1
|
Yokoyama Y, Goda T, Sato K, Suzuki M, Kanda T, Sato Y. Leiomyosarcoma arising from the ovarian vein as a gynecologic malignancy: Two case reports and a review of the literature. J Obstet Gynaecol Res 2022; 48:2224-2230. [PMID: 35793911 DOI: 10.1111/jog.15242] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/06/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022]
Abstract
Leiomyosarcoma arising from the ovarian vein has rarely been reported. Herein, we report two cases from a single institute. Given their direct connections to ovarian vessels, both leiomyosarcomas were initially suspected to be gynecological malignancies. In one case, leiomyosarcoma was discovered incidentally without any clinical symptoms; it had a close connection with the ovarian vein, was removed surgically, and the patient has survived for over 12 years. In another case, bowel obstruction caused by the tumor helped to identify metastatic leiomyosarcoma. Blood flow was supplied by the ovarian artery and grew into the lumen of the ovarian vein without invading adjacent organs. After surgical resection, the patient underwent 18 months of chemotherapy prior to palliative care. We propose that leiomyosarcoma arising from the ovarian vein should be treated as a gynecologic malignancy, especially if it develops in the lower abdomen.
Collapse
Affiliation(s)
- Yasuhiro Yokoyama
- Department of Gynecology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Tomohiro Goda
- Department of Gynecology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Kazuki Sato
- Department of Gynecology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Mariko Suzuki
- Department of Gynecology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Tomoko Kanda
- Department of Gynecology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Yasumasa Sato
- Department of Gynecology, Gifu Prefectural General Medical Center, Gifu, Japan
| |
Collapse
|
2
|
Puerta Vicente A, Sanjuanbenito A, Lobo E. Leiomyosarcoma of the right gonadal vein. Cir Esp 2021; 99:764-766. [PMID: 34764061 DOI: 10.1016/j.cireng.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 09/20/2020] [Indexed: 10/19/2022]
Affiliation(s)
- Ana Puerta Vicente
- Unidad de Cirugía Hepatobiliopancreática, Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - Alfonso Sanjuanbenito
- Unidad de Cirugía Hepatobiliopancreática, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Eduardo Lobo
- Unidad de Cirugía Hepatobiliopancreática, Hospital Universitario Ramón y Cajal, Madrid, Spain
| |
Collapse
|
3
|
Sheaffer WW, Davila VJ, Mendes BC, Meltzer AJ, Stone WM, Soh IY, Truty MJ, Nagorney DM, Money SR, Bower TC. Surgical and reconstructive outcomes in primary venous leiomyosarcoma. J Vasc Surg Venous Lymphat Disord 2021; 10:901-907. [PMID: 34352417 DOI: 10.1016/j.jvsv.2021.07.010] [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: 02/21/2020] [Accepted: 07/22/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Primary venous leimyosarcomas (PVL) are rare and pose challenges in surgical management. This study evaluates the clinical outcomes and identifies predictors of survival in our surgical series of PVL. METHODS A retrospective review was performed of patients who had resection of PVL at three centers between 1990-2018. Patient demographics, comorbidities, intraoperative data, survival, and graft related outcomes were recorded. Survival analysis was performed using Kaplan-Meier curves and Cox proportional hazards regression. RESULTS Seventy patients with a diagnosis of PVL were identified between 1990 and 2018. Fifty-four patients (77%) had PVL of the IVC and 16 (23%) had peripheral PVL. Mean follow up for the series was 55.0 months (range 1-217 months). Fifty one patients (96%) with IVC PVL needed caval reconstruction and 3 (4%) had resection only. There were no deaths within thirty days of surgery. Five patients (9%) required early re-intervention including one (2%) IVC stent. Sixteen peripheral PVL were identified. Eight patients (50%) had venous reconstructions performed and 8 (50%) had the vein resected without reconstruction. There were no deaths within thirty days. Five year survival was 57.5% for IVC PVL and 70.0% for peripheral PVL . Kaplan-Meier survival analysis for IVC and peripheral PVL revealed no difference in overall survival (p = 0.624) at 5 years. CONCLUSIONS PVL is a rare and aggressive disease even with surgical resection. We found no difference in survival between IVC and peripheral lesions suggesting aggressive management is warranted for PVL of any origin. Management of PVL requires a multidisciplinary approach to provide patients with the best long term outcomes.
Collapse
Affiliation(s)
- William W Sheaffer
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054.
| | - Victor J Davila
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054
| | - Bernardo C Mendes
- Mayo Clinic Rochester Division of Vascular Surgery, 200 First St. SW, Rochester, MN 55905
| | - Andrew J Meltzer
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054
| | - William M Stone
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054
| | - Ina Y Soh
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054
| | - Mark J Truty
- Mayo Clinic Rochester Department of General Surgery Subspecialties, 200 First St. SW, Rochester, MN 55905
| | - David M Nagorney
- Mayo Clinic Rochester Department of General Surgery Subspecialties, 200 First St. SW, Rochester, MN 55905
| | - Samuel R Money
- Mayo Clinic Arizona Division of Vascular Surgery, 5777 E Mayo Boulevard, Phoenix, AZ 85054
| | - Thomas C Bower
- Mayo Clinic Rochester Division of Vascular Surgery, 200 First St. SW, Rochester, MN 55905
| |
Collapse
|
4
|
Puerta Vicente A, Sanjuanbenito A, Lobo E. Leiomyosarcoma of the right gonadal vein. Cir Esp 2020; 99:S0009-739X(20)30301-8. [PMID: 33143848 DOI: 10.1016/j.ciresp.2020.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 09/14/2020] [Accepted: 09/20/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Ana Puerta Vicente
- Unidad de Cirugía Hepatobiliopancreática, Hospital Universitario Ramón y Cajal, Madrid, España.
| | - Alfonso Sanjuanbenito
- Unidad de Cirugía Hepatobiliopancreática, Hospital Universitario Ramón y Cajal, Madrid, España
| | - Eduardo Lobo
- Unidad de Cirugía Hepatobiliopancreática, Hospital Universitario Ramón y Cajal, Madrid, España
| |
Collapse
|
5
|
van der Hel O, Timmermans M, van Altena A, Kruitwagen R, Slangen B, Sonke G, van de Vijver K, van der Aa M. Overview of non-epithelial ovarian tumours: Incidence and survival in the Netherlands, 1989–2015. Eur J Cancer 2019; 118:97-104. [DOI: 10.1016/j.ejca.2019.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 06/07/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023]
|
6
|
Hirano T, Okumura H, Maeda S, Shimada M, Imakiire A, Makisumi K, Higashi M, Natsugoe S. Vascular leiomyosarcoma originating from the right ovarian vein: a case report and literature review. Surg Case Rep 2019; 5:120. [PMID: 31342204 PMCID: PMC6656842 DOI: 10.1186/s40792-019-0679-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/19/2019] [Indexed: 01/21/2023] Open
Abstract
Background Primary leiomyosarcoma (LMS) of vascular origin is a rare lesion, and patients with LMS of vascular origin have poorer prognoses than patients with LMS of other origins. The inferior vena cava is the most commonly affected vessel and accounts for 60% of all vascular cases. However, LMS originating from the ovarian vein is extremely rare, and we are only aware of 15 reported cases. Therefore, we report our experience with a case of LMS originating from the right ovarian vein and review the related literature. Case presentation A 71-year-old Japanese woman with no symptoms was admitted to our hospital because of abnormal findings in a routine abdominal ultrasonography check-up. Contrast-enhanced computed tomography of the abdomen revealed a well-defined, lobulated solid mass with a diameter of 5.5 cm in the right retroperitoneal space. The mass exhibited relatively low uptake during 18F-fluorodeoxyglucose positron emission tomography. Based on these findings, the differential diagnosis included a retroperitoneal tumor, such as a desmoid tumor, leiomyoma, LMS, and malignant mesothelioma. Operative findings confirmed that the mass had originated from the right ovarian vessels, and en bloc excision was performed for the mass and the right ovarian vessels. The final pathological diagnosis was LMS originating from the right ovarian vein, and the surgical resection margins were free from tumor cells. After histological findings confirmed the LMS diagnosis, the patient underwent adjuvant radiation therapy and has not exhibited signs of local recurrence or metastasis in the 6 months after surgery. Conclusions We encountered a 71-year-old woman with LMS originating from her right ovarian vein. The prognosis of vascular LMS is generally poor. Therefore, careful follow-up will be required for our patient.
Collapse
Affiliation(s)
- Takuro Hirano
- Department of Surgery, Southern Region Hospital, Midorimachi 220, Makurazaki, Kagoshima, 898-0011, Japan.
| | - Hiroshi Okumura
- Department of Surgery, Southern Region Hospital, Midorimachi 220, Makurazaki, Kagoshima, 898-0011, Japan
| | - Satoru Maeda
- Department of Surgery, Southern Region Hospital, Midorimachi 220, Makurazaki, Kagoshima, 898-0011, Japan
| | - Mario Shimada
- Department of Surgery, Southern Region Hospital, Midorimachi 220, Makurazaki, Kagoshima, 898-0011, Japan
| | - Akira Imakiire
- Department of Surgery, Southern Region Hospital, Midorimachi 220, Makurazaki, Kagoshima, 898-0011, Japan
| | - Kanro Makisumi
- Department of Surgery, Southern Region Hospital, Midorimachi 220, Makurazaki, Kagoshima, 898-0011, Japan
| | - Michiyo Higashi
- Department of Pathology, Kagoshima University Hospital, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan
| | - Shoji Natsugoe
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka 8-35-1, Kagoshima, 890-8520, Japan
| |
Collapse
|
7
|
Ghirardi V, Bizzarri N, Guida F, Vascone C, Costantini B, Scambia G, Fagotti A. Role of surgery in gynaecological sarcomas. Oncotarget 2019; 10:2561-2575. [PMID: 31069017 PMCID: PMC6493462 DOI: 10.18632/oncotarget.26803] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/19/2019] [Indexed: 12/13/2022] Open
Abstract
Gynaecological sarcomas account for 3-4% of all gynaecological malignancies and have a poorer prognosis compared to gynaecological carcinomas. Pivotal treatment for early-stage uterine sarcoma is represented by total hysterectomy. Whereas oophorectomy provides survival advantage in endometrial stromal sarcoma is still controversial. When the disease is confined to the uterus, systematic pelvic and para-aortic lymphadenectomy is not recommended. Removal of enlarged lymph-nodes is indicated in case of disseminated or recurrent disease, where debulking surgery is considered the standard of care. Fertility sparing surgery for uterine leiomyosarcoma is not supported by strong evidence, whilst available data on fertility sparing treatment for endometrial stromal sarcoma are more promising. For ovarian sarcomas, in the absence of specific data, it is reasonable to adapt recommendations existing for uterine sarcomas, also regarding the role of lymphadenectomy in both early and advanced stage disease. Specific recommendations on cervical sarcomas' surgery are lacking. Existing data on surgical approach vary from radical hysterectomy to fertility-preserving surgery in the form of trachelectomy or wide local excision, however no definite conclusions can be drafted on the recommended surgical approach. For vulval sarcomas, complete surgical excision with at least 2 cm of free margin is considered to be the primary treatment which is associated with good prognosis. The aim of this review is to provide highest quality evidence to guide gynaecologic oncologists throughout surgical management of gynaecological sarcomas.
Collapse
Affiliation(s)
- Valentina Ghirardi
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.,Catholic University of Sacred Heart, Rome 00168, Italy
| | - Nicolò Bizzarri
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.,Catholic University of Sacred Heart, Rome 00168, Italy
| | - Francesco Guida
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.,Catholic University of Sacred Heart, Rome 00168, Italy
| | - Carmine Vascone
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.,Catholic University of Sacred Heart, Rome 00168, Italy
| | - Barbara Costantini
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.,Catholic University of Sacred Heart, Rome 00168, Italy
| | - Giovanni Scambia
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.,Catholic University of Sacred Heart, Rome 00168, Italy
| | - Anna Fagotti
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome 00168, Italy.,Catholic University of Sacred Heart, Rome 00168, Italy
| |
Collapse
|
8
|
[LEIOMYOSARCOMA OF THE OVARIAN VEIN WITH THE RENAL VEIN INVASION: A CASE REPORT]. Nihon Hinyokika Gakkai Zasshi 2017; 108:210-214. [PMID: 30333444 DOI: 10.5980/jpnjurol.108.210] [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] [Indexed: 11/08/2022]
Abstract
A 56-year-old woman had complained of two year's consecutive left-side abdominal pain. Retroperitoneal tumor was diagnosed and the patient was referred to our institute in December 2014. Laboratory data including endocrinological activity and serological markers were within the normal ranges. Imaging studies showed that the solid tumor measuring 5 cm in diameter was uncovered in the retroperitoneum, between the abdominal aorta and left kidney. The patient underwent surgical removal of the tumor with the left kidney because the mass was highly adhesive to the left ovarian vessels and left renal vein. Histological examination showed proliferating spindle cells in the tumor, and immunoreactivity for desmin and alfa-smooth muscle actin in tumor cells confirmed the diagnosis of leiomyosarcoma originated in left ovarian vein with left renal vein invasion. The patient has been free of disease 21 months after the surgery. Ovarian vein leiomyosarcoma is extremely rare and we have found 18 cases in literature. Furthermore, only three cases of leiomyosarcoma arising from the ovarian vein with the renal vein invasion were reported including our case.
Collapse
|