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Shafiee MN, Kah Teik C, Md Zain RR, Kampan N. Ovarian and uterine leiomyosarcoma: which one is the primary? Horm Mol Biol Clin Investig 2019; 41:hmbci-2019-0037. [PMID: 31398145 DOI: 10.1515/hmbci-2019-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 07/12/2019] [Indexed: 11/15/2022]
Abstract
Uterine leiomyosarcoma (LMS) is rare but primary ovarian LMS is even rarer constituting less than 0.1% of all gynecologic disorders. Neither histologic features nor immunohistochemistry could be utilized to distinguish between uterine or ovarian origin. We illustrate a clinical case of metastatic LMS to the ovary in a woman with underlying uterine fibroid presenting with anemia with heavy menses.
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Affiliation(s)
- Mohamad Nasir Shafiee
- Faculty of Medicine, Department of Obstetrics and Gynaecology, UKM Medical Centre, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Chew Kah Teik
- Faculty of Medicine, Department of Obstetrics and Gynaecology, UKM Medical Centre, Cheras, 56000 Kuala Lumpur, Malaysia, Phone: +60391455949, Fax: +60391455672
| | - Reena Rahayu Md Zain
- Faculty of Medicine, Department of Pathology, UKM Medical Centre, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Nirmala Kampan
- Faculty of Medicine, Department of Obstetrics and Gynaecology, UKM Medical Centre, Cheras, 56000 Kuala Lumpur, Malaysia
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Mizoshiri N, Shirai T, Terauchi R, Tsuchida S, Mori Y, Katsuyama Y, Hayashi D, Konishi E, Kubo T. Hepatic metastases from primary extremity leiomyosarcomas: Two case reports. Medicine (Baltimore) 2018; 97:e0598. [PMID: 29718861 PMCID: PMC6392636 DOI: 10.1097/md.0000000000010598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Leiomyosarcoma is a highly malignant soft tissue sarcoma. Most leiomyosarcomas of the extremities metastasize initially to the lungs, with few metastasizing to the liver. Also, it is difficult to diagnose metastases to other regions of the lung during follow-up. CASE PRESENTATION The first patient was a 51-year-old Japanese woman diagnosed with a leiomyosarcoma of the left distal femur. She underwent chemotherapy, followed by wide tumor excision and reconstruction using frozen autograft with total knee arthroplasty. Eleven months later, a focal lesion was observed in her right liver, despite the absence of lung metastases. Partial hepatic resection was performed, and the hepatic lesion was diagnosed a metastasis of leiomyosarcoma. Two years later, there has been no evidence of local recurrence. The second patient was a 60-year-old Japanese male diagnosed with a leiomyosarcoma of the left thigh. He underwent preoperative chemotherapy followed by wide excision. Three years later, a focal lesion was found in his medial liver, despite the absence of lung metastases. Partial hepatic resection was performed, and the hepatic lesion was diagnosed as a metastasis of leiomyosarcoma. At the latest follow-up, there has been no evidence of local recurrence. CONCLUSIONS The lung is the most common site of metastases from leiomyosarcomas of the extremeties, because these metastases are hematogenous. Both our patients presented with metastases of the liver, despite the absence of lung metastases. Hepatic metastasis is commonly found in computed tomography (CT) scan. Periodic CT scans of the chest and abdomen are necessary in following-up patients who undergo resection of primary leiomyosarcomas of the extremities.
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Affiliation(s)
- Naoki Mizoshiri
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Toshiharu Shirai
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Ryu Terauchi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Shinji Tsuchida
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Yuki Mori
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Yusei Katsuyama
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Daichi Hayashi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Eiichi Konishi
- Department of Pathology, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Kyoto, Japan
| | - Toshikazu Kubo
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
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An Y, Wang S, Li S, Zhang L, Wang D, Wang H, Zhu S, Zhu W, Li Y, Chen W, Ji S, Guo X. Distinct molecular subtypes of uterine leiomyosarcoma respond differently to chemotherapy treatment. BMC Cancer 2017; 17:639. [PMID: 28893210 PMCID: PMC5594508 DOI: 10.1186/s12885-017-3568-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 08/21/2017] [Indexed: 02/07/2023] Open
Abstract
Background Uterine leiomyosarcoma (ULMS) is an aggressive form of soft tissue tumors. The molecular heterogeneity and pathogenesis of ULMS are not well understood. Methods Expression profiling data were used to determine the possibility and optimal number of ULMS molecular subtypes. Next, clinicopathological characters and molecular pathways were analyzed in each subtype to prospect the clinical applications and progression mechanisms of ULMS. Results Two distinct molecular subtypes of ULMS were defined based on different gene expression signatures. Subtype I ULMS recapitulated low-grade ULMS, the gene expression pattern of which resembled normal smooth muscle cells, characterized by overexpression of smooth muscle function genes such as LMOD1, SLMAP, MYLK, MYH11. In contrast, subtype II ULMS recapitulated high-grade ULMS with higher tumor weight and invasion rate, and was characterized by overexpression of genes involved in the pathway of epithelial to mesenchymal transition and tumorigenesis, such as CDK6, MAPK13 and HOXA1. Conclusions We identified two distinct molecular subtypes of ULMS responding differently to chemotherapy treatment. Our findings provide a better understanding of ULMS intrinsic molecular subtypes, and will potentially facilitate the development of subtype-specific diagnosis biomarkers and therapy strategies for these tumors. Electronic supplementary material The online version of this article (10.1186/s12885-017-3568-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yang An
- Department of Biochemistry and Molecular Biology, Joint National Laboratory for Antibody Drug Engineering, Institute of Biomedical Informatics, Medical School, Henan University, Kaifeng, 475004, China.,Cell signal transduction Laboratory, Henan University, Kaifeng, 475004, China
| | - Shuzhen Wang
- Department of Biochemistry and Molecular Biology, Joint National Laboratory for Antibody Drug Engineering, Institute of Biomedical Informatics, Medical School, Henan University, Kaifeng, 475004, China.,Cell signal transduction Laboratory, Henan University, Kaifeng, 475004, China
| | - Songlin Li
- Department of Biochemistry and Molecular Biology, Joint National Laboratory for Antibody Drug Engineering, Institute of Biomedical Informatics, Medical School, Henan University, Kaifeng, 475004, China.,Department of Neurology, The First Affiliated Hospital of Henan University, Kaifeng, 475001, China
| | - Lulu Zhang
- Department of Biochemistry and Molecular Biology, Joint National Laboratory for Antibody Drug Engineering, Institute of Biomedical Informatics, Medical School, Henan University, Kaifeng, 475004, China.,Department of Neurology, The First Affiliated Hospital of Henan University, Kaifeng, 475001, China
| | - Dayong Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Henan University, Kaifeng, 475001, China
| | - Haojie Wang
- Department of Biochemistry and Molecular Biology, Joint National Laboratory for Antibody Drug Engineering, Institute of Biomedical Informatics, Medical School, Henan University, Kaifeng, 475004, China.,Cell signal transduction Laboratory, Henan University, Kaifeng, 475004, China
| | - Shibai Zhu
- Department of Orthopedic Surgery, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China
| | - Wan Zhu
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, 94110, USA
| | - Yongqiang Li
- Department of Biochemistry and Molecular Biology, Joint National Laboratory for Antibody Drug Engineering, Institute of Biomedical Informatics, Medical School, Henan University, Kaifeng, 475004, China.,Cell signal transduction Laboratory, Henan University, Kaifeng, 475004, China
| | - Wenwu Chen
- Department of Neurology, The First Affiliated Hospital of Henan University, Kaifeng, 475001, China
| | - Shaoping Ji
- Department of Biochemistry and Molecular Biology, Joint National Laboratory for Antibody Drug Engineering, Institute of Biomedical Informatics, Medical School, Henan University, Kaifeng, 475004, China. .,Cell signal transduction Laboratory, Henan University, Kaifeng, 475004, China.
| | - Xiangqian Guo
- Department of Biochemistry and Molecular Biology, Joint National Laboratory for Antibody Drug Engineering, Institute of Biomedical Informatics, Medical School, Henan University, Kaifeng, 475004, China. .,Cell signal transduction Laboratory, Henan University, Kaifeng, 475004, China. .,Department of Preventive Medicine, Medical School, Henan University, Kaifeng, 475004, China. .,Institute of Environmental Medicine, Henan University, Kaifeng, 475004, China.
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