scholarly journals Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Andrea Cassoni ◽  
Valentina Terenzi ◽  
Davina Bartoli ◽  
Oriana Rajabtork Zadeh ◽  
Andrea Battisti ◽  
...  
Keyword(s):  
Lung Metastases ◽  
Muscle Flap ◽  
Surgical Excision ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Local Relapse ◽  
Primary Treatment ◽  
High Rate ◽  
Uterine Leiomyosarcoma ◽  
Temporalis Muscle Flap

Uterine leiomyosarcoma (LMS) is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center) and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, “local” relapse was observed 5 months after surgery.

scholarly journals The Imaging and Pathological Features of Metastatic Leiomyosarcoma in the Gallbladder

Rare Tumors ◽  
2016 ◽  
Vol 8 (4) ◽  
pp. 179-181 ◽  
Author(s):  
Yi Guo ◽  
Eleanor Chen ◽  
Darin J. Davidson ◽  
Venu G. Pillarisetty ◽  
Robin L. Jones ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Uterine Fibroids ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Metastatic Lesion ◽  
Uterine Leiomyosarcoma ◽  
High Grade ◽  
Initial Management ◽  
Pelvic Radiation

Uterine leiomyosarcoma is a rare and aggressive malignancy with poor overall prognosis. There have been few reports of metastatic leiomyosarcoma in the gallbladder. We report a case of a 41-year-old female who underwent total abdominal hysterectomy due to presumed uterine fibroids. The postoperative pathology revealed high-grade pleomorphic leiomyosarcoma, with involvement of the uterine serosal surface. She subsequently underwent exploratory laparotomy, followed by pelvic radiation and chemotherapy. Since initial management she has developed metastatic disease and has been under treatment and surveillance for 11 years. She has undergone multiple surgical procedures and numerous lines of systemic therapy for metastatic leiomyosarcoma, including cholecystectomy for a metastatic lesion in the gallbladder. There have been no previous reports of metastatic leiomyosarcoma in the gallbladder. Despite extensive metastatic disease this patient has had prolonged survival with multi-modality management.

scholarly journals Management Strategies in Advanced Uterine Leiomyosarcoma: Focus on Trabectedin

Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-14 ◽  
Author(s):  
Frédéric Amant ◽  
Domenica Lorusso ◽  
Alexander Mustea ◽  
Florence Duffaud ◽  
Patricia Pautier
Keyword(s):  
Therapeutic Potential ◽  
Management Strategies ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Uterine Leiomyosarcoma ◽  
Chemotherapy Drugs ◽  
Risk Patients ◽  
Overall Survival Benefit

The treatment of advanced uterine leiomyosarcomas (U-LMS) represents a considerable challenge. Radiological diagnosis prior to hysterectomy is difficult, with the diagnosis frequently made postoperatively. Whilst a total abdominal hysterectomy is the cornerstone of management of early disease, the role of routine adjuvant pelvic radiotherapy and adjuvant chemotherapy is less clear, since they may improve local tumor control in high risk patients but are not associated with an overall survival benefit. For recurrent or disseminated U-LMS, cytotoxic chemotherapy remains the mainstay of treatment. There have been few active chemotherapy drugs approved for advanced disease, although newer drugs such as trabectedin with its pleiotropic mechanism of actions represent an important addition to the standard front-line systemic therapy with doxorubicin and ifosfamide. In this review, we outline the therapeutic potential and in particular the emerging evidence-based strategy of therapy with trabectedin in patients with advanced U-LMS.

Doxorubicin, cisplatin, and ifosfamide (API) as first-line therapy for relapsed or metastatic uterine leiomyosarcoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10098-10098
Author(s):  
Julien Hadoux ◽  
Annie Rey ◽  
Pierre Duvillard ◽  
Catherine Lhomme ◽  
Corinne Balleyguier ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Response Rate ◽  
Objective Response ◽  
Local Relapse ◽  
High Rate ◽  
Physiological Age ◽  
Uterine Leiomyosarcoma ◽  
First Line ◽  
First Line Therapy ◽  
Metastatic Sites

10098 Background: Uterine leiomyosarcomas (ULMS) are rare gynecologic malignancies characterized by a poor prognosis due to a high rate of local and metastatic recurrences. Chemotherapy (CT) with doxorubicin or ifosfamide or both is associated with a 10 to 30% objective response rate (ORR) and a cisplatin-based multiCT approach achieved a good response rate (DECAV therapy: API + dacarbazine + vindesine, 54% ORR in uterine sarcomas), though toxic. We aimed to determine efficacy and toxicity of doxorubicin, cisplatin and ifosfamide (API) combination as first line treatment of metastatic or relapsed ULMS (MRULMS). Methods: This monocentric study included MRULMS pts with a physiological age < 65 y. CT consisted in doxorubicin 50 mg/m² d1, ifosfamide 3 g/m²/d d1d2 + mesna, cisplatin 75 mg/m² d3, + G-CSF; q 3 weeks. Results: Results in 38 pts with MRULMS were analyzed; median age was 51 (40-64), median cycles of CT was 5; 8 (21%) pts were treated for local relapse, 21 (55.3%) for metastatic disease and 9 (23.7%) for both. Metastatic sites were: lungs in 16 pts (42.1%), pelvis in 7 pts (18.4%), liver in 7 pts (18.4%), peritoneum in 6 pts (15.8%) and bone in 5 pts (13.2%); 14 pts (36.8%) had a multisite metastatic disease. Main grade 3-4 toxicities in 38 pts were neutropenia (74%), thrombopenia (60%), anemia (55%), fatigue (18%) and vomiting (13%). Febrile neutropenia was observed in 35% of pts and 1 patient died of septic shock after cycle 1. Thirty four pts were evaluable for response (4 pts had complete surgery at relapse) and 16 pts responded (4 CR + 12 PR) (ORR: 47%); 23.5% and 29.4% of the pts had respectively stable and progressive disease. For all pts (38) and evaluable pts (34), median PFS were 9.8 and 9.5 months and OS 27 and 25.3 months respectively. Conclusions: Despite toxicity observed, API is an effective treatment which compares favorably with other first line therapies for MRULMS pts.

scholarly journals Fumarase-deficient uterine leiomyoma: a case of a rare entity and surgical innovation

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Hong Lee ◽  
Saman Shafiezadeh ◽  
Rajeev Singh
Keyword(s):  
Renal Cell Carcinoma ◽  
Uterine Leiomyoma ◽  
Fumarate Hydratase ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Leiomyosarcoma ◽  
Rare Entity ◽  
Surgical Innovation ◽  
Final Histology ◽  
Hereditary Leiomyomatosis

Abstract We report a case of a 47-year-old female, with strong preoperative clinical and radiological suspicious of uterine leiomyosarcoma who underwent a total abdominal hysterectomy. Despite the final histology concluded as benign uterine leiomyoma, the loss of fumarate hydratase expression of the same specimen still put her at risk of having hereditary leiomyomatosis and renal cell carcinoma syndrome. Intraoperatively, an obstetric vacuum cup was used for uterine manipulation to avoid breaching of the uterine serosa.

scholarly journals A rare case of steroid cell tumor of ovary: case report

2019 ◽  
Vol 8 (11) ◽  
pp. 4622
Author(s):  
Sharanya . ◽  
Monalisa Peter
Keyword(s):  
Endometrial Hyperplasia ◽  
Endometrial Thickness ◽  
Frozen Section ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Primary Treatment ◽  
Cell Tumor ◽  
Simple Cyst ◽  
Steroid Cell Tumor ◽  
Gaseous Distension

Steroid cell tumors of the ovary account for less than 0.1% of all ovarian tumors. These tumors may present at any age with presentations related to the hormonal activity and virilizing properties of tumor. A 61-year-old postmenopausal women presented with complaints of postmenopausal bleeding for 15 days. Parity score of P3L3, not tubectomised. Menopaused 16 years back. History of weight loss noted. She is a known case of diabetes mellitus for 6 years not on any treatment and a known case of depressive disorder for 35 years on treatment on trihexphenidyl lurasidone. Had undergone sigmoid colon polyp removal in June 2018. On examination, P/A- mild gaseous distension (+). P/S- cervix flushed with vagina, pulled up cervix. P/V- uterus size and position couldn’t be made out, anterior fornix fullness (+). Ultrasonography showed bulky uterus with fibroid 4x4cm, endometrial thickness- 9 mm? Krukenberg tumor and posterior mediastinal lymph nodes. Patient underwent Total abdominal hysterectomy with bilateral salpingo-oophorectomy with frozen section on 01/07/19. Frozen section: 1. Ovaries: right ovary - fibrothecoma, left ovary- simple cyst. 2. Uterus- endometrial hyperplasia with atypia. 3. Myometrium- leiomyoma and adenomyosis. Postoperative period was uneventful. On microscopic examination, impression: right ovary- steroid cell tumor, uterus-endometrial hyperplasia with cytological atypia. Ovarian steroid cell tumors are grouped under sex chord stromal tumors and are usually benign, unilateral and characterized by a steroid cell proliferation. Steroid cell tumors are associated with androgenic changes with variable frequency, ranging from 12% to over 50% respectively. The primary treatment is surgical extirpation of the primary lesion and there are no reports of effective radiation or chemotherapy. In a young patient with stage IA disease, a unilateral salpingo oophorectomy is adequate.

scholarly journals Metastatic Uterine Leiomyosarcoma in a Nullipara with Primary Infertility: A Case Report

2019 ◽  
Vol 4 (11) ◽  
Author(s):  
Okechukwu B. Anozie ◽  
Johnbosco I. Nwafor ◽  
Chidi U. Esike ◽  
Chukwuemeka I. Ukaegbe ◽  
Richard L. Ewah ◽  
...  
Keyword(s):  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Leiomyosarcoma ◽  
Presenting Symptoms ◽  
Primary Infertility ◽  
History Of ◽  
Uterine Cancers ◽  
Operative Findings ◽  
High Index Of Suspicion ◽  
Lost To Follow Up

Uterine leiomyosarcoma accounts for 1-2% of uterine cancers. It is an extremely aggressive malignancy associated with a poor prognosis. Women affected may vary in age, but are most common between 4th and 7th decades of life. Presenting symptoms mimic uterine leiomyoma. Preoperative diagnosis of uterine leiomyosarcoma is difficult and often made at time of surgical resection. We report a case of Mrs A.E, a 40 year old nullipara with history of primary infertility of 20 years duration, who presented with abdominal swelling of 3 years and vaginal bleeding of 7 weeks duration. Abdominopelvic ultra-sonography done at presentation was suggestive of leiomyoma. She was scheduled for myomectomy and subsequently had total abdominal hysterectomy and omentectomy following intra-operative findings of features suggestive of leiomyosarcoma with evidence of metastasis to omentum. These findings were confirmed on histology of the specimen. She received one cycle of combination chemotherapy but was lost to follow up. Uterine LMS is an aggressive tumour, therefore, a high index of suspicion is needed especially for huge uterine nodules and such patients must be closely monitored for adequate management.

scholarly journals Surgical challenges of chest wall and intra-thoracic desmoid tumors

2011 ◽  
Vol 152 (1) ◽  
pp. 3-13 ◽  
Author(s):  
Zoltán Mátrai ◽  
László Tóth ◽  
Zoltán Szentirmay ◽  
János Papp ◽  
Imre Antal ◽  
...  
Keyword(s):  
Chest Wall ◽  
Relevant Literature ◽  
Surgical Techniques ◽  
Surgical Excision ◽  
Shoulder Girdle ◽  
Lung Parenchyma ◽  
Primary Treatment ◽  
High Rate ◽  
Aesthetic Results ◽  
Reconstructive Plastic

Chest wall desmoids are rare, borderline tumors. Radical surgical excision is considered to be the primary treatment. Tendency of desmoids to infiltrate the chest wall, the shoulder girdle, lung parenchyma, brachial plexus and vital components of the mediastinum provides a difficult surgical challenge in the efforts of achieving microscopically negative margins. Implantation of synthetic meshes and reconstructive plastic surgical techniques might be necessary to perform in order to preserve stability of the thorax, and to achieve optimal functional and aesthetic results. Multidisciplinary surgeries may result in a high rate of morbidity even in specialized centers. Within the framework of a retrospective multicenter review, authors assessed surgical techniques implemented in the case of patients who underwent surgical management for sporadically appearing chest-wall and intra-thoracic desmoids, and reviewed the relevant literature. Orv. Hetil., 2011, 152, 3–13.

scholarly journals Uterine myxoid leiomyosarcoma: a diagnostic challenge

2017 ◽  
Vol 6 (7) ◽  
pp. 3170
Author(s):  
Jayalakshmi Durairaj ◽  
Swaramya Chandrasekaran
Keyword(s):  
Urinary Retention ◽  
Vaginal Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Leiomyosarcoma ◽  
Diagnostic Challenge ◽  
Uterine Sarcomas ◽  
Myxomatous Degeneration ◽  
Abnormal Vaginal Bleeding

Uterine sarcomas are histologically diverse tumours which comprise about 3-7% of uterine malignancies. Myxoid leiomyosarcoma (MLMS) is an extremely uncommon variant of uterine leiomyosarcoma. This report is of a 35 year old woman who presented with urinary retention and abnormal vaginal bleeding, who underwent a total abdominal hysterectomy for cervical fibroid. A diagnosis of leiomyoma with myxomatous degeneration was made. The woman subsequently developed a recurrence within 5 months of the surgery and was diagnosed with MLMS following biopsy. This case reiterates the uncertainties associated with the diagnosis of MLMS and the need for heightened vigilance in women with myxomatous degeneration of leiomyoma.

scholarly journals Leiomyosarcoma in pregnancy: Incidental finding during routine caesarean section

2021 ◽  
Vol 4 (3) ◽  
pp. 092-095
Author(s):  
Tang Toon Wen ◽  
Jessie Phoon Wai Leng
Keyword(s):  
Caesarean Section ◽  
Reproductive Tract ◽  
Incidental Finding ◽  
Elective Caesarean Section ◽  
Breech Presentation ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Female Reproductive Tract ◽  
Uterine Leiomyosarcoma ◽  
In Pregnancy

Uterine leiomyosarcoma (LMS) is uncommon tumour arising from the female reproductive tract. Incidence of LMS in pregnancy is extremely rare, with only 10 cases reported thus far in medical literature. We present a case of myomectomy performed during elective caesarean section for breech presentation, due to its easy accessibility and well contracted uterus. Subsequent histology revealed LMS on final specimen. Patient subsequently underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy. No chemotherapy was given as she opted for close clinical- radiological monitoring instead. This case report highlights the importance of discussion with patients regarding the risk of occult malignancy in a fibroid uterus. Appropriate management of uterine leiomyosarcoma in pregnancy remains unclear. Consideration of removing an enlarging leiomyoma during caesarean section might be ideal in view of its malignant potential, just like in this case; however, location of the tumour and risk of bleeding needs to be weighed. Ultimately, management of such cases needs proper discussion between obstetrician and the patient.

scholarly journals The Controversy of Hydatidiform Mole Treatment In Women age ≥ 40 year-old

Medicinus ◽  
2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Gabriella Farah ◽  
Julita D.L Nainggolan
Keyword(s):  
Older Patients ◽  
Economic Status ◽  
Hydatidiform Mole ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Gestational Trophoblastic Disease ◽  
Primary Treatment ◽  
Molar Pregnancy ◽  
Recommended Treatment ◽  
Suction Curettage

<p>Background: Hydatidiform mole or commonly known as molar pregnancy is one of the gestational trophoblastic disease (GTD) caused by an abnormal trophoblast proliferation. About 50% of gestational trophoblast neoplasm (GTN) arises from molar pregnancy. Higher risk of GTN was found in older patient, especially women age ≥40 years old. Management of hydatidiform mole is often faced come challenges, especially in developing country like Indonesia. Although, suction curettage is the most recommended treatment for the evacuation of molar pregnancy, hysterectomy is considerable for women who have completed childbirth and do not wish to preserve their fertility.<br />Case: Here we present case of 48 years old women with hydatidiform mole. Considering the age of the patient and the completion of her childbearing, we decided to do a laparotomy total abdominal hysterectomy for the evacuation of the mole instead of suction curettage. Turned out that this patient had an invasive mole, one of the types of gestational trophoblastic neoplasia.<br />Conclusion: Although suction curettage is the most frequent technique for molar evacuation, hysterectomy is a reasonable option as primary treatment to be performed in older patients and for those who do not wish to preserve their fertility. The other important points such as socio-economic status, education level, and geographical issues should be considered also on managing older patients with hydatidiform mole in developing countries</p>

Sign in / Sign up

Export Citation Format

Share Document