1
|
Lee D, Mo JW, Yoon S, Kwon J, Jo Y, Lee SI, Kwon T, Kwon J, Kim J. Subcutaneous leiomyosarcoma in a cynomolgus macaque (Macaca fascicularis). Vet Med Sci 2024; 10:e1321. [PMID: 38227706 PMCID: PMC10790726 DOI: 10.1002/vms3.1321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/05/2023] [Accepted: 11/06/2023] [Indexed: 01/18/2024] Open
Abstract
Leiomyosarcoma, a malignant tumour originating from smooth muscle cells, has rarely been documented in non-human primates. In this case study, a 7-year-old female cynomolgus macaque (Macaca fascicularis) presented with a rapidly growing mass overlying the left elbow joint. Radiographs indicated the presence of a soft tissue neoplasm without any associated bone involvement. The mass was surgically resected. Histological and immunohistochemical analyses revealed spindle-shaped cells with eosinophilic cytoplasm that resembled smooth muscle cells, exhibiting positive immunoreactions for vimentin, desmin and smooth muscle actin and a negative reaction for pan-cytokeratin. This is the first reported case of subcutaneous leiomyosarcoma in a cynomolgus macaque and provides important insights into the incidence and characteristics of this condition in this species.
Collapse
Affiliation(s)
- Dong‐Ho Lee
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupJeonbukRepublic of Korea
- Department of Laboratory Animal MedicineCollege of Veterinary MedicineJeonbuk National UniversityIksanJeonbukRepublic of Korea
| | - Jun Won Mo
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupJeonbukRepublic of Korea
| | - Seung‐Bin Yoon
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupJeonbukRepublic of Korea
| | - Jeongwoo Kwon
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupJeonbukRepublic of Korea
| | - Yu‐Jin Jo
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupJeonbukRepublic of Korea
| | - Sang Il Lee
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupJeonbukRepublic of Korea
| | - Taeho Kwon
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupJeonbukRepublic of Korea
| | - Jungkee Kwon
- Department of Laboratory Animal MedicineCollege of Veterinary MedicineJeonbuk National UniversityIksanJeonbukRepublic of Korea
| | - Ji‐Su Kim
- Primate Resources CenterKorea Research Institute of Bioscience and Biotechnology (KRIBB)JeongeupJeonbukRepublic of Korea
| |
Collapse
|
2
|
Lombardi N, Varoni EM, Rabbiosi D, Cucurullo M, Moneghini L, Lodi G. Primary oral leiomyosarcoma of the maxillary bone and sinus: case report and up-to-date review of literature. Braz J Otorhinolaryngol 2022; 88 Suppl 4:S205-S211. [PMID: 34756559 DOI: 10.1016/j.bjorl.2021.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- Niccolò Lombardi
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche, Milan, Italy; ASST Santi Paolo e Carlo, Odontostomatology II Unit, Milan, Italy.
| | - Elena M Varoni
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche, Milan, Italy; ASST Santi Paolo e Carlo, Odontostomatology II Unit, Milan, Italy
| | - Dimitri Rabbiosi
- ASST Santi Paolo e Carlo, Maxillofacial Surgery Unit, Milan, Italy
| | - Marco Cucurullo
- ASST Santi Paolo e Carlo, Maxillofacial Surgery Unit, Milan, Italy
| | - Laura Moneghini
- ASST Santi Paolo e Carlo, Human Pathology Unit, Milan, Italy
| | - Giovanni Lodi
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche Chirurgiche e Odontoiatriche, Milan, Italy; ASST Santi Paolo e Carlo, Odontostomatology II Unit, Milan, Italy
| |
Collapse
|
3
|
Wang S, Song C, Yang X, Yang Y, Wei J. Children tongue leiomyosarcoma: A rare case and literature review. EAR, NOSE & THROAT JOURNAL 2022:1455613221112365. [PMID: 35793206 DOI: 10.1177/01455613221112365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Primary leiomyosarcoma of the tongue is a rare malignant mesenchymal tumor with high recurrence rate and metastatic potential. Through analysis of one case condition and literature review, this paper discusses the clinical characteristics and treatment methods and recommends that expanded resection surgery should be the first intervention. Postoperative adjuvant radiotherapy and combined chemotherapy should be administered if the case specifically requires such an approach.
Collapse
Affiliation(s)
- Shaojie Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Changlong Song
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Xinjie Yang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Yaowu Yang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| | - Jianhua Wei
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, Fourth Military Medical University, Xi'an, Shaanxi Province, China
| |
Collapse
|
4
|
Paricio JJ, Panadero P, Baptista P, Idoate MÁ. [Leiomyosarcoma of the nasal fossa. A case report]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2022; 55:192-196. [PMID: 35779886 DOI: 10.1016/j.patol.2019.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/30/2019] [Accepted: 09/17/2019] [Indexed: 06/15/2023]
Abstract
A 54-year-old female patient presented with a left nasal obstruction. On physical examination a pink delimited mass in the left nostril was observed. A cranial computed tomography scan revealed an expansive mass in the upper anterior third of the left nasal fossa, partially obstructing it. Endoscopic resection of the mass was performed. Histopathology revealed an atypical mesenchymal proliferation formed by cells disposed in disorganized and interconnected long bundles. Tumor cells had abundant eosinophilic cytoplasm and an oval, vesicular and hyperchromatic nucleus. Frequent mitotic figures were observed, many of them atypical. Necrosis was not observed. Immunohistochemistry showed tumor cells to be positive for calponin, muscle specific actin, caldesmon and smooth muscle specific myosin. Ki-67 index proliferation was 30%. A diagnosis of leiomyosarcoma of the nasal fossa was established.
Collapse
Affiliation(s)
- José Joaquín Paricio
- Departamento de Anatomía Patológica, Clínica Universidad de Navarra, Pamplona, Navarra, España.
| | - Pablo Panadero
- Departamento de Anatomía Patológica, Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - Peter Baptista
- Departamento de Otorrinolaringología, Clínica Universidad de Navarra, Pamplona, Navarra, España
| | - Miguel Ángel Idoate
- Departamento de Anatomía Patológica, Clínica Universidad de Navarra, Pamplona, Navarra, España
| |
Collapse
|
5
|
de Araújo GR, Costa SFDS, Mesquita RA, Gomez RS, Dos Santos JN, Pontes HAR, de Andrade BAB, Romañach MJ, Agostini M, Vargas PA, de Cáceres CVBL, Santos-Silva AR, Ribeiro ACP, Brandão TB, Tomasi RA, Ferreyra RS, de Almeida OP, Fonseca FP. Leiomyoma and Leiomyosarcoma (Primary and Metastatic) of the Oral and Maxillofacial Region: A Clinicopathological and Immunohistochemical Study of 27 Cases. Head Neck Pathol 2021; 16:294-303. [PMID: 34106410 PMCID: PMC9018928 DOI: 10.1007/s12105-021-01336-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/18/2021] [Indexed: 11/27/2022]
Abstract
Smooth muscle neoplasms represent an important group of lesions which is rare in the oral cavity. Leiomyoma (LM) is benign smooth muscle/pericytic tumor usually presenting as non-aggressive neoplasm, while leiomyosarcoma (LMS) represents its malignant counterpart. The rarity of these lesions, together with its unspecific clinical presentation and a variable histopathological appearance, lead to a broad list of differential diagnoses, hampering their diagnoses. Therefore, in this study we describe the clinical and microscopic features of a series of oral and maxillofacial LMs and LMSs. A retrospective search from 2000 to 2019 was performed and all cases diagnosed as LM and LMS affecting the oral cavity and gnathic bones were retrieved. Clinical and demographic data were obtained from the patients' pathology records, while microscopic features and immunohistochemistry were reviewed and completed when necessary to confirm the diagnoses. Twenty-two LMs and five LMSs were obtained. In the LM group, males predominated, with a mean age of 45.7 years. The upper lip was the most affected site, and 18 cases were classified as angioleiomyomas and four as solid LM. In the LMS group, females predominated, with a mean age of 47.6 years. The mandible was the most affected site. Diffuse proliferation of spindle cells, with necrosis and mitotic figures, were frequent microscopic findings. LMs and LMSs were positive for α-smooth muscle actin, HHF-35 and h-caldesmon. In conclusion, oral LM/LMS are uncommon neoplasms with the latter usually presenting as metastatic disease. H&E evaluation may be very suggestive of oral LMs, but h-caldesmon staining is strongly recommended to confirm LMS diagnosis.
Collapse
Affiliation(s)
- Gabriela Ribeiro de Araújo
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Sara Ferreira Dos Santos Costa
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Jean Nunes Dos Santos
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Bahia, Salvador, Brazil
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | | | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis Department (Pathology and Semiology Areas), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Department of Oral Biology and Oral Pathology, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | | | - Alan Roger Santos-Silva
- Oral Diagnosis Department (Pathology and Semiology Areas), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Thaís Bianca Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | | | - Ruth Salomé Ferreyra
- Deparment of Pathology, Dental School, National University of Córdoba, Córdoba, Argentina
| | - Oslei Paes de Almeida
- Oral Diagnosis Department (Pathology and Semiology Areas), Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
- Department of Oral Biology and Oral Pathology, School of Dentistry, University of Pretoria, Pretoria, South Africa.
| |
Collapse
|
6
|
Whaley RD, Thompson LDR. Epstein-Barr Virus-Associated Smooth Muscle Tumors of Larynx: A Clinicopathologic Study and Comprehensive Literature Review of 12 Cases. Head Neck Pathol 2021; 15:1162-1171. [PMID: 33891274 PMCID: PMC8633162 DOI: 10.1007/s12105-021-01328-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/08/2021] [Indexed: 01/13/2023]
Abstract
Laryngeal mesenchymal neoplasms are rare, with smooth muscle tumors comprising a small subset. Specifically, Epstein-Barr virus (EBV)-associated smooth muscle tumors are exceptionally rare, lacking a comprehensive evaluation of their clinical and histologic features. Two patients (a 59 year old male and 51 year old female) had received renal transplants 156 and 240 months, respectively prior to onset of laryngeal symptoms. Supraglottic polypoid masses were identified and removed conservatively. Histologically, the tumors were hypercellular, showing alternating light and dark areas, the latter composed of primitive appearing round cells, while a more characteristic spindled tumor cell population was noted in the remaining areas. Cytoplasmic vacuoles were noted adjacent to the nucleus. There was no tumor necrosis or pleomorphism, but increased mitotic figures (11-12/2 mm2) were seen, without atypical forms. The tumor cells were strongly immunoreactive with smooth muscle actin and smooth muscle myosin heavy chain and with Epstein-Barr virus encoded RNA (EBER) by in situ hybridization. These patients were reviewed in the context of a thorough English literature review, which demonstrates a wide age range at presentation without a sex predilection, but with most patients from specific ethnic groups (Chinese, Thai, Pilipino). Three-quarters of patients are part of multifocal disease and the majority are post-renal transplantation patients. Conservative management seems to yield the best overall outcome for these indolent tumors. In conclusion, EBV-associated smooth muscle tumors should be considered in any immunocompromised patient with a head and neck smooth muscle tumor, especially when EBER is documented by in situ hybridization. Conservative management may be employed, even when multifocal tumors are documented.
Collapse
Affiliation(s)
| | - Lester D. R. Thompson
- Department of Pathology, Southern California Permanente Medical Group, 5601 De Soto Avenue, Woodland Hills, CA 91365 USA
| |
Collapse
|
7
|
Cazzato F, D'Ercole A, De Luca G, Aiello FB, Croce A. Neck subcutaneous nodule as first metastasis from broad ligament leiomyosarcoma: a case report and review of literature. BMC Surg 2020; 20:297. [PMID: 33238975 PMCID: PMC7687730 DOI: 10.1186/s12893-020-00951-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
Background Leiomyosarcoma usually develops in the myometrium and is characterized by a high recurrence rate, frequent hematogenous dissemination, and poor prognosis. Metastasis is usually to lungs, liver, and bone, and occasionally to the brain, but seldom to the head and neck region. Primary leiomyosarcoma very rarely arises in the broad ligament. Case presentation A 54-year old woman presented to the otolaryngology department with a mass in the right posterior region of the neck 4 years after surgery for a primary leiomyosarcoma of the right broad ligament. The neck mass was removed and found to be a metastatic leiomyosarcoma. Leiomyosarcoma localizations in lungs and liver were absent. Morphological examination showed both the primary and the secondary leiomyosarcomas to have features of low-grade tumors. One year after excision of the neck mass, the patient presented with tachycardia. Echocardiography detected two intracardiac nodules suggestive of metastatic tumors. Chemotherapy was administered; the disease has been stable since then. Conclusions We report the first case of broad ligament leiomyosarcoma with the neck subcutaneous region being the first site of secondary involvement. We speculate that the Batson venous plexus might have been the pathway of dissemination.
Collapse
Affiliation(s)
- Fiorella Cazzato
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy
| | - Angela D'Ercole
- Surgical Pathology Unit, Santissima Annunziata Hospital, Chieti, Italy
| | - Graziano De Luca
- Clinical Pathology Unit, Giuseppe Mazzini Hospital, Teramo, Italy
| | - Francesca B Aiello
- Department of Medicine and Aging Sciences, University G. D'Annunzio, Chieti-Pescara, Chieti, Italy
| | - Adelchi Croce
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Via dei Vestini, 66100, Chieti, Italy.
| |
Collapse
|
8
|
Choi YS, Almansoori AA, Jung TY, Lee JI, Kim SM, Lee JH. Leiomyosarcoma of the jaw: case series. J Korean Assoc Oral Maxillofac Surg 2020; 46:275-281. [PMID: 32855375 PMCID: PMC7469964 DOI: 10.5125/jkaoms.2020.46.4.275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/08/2019] [Accepted: 11/14/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives Leiomyosarcoma is a malignant neoplasm that affects smooth muscle tissue and it is very rare in the field of oral and maxillofcial surgery. The purpose of this study was to obtain information on diagnosis of and treatment methods for leiomyosarcoma by retrospectively reviewing of the cases. Patients and Methods The study included nine patients who were diagnosed with leiomyosarcoma in the Department of Oral and Maxillofacial Surgery at Seoul National University Dental Hospital. The subjects were analyzed with respect to sex, age, clinical features, primary site of disease, treatment method, recurrence, and metastasis. Results Particular clinical features included pain, edema, mouth-opening limitations, dysesthesia, and enlarged lymph nodes. All cases except one were surgically treated, and recurrence was found in two cases. Four of nine patients were followed up without recurrence and one patient underwent additional surgery due to recurrence. Conclusion In our case series, notable symptoms included pain, edema, mouth-opening limitations, and dysesthesia; however, it was difficult to label these as specific symptoms of leiomyosarcoma. Considering the aggressive characteristics of the disease and poor prognosis, surgical treatment is necessary with careful consideration of postoperative radiotherapy and chemotherapy.
Collapse
Affiliation(s)
- Yong-Suk Choi
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea
| | - Akram Abdo Almansoori
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea.,Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea.,Oral Cancer Center, Seoul National University Dental Hospital, Seoul, Korea
| | - Tae-Young Jung
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea.,Department of Oral and Maxillofacial Surgery, Inje University Busan Paik Hospital, Busan, Korea
| | - Jae-Il Lee
- Department of Oral Pathology, Seoul National University Dental Hospital, Seoul, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea.,Oral Cancer Center, Seoul National University Dental Hospital, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Korea.,Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea.,Oral Cancer Center, Seoul National University Dental Hospital, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| |
Collapse
|
9
|
Leiomyosarcoma: Prognostic outline of a rare head and neck malignancy. Oral Oncol 2019; 95:100-105. [PMID: 31345375 DOI: 10.1016/j.oraloncology.2019.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/29/2019] [Accepted: 06/07/2019] [Indexed: 11/23/2022]
Abstract
Soft tissue sarcomas (STS) are mesenchymal malignant neoplasms with a broad spectrum of biologic behaviour. Most STS show predilection for extremities with rarity in head and neck. Leiomyosarcoma (LMS) is an extremely rare STS in head and neck due to the paucity of smooth muscles in this anatomical region. Owing to its rarity, diagnosis of LMS is often delayed or is often misdiagnosed. Our study aimed to evaluate clinico-demographic factors determining clinical course of primary head-neck LMS. Further, we also assessed cases of secondary head-neck LMS and LMS due to other causes to compare their clinical outcome with primary head-neck LMS. In primary LMS cases, intraoral LMS showed slightly better prognosis than extraoral LMS. Survival analysis revealed that prognosis of primary LMS was significantly better than secondary LMS. No significant difference in survival was seen between primary LMS and LMS due to other causes. These observations indicate that site of origin appears to determine the clinical behaviour of LMS. Results showed that size, recurrence and metastasis are important prognostic variables. Though large tumor size was associated with poor prognosis, tumor aggressiveness may not be directly proportional to its size. Surgical management with or without adjuvant therapy was associated with favourable outcome. As several factors are associated with prognostic outcome of head-neck LMS, multimodality therapy approach after careful analysis of various prognostic variables in each case on an individual basis is essential.
Collapse
|
10
|
Abstract
This clinicopathologic study of primary oral leiomyosarcoma of the buccal mucosa involves a literature review of 15 cases with the addition of our report of a case. The demographic details, tumor size, treatment and outcome are documented for all the cases. In addition, this review examines the histologic features of leiomyosarcoma while noting that differentiation from other spindle cell tumors can be challenging, underscoring the necessity of an immunohistochemical work up for an accurate diagnosis. The unpredictability of the clinical behavior of these aggressive tumors requires, at the very least, wide local surgical excision and prolonged follow up.
Collapse
Affiliation(s)
- Eugene M. Ko
- 0000000086837370grid.214458.eSchool of Dentistry, University of Michigan, 1011 N University Ave, Ann Arbor, MI 48109 USA
| | - Jonathan B. McHugh
- 0000000086837370grid.214458.eDepartment of Pathology, University of Michigan, Ann Arbor, MI USA
| |
Collapse
|
11
|
Agaimy A, Semrau S, Koch M, Thompson LDR. Sinonasal Leiomyosarcoma: Clinicopathological Analysis of Nine Cases with Emphasis on Common Association with Other Malignancies and Late Distant Metastasis. Head Neck Pathol 2017; 12:463-470. [PMID: 29270859 PMCID: PMC6232217 DOI: 10.1007/s12105-017-0876-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
Abstract
Sinonasal tract (SNT) leiomyosarcoma (LMS) is exceedingly rare with < 100 cases reported. Their relationship to retinoblastoma and other malignancies, along with previous irradiation has not been clarified. Routine and consultation cases were reviewed for histologically and immunohistochemically proven SNT LMS. The tumors were tested with antibodies against α-smooth muscle actin, desmin, h-caldesmon, HMB45, S100 protein, Rb1, MDM2, CDK4 and EBV (EBER-ISH). Nine tumors affecting 5 males and 4 females aged 26 to 77 years (median: 48 years) were identified in the maxillary sinus (n = 4), nasal cavity (n = 3) and combined SNT (n = 2). Three patients had previous irradiation (2 for retinoblastoma, 1 for fibrous dysplasia) and 1 patient had chemotherapy and stem cell transplantation for Hodgkin lymphoma. One patient had prostatic adenocarcinoma (prior) and rectal adenocarcinoma (post) to the LMS. All patients with follow-up developed either local recurrences and/or metastases, principally to lung (time to metastasis: 16-156 months, mean 62 months). Histologically, 6 tumors were conventional high-grade LMS, two had glycogen-rich clear cell (PEComa-like) morphology and one was spindle cell low-grade. The latter showed grade 2 in the recurrence and grade 3 in the lung metastases. Two cases showed dedifferentiation to anaplastic pleomorphic (inflammatory MFH-like) phenotype. Immunohistochemistry revealed diffuse expression of at least 2 smooth muscle markers in 8 and only actin in one case/s. All other markers were negative. RB1 loss was observed in 6/8 cases tested. Sinonasal tract leiomyosarcomas are rare aggressive sarcomas that frequently develop in a background of previous cancer therapy (4/9), most frequently irradiation. Their varied morphology underlines the wide differential diagnostic considerations. Long-term survival may be achieved with aggressive multimodal therapy.
Collapse
Affiliation(s)
- Abbas Agaimy
- 0000 0000 9935 6525grid.411668.cInstitute of Pathology, University Hospital, Krankenhausstrasse 8-10, 91054 Erlangen, Germany
| | - Sabine Semrau
- 0000 0000 9935 6525grid.411668.cDepartment of Radiation Oncology, University Hospital, Erlangen, Germany
| | - Michael Koch
- 0000 0000 9935 6525grid.411668.cDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Erlangen, Germany
| | - Lester D. R. Thompson
- 0000 0004 0445 0789grid.417224.6Department of Pathology, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91367 USA
| |
Collapse
|
12
|
Ip PP, Lim D, Cheung ANY, Oliva E. Immunoexpression of p16 in uterine leiomyomas with infarct-type necrosis: an analysis of 35 cases. Histopathology 2017; 71:743-750. [DOI: 10.1111/his.13282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/07/2017] [Indexed: 01/12/2023]
Affiliation(s)
- Philip P Ip
- Department of Pathology; The University of Hong Kong; Queen Mary Hospital; Hong Kong
| | - Diana Lim
- Department of Pathology; National University Health System; Singapore
| | - Annie N Y Cheung
- Department of Pathology; The University of Hong Kong; Queen Mary Hospital; Hong Kong
| | - Esther Oliva
- Department of Pathology; Massachusetts General Hospital; Harvard Medical School; Boston MA USA
| |
Collapse
|
13
|
Pinotti E, Sandini M, Famularo S, Jaconi M, Romano F, Nespoli L, Gianotti L. Disseminated and late metastatic disease from nasal pit leiomyosarcoma after radical surgical resection. Case report of a singular presentation of a rare disease. Clin Sarcoma Res 2017; 7:12. [PMID: 28593036 PMCID: PMC5461669 DOI: 10.1186/s13569-017-0078-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 02/15/2017] [Indexed: 11/19/2022] Open
Abstract
Background Leiomyosarcoma of the head and neck is a rare cancer with high local aggressiveness. Radical surgery and adjuvant treatment offer the best chance for cure, nonetheless 5-years recurrence rate remains high. Despite international guidelines are available for soft tissue sarcomas, no recommendations are specifically endorsed for leiomyosarcoma of the head and neck, due to the rarity of its presentation and consequently scarcity of data on long-term outcome. Case presentation A 50-year old woman, operated 10 years before for leiomyosarcoma of the nasal pit and with negative 5-years follow-up, was admitted to our ward for impairment of the hepatic function. Total-body CT scan detected multiple localizations at lungs, kidneys, pancreas, bones, muscles, lymph nodes and thyroid. The pathologic report after lung biopsy confirmed the diagnosis of metastasis from leiomyosarcoma and the patients was scheduled for first line chemo-radiotherapy. Conclusions Despite adequate primary treatment, distant and disseminated metastatic disease may be not excluded in leiomyosarcoma of the head and neck.
Collapse
Affiliation(s)
- Enrico Pinotti
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| | - Marta Sandini
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| | - Simone Famularo
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| | - Marta Jaconi
- Unit of Pathology, School of Medicine and Surgery, San Gerardo Hospital, University of Milano Bicocca, Monza, Italy
| | - Fabrizio Romano
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| | - Luca Nespoli
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| | - Luca Gianotti
- Department of Surgery, School of Medicine and Surgery, San Gerardo Hospital (4° Piano A), University of Milano Bicocca, Via Pergolesi 33, 20900 Monza, Italy
| |
Collapse
|
14
|
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.
Collapse
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.
| |
Collapse
|