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Kusanishi T, Tanaka N, Itoi M, Ijiri M, Ebisawa K, Suzuka K, Hagiwara Y, Yonemoto T, Araki A, Itami M. Multidisciplinary management for primary uterine osteosarcoma, including gene panel testing: case report and literature review. Int Cancer Conf J 2023; 12:241-247. [PMID: 37577351 PMCID: PMC10421837 DOI: 10.1007/s13691-023-00613-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/28/2023] [Indexed: 08/15/2023] Open
Abstract
Primary osteosarcoma of the uterus (uOS) is rare, and its standard treatment has not yet been established. Herein, we present the case of a 50-year-old woman with uOS who demonstrated an improved prognosis after multiple surgeries to the metastatic sites. After the initial diagnosis of uOS, the patient showed recurrence and distant metastasis and hence expected to exhibit a poor prognosis. The patient underwent multiple surgical resections of the metastatic as well as primary tumors, which enabled the patient to survive for 24 months after the initial surgery. Considering that the median survival time of patients with uOS is approximately 6 months, the survival rate of our patient is noteworthy. Based on our observations, it is suggested that the resection of the primary and metastatic tumors might contribute to the extension of the survival period of the patient with chemo-resistant uOS.
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Affiliation(s)
- Takako Kusanishi
- Department of Gynecology, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba 260-8717 Japan
| | - Naotake Tanaka
- Department of Gynecology, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba 260-8717 Japan
| | - Mizue Itoi
- Department of Gynecology, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba 260-8717 Japan
| | - Miwa Ijiri
- Department of Gynecology, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba 260-8717 Japan
| | - Keiko Ebisawa
- Department of Gynecology, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba 260-8717 Japan
| | - Kiyomi Suzuka
- Department of Gynecology, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba 260-8717 Japan
| | - Youko Hagiwara
- Department of Orthopedics, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba 260-8717 Japan
| | - Tukasa Yonemoto
- Department of Orthopedics, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba 260-8717 Japan
| | - Akinobu Araki
- Department of Pathology, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba 260-8717 Japan
| | - Makiko Itami
- Department of Pathology, Chiba Cancer Center, 666-2, Nitona-cho, Chuo-ku, Chiba 260-8717 Japan
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Yang J, Chen X, Li X, Liu W, Liao S, Wang Y, Zuo Y. Case Report: Clinical application of immunotherapy-based combination regimen in primary osteosarcoma of the uterus. Front Oncol 2023; 13:1198765. [PMID: 37469418 PMCID: PMC10352772 DOI: 10.3389/fonc.2023.1198765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/01/2023] [Indexed: 07/21/2023] Open
Abstract
Primary osteosarcoma of the uterus is an extremely rare pure heterologous sarcoma of the uterus. The relevant available information is limited to case reports. To date, only 31 cases of this type of cancer have been reported. Here, we report the first clinical experience with the administration of an immunotherapy-based combination regimen for multiple metastatic primary osteosarcomas of the uterus. The patient had undergone multiple treatments prior to this regimen, but her condition continued to progress. However, after 3 cycles of immunotherapy combined with targeted therapy and chemotherapy, a review showed that the disease was stable and even in partial remission. The patient has a good quality of life, and long-term survival is expected.
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Affiliation(s)
- Jing Yang
- Department of Gynecological Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xiaowen Chen
- Department of Gynecological Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xiaofang Li
- Department of Pathology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Wenci Liu
- Department of Imaging, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Sihai Liao
- Department of Gynecological Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yuzhou Wang
- Department of Gynecological Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yufang Zuo
- Department of Gynecological Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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Ruhotina M, Kukla J, Wilcox A, Murphy C, Menderes G. Primary uterine osteosarcoma arising in a leiomyoma with rapid local recurrence: A case report. Gynecol Oncol Rep 2022; 44:101102. [PMID: 36405307 PMCID: PMC9672400 DOI: 10.1016/j.gore.2022.101102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Extraskeletal osteosarcoma is an extremely rare malignant neoplasm. Literature regarding primary osteosarcoma of the uterus is confined to only a small number of case reports. Case: A 57-year-old female with a history of uterine fibroids presented to the emergency department with abdominal pain. Imaging was notable for an enlarged uterus with a 15 cm calcified fibroid extending along the posterior uterus. The patient underwent a laparotomy for total hysterectomy and bilateral salpingo-oophorectomy. Pathological evaluation of the specimen yielded mesenchymal proliferation with osteoid formation and tumor cells with densely eosinophilic cytoplasm resembling osteoblasts with a final diagnosis of primary uterine osteosarcoma. Multidisciplinary tumor board recommended against adjuvant treatment, given the lack of evidence for improved outcomes for early-stage uterine sarcomas. The patient was followed up with surveillance visits every-three months, entailing physical examination and computed tomography(CT) scans. Unfortunately, she had locoregional oligometastatic recurrence of her disease at 1-year follow up. Conclusion Primary uterine osteosarcoma is an extremely rare and aggressive neoplasm with limited understanding regarding optimal treatment options.
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Affiliation(s)
- Merima Ruhotina
- Department of Obstetrics and Gynecology, Bridgeport Hospital/Yale New Haven Health, Bridgeport, CT, USA
- Corresponding author at: Department of Obstetrics and Gynecology, Bridgeport Hospital/Yale New Haven Health 267 Grant Street, Bridgeport, CT 06610, USA.
| | - Joanna Kukla
- Department of Obstetrics and Gynecology, Bridgeport Hospital/Yale New Haven Health, Bridgeport, CT, USA
| | - Annemieke Wilcox
- Department of Obstetrics and Gynecology, Bridgeport Hospital/Yale New Haven Health, Bridgeport, CT, USA
| | - Colleen Murphy
- Department of Obstetrics and Gynecology, Bridgeport Hospital/Yale New Haven Health, Bridgeport, CT, USA
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Zhang J, He X, Yu W, Ying F, Cai J, Deng S. Primary Exophytic Extraskeletal Osteosarcoma of the Liver: A Case Report and Literature Review. Risk Manag Healthc Policy 2021; 14:1009-1014. [PMID: 33737841 PMCID: PMC7961132 DOI: 10.2147/rmhp.s296172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/24/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Primary hepatic extraskeletal osteosarcoma (ESOS) is a rare tumor with no specific clinical manifestations, and little is known about it. Here, we describe an elderly patient with primary hepatic osteosarcoma confirmed by pathology results to raise awareness. Case Report We report an unusual case of a 62-year-old man who presented with right upper quadrant pain. The inflammatory indicators were elevated, and alkaline phosphatase (AKP), carbohydrate antigen (CA-199 and CA-125) were slightly increased. Computed tomography images and magnetic resonance images discovered a 7.8 × 7.4 × 6.6 cm mass with irregular radiated and cotton-like tumor bone between the liver and right kidney space. Pathology revealed the mass to be primary exophytic ESOS of the liver. The patient underwent a surgical operation and standard chemotherapy and is still alive with no recurrence and metastasis to date. Conclusion Owing to the rarity of the tumor and the lack of clinical characteristics and specific laboratory indexes, it is difficult to make a correct diagnosis. Medical imaging features mainly behave soft tissue entity with tumor bone composition. Surgical resection combined with adjuvant chemotherapy is the main treatment for ESOS.
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Affiliation(s)
- Jing Zhang
- Department of Imaging Center, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang Province, 315000, People's Republic of China
| | - Xiuchao He
- Department of Imaging Center, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang Province, 315000, People's Republic of China
| | - Wenying Yu
- Ningbo Diagnostic Pathology Center, Ningbo, Zhejiang Province, 315000, People's Republic of China
| | - Fuming Ying
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang Province, 315000, People's Republic of China
| | - Jun Cai
- Department of PET-CT Diagnosis Center, Mingzhou Hospital of Zhejiang University, Ningbo, Zhejiang Province, 315000, People's Republic of China
| | - Shengde Deng
- Department of Imaging Center, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang Province, 315000, People's Republic of China
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Uterine osteosarcoma with peritoneo-omental osteosarcomatosis: a case report and review of the literature. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2020. [DOI: 10.1007/s40944-020-0373-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Clinicopathologic Features and Genetic Alterations of a Primary Osteosarcoma of the Uterine Corpus. Int J Gynecol Pathol 2019; 38:414-419. [DOI: 10.1097/pgp.0000000000000511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Tsuji K, Watanabe Y, Tokunaga H, Shimada M, Watanabe M, Yaegashi N. Primary osteosarcoma of the uterine cervix: A case report. J Obstet Gynaecol Res 2017; 43:1781-1783. [PMID: 28815813 DOI: 10.1111/jog.13443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/16/2017] [Accepted: 06/10/2017] [Indexed: 12/31/2022]
Abstract
Primary osteosarcoma of the uterine cervix is extremely rare. Only 20 cases have been reported, 19 of which originated in the uterine corpus. We report a case of primary uterine cervical osteosarcoma with pulmonary metastasis in a 30-year-old nulligravida woman. The initial diagnosis was carcinosarcoma of the uterine cervix, as detected by cervical cytology and biopsy analysis. We performed a total hysterectomy, bilateral salpingo-oophorectomy and colostomy without macroscopic residual tumors in the abdominal cavity, but pelvic recurrent tumors appeared 14 days postoperatively. Both recurrent and metastatic tumors were effectively reduced by combination therapy of adriamycin with ifosfamide; however, the patient died as a result of of disease progression nine months after her first visit to our department.
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Affiliation(s)
- Keita Tsuji
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoh Watanabe
- Department of Obstetrics and Gynecology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Muneaki Shimada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mika Watanabe
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
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