and fluorescence in-situ hybridization approaches: a case of recurrence 13 years after hysterectomy.

    Pulmonary metastasis from low-grade endometrial stromal sarcomas (ESSs) occasionally are found after long, disease-free periods, mostly as incidental histological or radiological discoveries. We describe a case of low-grade ESS presenting as nodular pulmonary metastases finally diagnosed by estrogen-receptor staining, cytogenetic and fluorescence in situ hybridization (FISH) analyses, and perusal of the histology of hysterectomy material. An abnormal nodule in the lung field was discovered by means of chest X-ray of a 47-year-old woman. She had been disease free for 13 years after hysterectomy for an alleged leiomyoma. A computed tomographic scan revealed nodules, with fluctuation in size over the 2-year period, in both lungs. Finally the lesion in the left lung was resected, and pulmonary endometriosis was suspected because of the lack of stromal cell nuclear atypia and positive immunohistochemical reactions for estrogen and progesterone receptors. However, a characteristic karyotype was identified cytogenetically: 46, XX, t(7;17)(p15;q11), the translocation of which, specific to ESS, was confirmed by FISH analysis. A final diagnosis of pulmonary metastases from an ESS could be made by reviewing the histology of the previous uterine tumor. In this case, metastatic lesions from an ESS showed a decrease as well as an increase in size, despite the malignant potential. Immunostaining for estrogen and progesterone receptors and cytogenetic and FISH analyses, together with clinical information on the past gynecological history, are valuable diagnostic keys.
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keywords = gynecologic
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4/17. eosinophilia and uterine leiomyosarcoma.

    BACKGROUND: Tumor-associated blood eosinophilia and tumor-associated tissue eosinophilia have been described in association with a spectrum of neoplasms. A case of uterine leiomyosarcoma exhibiting both blood and tissue eosinophilia is presented. CASE: A 67-year-old postmenopausal woman was evaluated for a 6-month history of postmenopausal bleeding. An office-based endometrial biopsy yielded atypical mesenchymal tissue with marked eosinophilic infiltrate suspicious for a uterine sarcoma, and the patient was referred to the gynecologic oncology service in a tertiary care hospital. There was evidence of leukocytosis and eosinophilia in preoperative laboratory assessment. The patient underwent an exploratory laparotomy, a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. Histopathology confirmed a low-grade uterine leiomyosarcoma confined to the uterus. There was extensive infiltration of the tumor with eosinophils. The systemic leukocytosis and the absolute eosinophilia responded to surgical removal of the tumor, with normalization of values in the immediate postoperative period. CONCLUSION: A differential diagnosis of malignancy should be entertained during an evaluation of systemic eosinophilia.
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ranking = 1
keywords = gynecologic
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5/17. Spontaneous internal jugular vein thrombosis associated with leiomyosarcoma of the omentum.

    A case of spontaneous internal jugular vein thrombosis associated with distant malignancy is presented. This unusual manifestation of a hypercoagulable state was associated with a low-grade epithelioid leiomyosarcoma of the omentum. It was discovered on a gynecologic oncology service in a patient explored for a pelvic abdominal mass.
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ranking = 1
keywords = gynecologic
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6/17. Primary leiomyosarcoma of the vagina: a case report involving a TVT allograft.

    INTRODUCTION: Primary malignant lesions of the vagina represent less than 2% of all gynecologic malignancies. Primary vaginal sarcomas account for about 2% of all malignant vaginal lesions, with leiomyosarcoma being the most common vaginal sarcoma found in adult women. CASE: We report a case of primary vaginal leiomyosarcoma occurring in the field of a prior tension-free vaginal tape (TVT) procedure using a Bard Duraderm allograft. CONCLUSION: This report represents the first report, to our knowledge, of a vaginal sarcoma arising in the field of a Bard Duraderm TVT allograft. Although the product is no longer available for this use, the ongoing studies of the TVT procedure and outcomes should include this potential complication in their review.
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ranking = 1
keywords = gynecologic
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7/17. Small cell carcinoma of the uterine corpus manifesting with visual dysfunction.

    BACKGROUND: Small cell carcinoma in the uterine corpus rather than the endometrium has not been reported yet which resembles a uterine leiomyosarcoma on an imaging study. Furthermore, gynecologic malignancies manifested as a visual dysfunction render the early suspicion and accurate diagnosis a difficult proposition. CASE: A 57-year-old Korean woman was referred to the Department of obstetrics and gynecology due to incidentally detected uterine mass. She had been suffering from a visual loss for several weeks. This uterine mass mimicking a leiomyosarcoma on pelvis MRI was identified to be a small cell carcinoma via a transvaginal gun biopsy and consequent immunostaining. The patient was then scheduled to undergo a regimen of chemotherapy with etoposide and carboplatin. CONCLUSION: Small cell carcinoma may arise from the uterine corpus rather than the endometrium and may also be accompanied by visual symptoms.
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ranking = 1
keywords = gynecologic
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8/17. leiomyosarcoma of the vulva: a case report.

    BACKGROUND: leiomyosarcoma of the vulva is a rare gynecologic malignancy, comprising approximately 1% of vulvar cancers. CASE: A 36-year-old woman was referred for a slowly growing painless vulvar mass that was initially thought to be a Bartholin's duct cyst but was cancerous upon biopsy. A modified radical vulvectomy was performed, and pathology revealed a grade 1 leiomyosarcoma. Thirteen months later, the tumor had not recurred. CONCLUSION: Vulvar cancer must be considered in patients with a suspected Bartholin duct cyst that demonstrates atypical features. A biopsy should be obtained if the mass appears firm or solid on palpation, is ulcerated or presents in a slightly different location from the usual area of the Bartholin gland.
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ranking = 1
keywords = gynecologic
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9/17. Development of uterine sarcoma after tamoxifen treatment for breast cancer: report of four cases.

    tamoxifen (TAM) is widely used in the treatment of breast cancer, and its paradoxical effects on female genital system are well known. During the past 10 years, many descriptions of nonepithelial uterine malignancies related to long-term TAM usage have been reported in the literature. Four uterine sarcoma patients who had history of TAM usage for previous breast cancer are presented in this study. The mean time of exposure to TAM was 6 (range 3-11) years, and the mean cumulative dose of drug was 43.82 g. All patients were postmenopausal, and the mean age was 66 (range 61-73) years at the time of the diagnosis of the uterine malignancy. Two (50%) patients had uterine malignant mixed mullerian tumor, and two (50%) had leiomyosarcoma. In one (25%) patient was diagnosed with endometrial biopsy made for a postmenopausal vaginal bleeding; the others (75%) were asymptomatic and their diseases were diagnosed during the pelvic examination and transvaginal ultrasonography. All patients underwent surgery /- adjuvant therapy (chemotherapy and/or radiation therapy), and two (50%) patients died because of the sarcoma. In consequence, early detection of TAM-related uterine sarcoma is required for orderly gynecological examination in patients having history of TAM usage for previous breast cancer.
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ranking = 1
keywords = gynecologic
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10/17. Reclassification of a tubal leiomyosarcoma as an eGIST by molecular evaluation of c-KIT.

    BACKGROUND: Extragastrointestinal stromal tumors (eGISTs) are rare mesenchymal-derived tumors arising outside of the GI tract. eGISTs are often histologically confused with leiomyosarcoma. Distinction between eGIST and leiomyosarcoma is critical because of the unique responsiveness of eGISTs to the molecularly targeted agent imatinib. CASE: A woman presented with a history of tubal spindle cell tumor that was initially diagnosed and treated as a leiomyosarcoma. Because of minimal response to sarcoma directed chemotherapy, the possibility that the tumor was in fact an eGIST was investigated and supported by immunohistochemical and mutational analyses of the c-Kit receptor tyrosine kinase. The patient currently has stable disease control on imatinib for the last 18 months. CONCLUSIONS: The possibility of eGIST should be considered in the differential diagnosis of tumors with a spindle cell morphology in the gynecologic tract especially when involving the ovary, fallopian tube, or uterine serosa.
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ranking = 1
keywords = gynecologic
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