Leiomyosarcoma of the hypopharynx: A case report

Primary leiomyosarcoma of cervical spine invading the vertebra without obvious osteoclasia: Case report and literature review

Context: Primary leiomyosarcomas are malignant tumors of smooth muscles, with few reported cases occurring in the cervical spine. The authors report a case involving a 29-year-old man with primary leiomyosarcoma in the spinal canal posterior to the C3-C5 vertebrae.Findings: No obvious osteolytic lesions could be found in neither X-ray nor computed tomography scan. Because of the confusion of nontypical imaging findings, a decompressive surgery of anterior cervical corpectomy of C4 and reconstruction with a mesh cage filled with allogenic bone grafts were performed. The patient refused a second operation and then was advised to receive the radiotherapy. No recurrence of the symptoms was evident 6 months after surgery.Conclusion: When a patient suffers from upper cervical tumor, the leiomyosarcoma should be kept in mind as possible diagnoses despite its low occurring ratio. Early detection, early diagnosis, and early treatment must be the goal of the strategy.

A rare case report of an solitary neurofibroma in postcricoid region of hypopharynx

RATIONALE

Postcricoid neurofibroma is an extremely rare hypopharynx tumor that can be challenging in both diagnosis and treatment. This case sheds light on the possibility of treatment with transoral microsurgery before pursuing open cervical incisions.

PATIENT CONCERNS

: A 43-year-old man presented with a four months history of a persistent foreign body sensation and mild dysphagia. Indirect and direct laryngoscopy at admission revealed a round and smooth submucosal mass in the postcricoid region.

DIAGNOSIS

A laryngeal enhanced computed tomography and laryngoscopy suggested that the tumor located in hypopharynx, with clear boundary and slightly strengthened edge. A supporting laryngoscopy surgery was performed under general anesthesia and a biopsy confirmed solitary neurofibroma of the postcricoid region.

INTERVENTIONS

The tumor was successfully resected en bloc transorally through supporting laryngoscope, and obviated the need for open cervical surgery and tracheostomy.

OUTCOMES

The patient recovered well without any intraoperative or postoperative complication and was discharged from hospital 2 days after surgery. There was no recurrence after 6 months follow-up.

LESSONS

Postcricoid neurofibroma is an extremely rare hypopharynx tumor that can be diagnostically challenging. To the best of our knowledge, this is the first case reported of solitary neurofibroma originating from the postcricoid region of the hypopharynx and was surgically removed with transoral surgery through supporting laryngoscope.

MRI and FDG PET/CT Findings of Primary Orbit Leiomyosarcoma

Primary leiomyosarcoma of the orbit is extremely rare. Here we report the case of a 32-year-old woman who presented with proptosis and diplopia of the left eye. MRI examination showed a solid mass in the left orbit with invasion to adjacent tissue, and the lesion had intense FDG uptake with SUVmax of 18.7 on F-FDG PET/CT. Primary orbit leiomyosarcoma was diagnosed by surgery-pathology. F-FDG PET/CT has an advantage in excluding secondary or metastatic orbit malignancy.

Tonsillar leiomyosarcoma

Leiomyosarcomas of the head and neck is an extremely rare entity that because of its infrequency has been associated with both delayed diagnosis and misdiagnosis. Sinonasal tract is the most common site in this region. The overall prognosis is poor. It is necessary for appropriate immunohistochemical investigation for accurate diagnosis. Tonsillar leiomyosarcoma presented only 1 case in the English-language literature (PubMed, Ovid, and Proquest databases). We report a second case of leiomyosarcoma arising in the tonsil in a 38-year-old woman.

LEVEL OF EVIDENCE

Level IV therapeutic study.

Spindle-cell carcinoma of the hypopharynx presenting with a pedunculated appearance: CT and MR features

Spindle-cell carcinoma (SPCC) is a rare tumor that presents biphasic components: squamous-cell carcinoma and sarcomatous features without any differentiation. We present a case of SPCC of the hypopharynx in a 60-year-old man. A well-demarcated mass occupying the hypomesopharynx and presenting a pedunculated appearance was observed originating from the lateral wall of left piriform sinus. High signal intensity on T2-weighted magnetic resonance (MR) images corresponded to the myxoid matrix of the tumor on MR pathologic correlation.

Leiomyosarcoma of the tonsil

Objective:

We report a case of leiomyosarcoma arising in the tonsil in a 73-year-old man.

Method:

Case report and review of the English language literature (using Pubmed, Ovid and Proquest databases).

Results:

To our knowledge, this is the first case of tonsillar leiomyosarcoma to be reported in the English language literature. Our patient presented with haemoptysis, unilateral odynophagia and an ulcerated, exophytic lesion of the tonsil. Histological examination confirmed the diagnosis of leiomyosarcoma, and the patient was treated with radical radiotherapy.

Conclusion:

Leiomyosarcomas are extremely rare in the head and neck; the common sites of origin are the skin and sinonasal tract. The overall prognosis is poor.