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Dedifferentiated Leiomyosarcoma of the Auricle with Heterologous Osteosarcoma Component: Case Report and Literature Review. Case Rep Otolaryngol 2022; 2022:3684461. [PMID: 35685483 PMCID: PMC9173960 DOI: 10.1155/2022/3684461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Abstract
Leiomyosarcomas are rare malignant tumors of smooth muscles. Head and neck involvement by this disease is very rare, and cutaneous leiomoysarcomas of the ear are even rarer. This is way clinically they are usually mistaken for either squamous or basal cell carcinomas, as was the case in an 85-year-old male patient presented in this report. However, the final diagnosis was even more interesting considering that it was a dedifferentiated leiomyosarcoma of the auricle with a heterologous component of osteosarcoma. The auricular cutaneous malignancies have a much higher rate of recurrence than the corresponding malignancy in other regions of the head and neck, even when resected with negative surgical margins, and dedifferentiated leiomyosarcoma is clinically even more aggressive. Thus, the treatment of choice is a total auriculectomy and great attention should be paid to appropriate margins.
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Primary Leiomyosarcoma of the Calvarium with Intracranial Extension: a Case Report. Indian J Surg Oncol 2020; 11:165-169. [PMID: 33364689 DOI: 10.1007/s13193-020-01129-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 06/08/2020] [Indexed: 11/27/2022] Open
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Workman AD, Farquhar DR, Brody RM, Parasher AK, Carey RM, Purkey MT, Nagda DA, Brooks JS, Hartner LP, Brant JA, Newman JG. Leiomyosarcoma of the head and neck: A 17-year single institution experience and review of the National Cancer Data Base. Head Neck 2017; 40:756-762. [PMID: 29286183 DOI: 10.1002/hed.25054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 08/21/2017] [Accepted: 11/16/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Leiomyosarcoma is a rare neoplasm of the head and neck. The purpose of this study was to present our single-institution case series of head and neck leiomyosarcoma and a review of cases in the National Cancer Data Base (NCDB). METHODS Patients with head and neck leiomyosarcoma at the University of Pennsylvania and in the NCDB were identified. Demographic characteristics, tumor factors, treatment paradigms, and outcomes were evaluated for prognostic significance. RESULTS Nine patients with head and neck leiomyosarcoma from the institution were identified; a majority had high-grade disease and cutaneous leiomyosarcoma, with a 5-year survival rate of 50%. Two hundred fifty-nine patients with leiomyosarcoma were found in the NCDB; macroscopic positive margins and high-grade disease were associated with poor prognosis (P < .01), and positive surgical margins were related to adjuvant radiation (P < .001). CONCLUSION Head and neck leiomyosarcoma presents at a high grade and is preferentially treated with surgery. Several demographic and tumor-specific factors are associated with outcomes and prognosis.
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Affiliation(s)
- Alan D Workman
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Douglas R Farquhar
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert M Brody
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Arjun K Parasher
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ryan M Carey
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael T Purkey
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Danish A Nagda
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John S Brooks
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lee P Hartner
- Penn Oncology Hematology Associates, Philadelphia, Pennsylvania
| | - Jason A Brant
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jason G Newman
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
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Kolk A, Wolff KD, Smeets R, Kesting M, Hein R, Eckert AW. Melanotic and non-melanotic malignancies of the face and external ear - A review of current treatment concepts and future options. Cancer Treat Rev 2014; 40:819-37. [PMID: 24814015 DOI: 10.1016/j.ctrv.2014.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 04/01/2014] [Accepted: 04/05/2014] [Indexed: 12/11/2022]
Abstract
Skin has the highest incidence and variety of tumors of all organs. Its structure is of great complexity, and every component has the potential to originate a skin neoplasm (SN). Because of its exposed nature, skin is vulnerable to carcinogenic stimuli such as UV radiation. Various entities can cause SN. Nonmelanotic skin cancers (NMSC) are the most common of all cancers, with over one million cases diagnosed annually in the US. Basal cell carcinoma (BCC) accounts for approximately 80% of all NMSC, most of the remaining 20% being squamous cell carcinoma (SCC). The skin of the head and neck is the most common site for tumors, accounting for more than 80% of all NMSC. BCC, SCC, and malignant melanomas (MM) represent 85-90% of all SN. Merkel cell tumors (MCC), lymphoepithelioma-like carcinomas of the skin (LELCS), dermato-fibro-sarcomas, leiomyosarkomas, and Kaposi-sarcomas are less frequent in the facial skin region and the external ear. Based on data from the German Federal Cancer Registry (2003/2004), 140,000 people in Germany were affected by SN (100,000 BCC, 22,000 SCC, 22,000 MM). This number increases considerably if malignant precursors, such as actinic keratosis, are included. Each year, the frequency of SN diagnosis rises by 3-7%. Among all known malignant tumors, MM exhibits the highest rate of increase in incidence. In the past, SN was primarily diagnosed in people aged 50 years or older. However, recently, the risk for developing SN has shifted, and younger people are also affected. Early diagnosis is significantly correlated with prognosis. Resection of SN creates defects that must be closed with local or microvascular flaps to avoid functional disturbing scar formation and deflection of the nose, eyelids, or lips. All therapeutic strategies for SN, the current standard for adjuvant and systemic treatment, and the management of the increasing number of patients under permanent blood thinner medication are described with regard to the treatment of SN.
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Affiliation(s)
- Andreas Kolk
- Department of Oral and Cranio-Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Klaus-Dietrich Wolff
- Department of Oral and Cranio-Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Marco Kesting
- Department of Oral and Cranio-Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Rüdiger Hein
- Department of Dermatology and Allergology, Technische Universität München, Munich, Germany.
| | - Alexander W Eckert
- Department of Oral and Maxillofacial Plastic Surgery, Martin Luther University Halle-Wittenberg, Germany.
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Rysz M, Jaworowski J, Krajewski R, Barańska J. Leiomyosarcoma of the external ear--case report. Otolaryngol Pol 2014; 68:42-5. [PMID: 24484949 DOI: 10.1016/j.otpol.2012.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Revised: 03/24/2012] [Accepted: 06/13/2012] [Indexed: 10/28/2022]
Abstract
In head and neck region leiomyosarcoma is a very rare finding. This tumor is usually located in abdominal cavity. We report a case of 78-year-old man with tumor of the auricle that was resected with 0.7 cm margin. Histological and immunohistochemical analysis revealed the leiomyosarcoma. Adjuvant therapy was not advised. During 3 years of follow-up there are no signs of recurrence. Review of the literature shows that the survival of patients with leiomyosarcoma in head and neck region seems to be similar to other kinds of sarcomas in this localization. It is not clear, how large surgical margins should be to achieve satisfactory local control.
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Affiliation(s)
- Maciej Rysz
- Head and Neck Cancer Department, Surgery Division, Memorial Cancer Center, Head: A. Kawecki MD, PhD, Poland.
| | - Janusz Jaworowski
- Head and Neck Cancer Department, Surgery Division, Memorial Cancer Center, Head: A. Kawecki MD, PhD, Poland
| | - Romuald Krajewski
- Head and Neck Cancer Department, Surgery Division, Memorial Cancer Center, Head: A. Kawecki MD, PhD, Poland
| | - Joanna Barańska
- Department of Pathology, Memorial Cancer Center, Warsaw, Head: K. Ptaszyński MD, Poland
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Postauricular leiomyosarcoma: a case report and literature review. Case Rep Otolaryngol 2013; 2013:284275. [PMID: 23573443 PMCID: PMC3618913 DOI: 10.1155/2013/284275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Accepted: 02/25/2013] [Indexed: 11/24/2022] Open
Abstract
Leiomyosarcoma arising in the head and neck region is a rare entity. Auricular involvement by the disease is further rarer with few cases reported in the literature. Usually auricular leiomyosarcoma is a disease of middle-old age. We report a case of leiomyosarcoma of the postauricular region in a young adolescent female. Surgery along with adjuvant radiotherapy was used for complete cure. Patient is disease-free for the last eight years and is on regular yearly followup. The aim of reporting this case is to add to the scarce existing literature regarding auricular leiomyosarcoma and its long-term outcome. Also, this is the first case report in young adolescent and second only of the post auricular region.
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Karakatsanis A, Nikolidakis A, Tsavdaris G, Hotzoglou N, Krokos N, Kamas A. Cutaneous leiomyosarcoma of the scalp. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s13126-012-0041-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kobraei KB, Church AA, Shigo AL, Judge KW, Glavin FL, Vincek V. Crusted pink papule in a 20-year-old. Int J Dermatol 2011; 49:1089-91. [PMID: 20883398 DOI: 10.1111/j.1365-4632.2010.04525.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Katherina B Kobraei
- Department of Medicine, Division of Dermatology, University of Florida, 24800 South West 35th Drive, Gainesville, FL 32611, USA.
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TORRES T, OLIVEIRA A, SANCHES M, SELORES M. Superficial cutaneous leiomyosarcoma of the face: Report of three cases. J Dermatol 2010; 38:373-6. [DOI: 10.1111/j.1346-8138.2010.01105.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Park JK, Hong IH, Goo MJ, Ki MR, Hong KS, Hwang OK, Han JY, Ji AR, Park SI, Jeong KS. Subcutaneous leiomyosarcoma in an adrenomedullin heterozygous mouse. ACTA ACUST UNITED AC 2010; 62:221-5. [DOI: 10.1016/j.etp.2009.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Accepted: 03/23/2009] [Indexed: 10/20/2022]
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De Giorgi V, Sestini S, Massi D, Papi F, Alfaioli B, Lotti T. Superficial cutaneous leiomyosarcoma: a rare, misleading tumor. Am J Clin Dermatol 2008; 9:185-7. [PMID: 18429649 DOI: 10.2165/00128071-200809030-00008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Leiomyosarcomas are rare malignant tumors of smooth muscles. Superficial leiomyosarcoma is generally a disease of middle age, most frequently encountered between 40 and 60 years of age. It is usually diagnosed late or misdiagnosed, since it is a very rare tumor of the head and neck. Awareness of the particularly misleading features of this tumor, especially in elderly patients, is important, as delayed diagnosis is correlated with larger size and invasiveness into contiguous structures, which influence the practicability of radical resection. We present the case of an 81-year-old man with cutaneous leiomyosarcoma on the forehead.
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