Primary Leiomyosarcoma of the Inferior Vena Cava: is vascular reconstruction always necessary?

Primary leimyosarcoma of the inferior vena cava is considered as rare vascular retroperitoneal sarcoma. Although radical resection with free margin is necessary, vascular strategies are very challenging.

Comparison of clinicopathological features and outcomes in patients with primary leiomyosarcoma of bone and soft tissue.

e23526 Background: Leiomyosarcoma is a rare malignancy that may occur in bone. This investigation described the characteristics and outcomes of primary leiomyosarcoma of bone (PLB) compared to soft tissue leiomyosarcoma (SLMS). Methods: This study was a retrospective review using the Surveillance, Epidemiology, and End Results (SEER) database from 1975 to 2016. Continuous and categorial variables were described, and Cox regression were used to identify factors of prognostic significance. Results: Seven thousand five-hundred two patients met inclusion criteria. Seventy-four (1%) were PLB and 7428 (99%) were SLMS. On multivariable analysis for high-grade SLMS radiation (neoadjuvant: HR, 0.56; 95% CI, 0.4-0.8; p = 0.003, and adjuvant: HR, 0.75; 95% CI, 0.6-0.9; p = 0.008) and surgery (procedure specific) improved DSS, while age (HR, 1.013; 95% CI, 1.0-1.1; p < 0.001), tumor size greater than or equal to 5 cm (HR, 3.16; 95% CI, 2.3-4.2; p < 0.001), abdomen/pelvis/trunk/thorax tumors (HR, 1.31; 95% CI, 1.1-1.6; p = 0.006), and distant metastases at presentation (HR, 2.6; 95% CI, 2.1-3.3; p < 0.001) negatively influenced DSS. Conclusions: Radiation and surgery positively influence survival in high-grade SLMS while chemotherapy appears to have no benefit. Surgery alone appears to lower the mortality risk in PLB.

Primary leiomyosarcoma of femur: A rare entitycase report and review of literature

Background: We report this case to highlight clinical and pathological features of this rare entity. Methods: It is about a 48 year-old woman with an osteolytic lesion of the lower extremity of the left femur. Result: A biopsy of the lesion showed densely cellular malignant mesenchymal proliferation. It was made by bundles of smooth muscle cells with nuclei of moderate to severe atypia. The immunohistochemical study showed an intense and diffuse cytoplasmic positivity of tumor cells with the smooth anti-muscle. Desmin was focal positive. After neoadjuvant chemotherapie, a knee block resection was made. Macroscopically, it was a 10 cm sized tumor located in the distal part of tumor. Histologically tumor showed post chemotherapy effects estimated at 20%. The bone and muscle surgical limits were unscathed. Conclusion: Primary leiomyosarcoma of bone is a rare and a diagnostically challenging tumor entity.