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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.
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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
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2
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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
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3
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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
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Karaosmanoglu AD, Onur MR, Uysal A, Akata D, Ozmen MN, Karcaaltincaba M. Tumor in the veins: an abdominal perspective with an emphasis on CT and MR imaging. Insights Imaging 2020; 11:52. [PMID: 32215762 PMCID: PMC7096619 DOI: 10.1186/s13244-020-00854-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/02/2020] [Indexed: 02/06/2023] Open
Abstract
Endovenous tumor thrombus in abdomen should be accurately diagnosed as it is a significant finding that may change medical and surgical treatment approaches. As some underlying reasons for endovenous tumor thrombi are relatively rare and imaging findings may be quite subtle, they can be easily overlooked which may have important clinical consequences. In this paper, we described the various imaging aspects of endovenous tumor thrombi originating from various tumor types in different venous structures of the abdomen.
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Affiliation(s)
| | - Mehmet Ruhi Onur
- Department of Radiology, Hacettepe University School of Medicine, 06100, Ankara, Turkey.
| | - Aycan Uysal
- Department of Radiology, Gulhane Training and Research Hospital, 06010, Ankara, Turkey
| | - Deniz Akata
- Department of Radiology, Hacettepe University School of Medicine, 06100, Ankara, Turkey
| | - Mustafa Nasuh Ozmen
- Department of Radiology, Hacettepe University School of Medicine, 06100, Ankara, Turkey
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Suzuki K, Taniguchi K, Ito S, Serizawa A, Yamamoto M. Leiomyosarcoma arising from the right ovarian vein. J Surg Case Rep 2019; 2019:rjz302. [PMID: 31807266 PMCID: PMC6884958 DOI: 10.1093/jscr/rjz302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 09/02/2019] [Accepted: 09/13/2019] [Indexed: 01/21/2023] Open
Abstract
Leiomyosarcomas (LMS) of the ovarian vein are extremely rare and have a poor prognosis. Only 10 cases have been reported since 1977. The patient is a 69-year-old woman presented with right abdominal pain. Computed tomography showed a regularly shaped tumor, 80 mm in diameter in the retroperitoneum, adjacent to the descending part of the duodenum. Intraoperatively, the right ovarian vein was found to run through the tumor and was, therefore, resected together with the tumor. Pathological examination revealed a LMS of the right ovarian vein. Nine months postoperatively, multiple lung metastases were detected and chemotherapy was initiated. Delayed diagnosis is associated with high mortality. It is important that the diagnosis of LMS should be made preoperatively when you have already diagnosed a tumor to better direct the surgical approach. Multimodal therapy may improve prognosis.
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Affiliation(s)
- Kazuomi Suzuki
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawata-cho, Shinjyuku-ku, Tokyo 162-8666, Japan
| | - Kiyoaki Taniguchi
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawata-cho, Shinjyuku-ku, Tokyo 162-8666, Japan
| | - Shunichi Ito
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawata-cho, Shinjyuku-ku, Tokyo 162-8666, Japan
| | - Akiko Serizawa
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawata-cho, Shinjyuku-ku, Tokyo 162-8666, Japan
| | - Masakazu Yamamoto
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawata-cho, Shinjyuku-ku, Tokyo 162-8666, Japan
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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.
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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
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Fischetti A, Rutigliani M, Romano N, Marinaro EL, Puppo C, Gorlero F, Melani EF, Rollandi GA. Imaging findings of ovarian leiomyosarcoma with histopathologic correlations. Eur J Obstet Gynecol Reprod Biol 2019; 236:261-262. [PMID: 30898403 DOI: 10.1016/j.ejogrb.2019.02.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 02/26/2019] [Indexed: 11/18/2022]
Abstract
Leiomyosarcoma (LMS) is a malignant mesenchymal tumor deriving from smooth muscle. Ovarian LMS is exceedingly rare and only few reports have been reported in literature. The article illustrates a case of ovarian leiomyosarcoma in a 61-year-old woman, describing CT and MRI features correlated to histopathologic findings. LMS should be included in the differential diagnosis of solid and multiloculated ovarian lesions, in particular in post-menopausal women.
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Affiliation(s)
- Aldo Fischetti
- Department of Health Sciences (DISSAL) - Radiology Section, University of Genoa, Genoa, Italy
| | | | - Nicola Romano
- Department of Health Sciences (DISSAL) - Radiology Section, University of Genoa, Genoa, Italy.
| | | | - Cristina Puppo
- Department of Radiology, E.O. Ospedali Galliera, Genoa, Italy
| | - Franco Gorlero
- Department of Gynecology, E.O. Ospedali Galliera, Genoa, Italy
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Leiomyosarcoma of the Right Gonadal Vein: Review of the Approach and Prognostic in a Rare Case. Case Rep Surg 2019; 2019:4042689. [PMID: 30805242 PMCID: PMC6362473 DOI: 10.1155/2019/4042689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 01/09/2019] [Indexed: 12/28/2022] Open
Abstract
Background Venous leiomyosarcoma is a mesenchymal tumour that represents 5-7% of soft tissue sarcomas. It originates in the smooth muscle cells of the vessel wall and is frequently located in the inferior vena cava. Primary leiomyosarcomas of the gonadal vein are rare, with only 10 cases reported in the literature. Case report We present the case of a 51-year-old woman diagnosed with a right retroperitoneal mass by computed tomography (CT). The differential diagnosis was between a neurogenic tumour and a mesodermic tumour. The tumour was dissected from the vena cava and right ureter by laparoscopy without performing resection en bloc. Histologic examination of the surgical specimen showed a high-grade leiomyosarcoma of the right gonadal vein. The postoperative course was uneventful. Three cycles of chemotherapy with epirubicin-ifosfamide were performed. Discussion and conclusions Venous leiomyosarcoma is an aggressive tumour, and prognosis is poor due to haematogenous spread. No chemotherapy or radiotherapy has yet proven effective in improving survival, and complete surgical excision is currently considered to offer the best chance of cure. Despite the more conservative treatment approach used in the present case, the patient is alive three years after surgery and has a good quality of life. Although it was not used in this patient, the standard procedure for optimal survival is resection en bloc.
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[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.
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