Leiomyosarcoma Presenting Research Articles

Subcutaneous Leiomyosarcoma Presenting as Tophaceous Gout on the Left Knee.

Subcutaneous Leiomyosarcoma Presenting as Tophaceous Gout on the Left Knee.

S2533 A Rare Metastatic Presentation of Leiomyosarcoma Every Gastroenterologist Should Know

S2533 A Rare Metastatic Presentation of Leiomyosarcoma Every Gastroenterologist Should Know

Breast lump as the initial presentation of metastatic uterine leiomyosarcoma: a case report and comprehensive literature review

Breast lump as the initial presentation of metastatic uterine leiomyosarcoma: a case report and comprehensive literature review

Endometrial Serous Adenocarcinoma and Perineal Leiomyosarcoma: A rare case report of Synchronous Primaries

The simultaneous presentation of endometrial carcinoma and perineal leiomyosarcoma in a patient as a synchronous tumor is very rare.

A monster into the heart: an unusual presentation of cardiac leiomyosarcoma

BackgroundMalignant primary cardiac tumors are infrequent and can lead to an unfavorable prognosis if not identified and treated promptly. Early detection and prompt treatment of malignant primary cardiac tumors are crucial for a better prognosis. This article presents a case of primary cardiac leiomyosarcoma and reviews the literature on this topic.Case presentationFemale patient that developed recurrent pericardial effusion and hemodynamic instability caused by a cardiac tumor, later identified as leiomyosarcoma. Multidisciplinary treatment was administered to the patient.ConclusionsThe initial approach to this type of pathology should include multimodality imaging to establish a prompt diagnosis leading to complete standard treatment, to minimize risks to the patient's heart function which may include resection with complete margins of the neoplasm, otherwise the prognosis may be poor.

S3826 A Rare Case of Metastatic Inferior Vena Cava Leiomyosarcoma Presenting as a Primary Hepatic Malignancy

S3826 A Rare Case of Metastatic Inferior Vena Cava Leiomyosarcoma Presenting as a Primary Hepatic Malignancy

Leiomyosarcoma Presenting as Rupture With a Type II Endoleak After Thoracic Endovascular Aortic Repair.

Endovascular stent-graft therapy is a commonly performed procedure for aortic lesions worldwide and complications unique to stent grafts, such as postoperative endoleaks, are well known. However, as this treatment modality becomes more popular, physicians should carefully monitor for other unexpected complications, which may not always be related to the graft. This study presents a case of leiomyosarcoma of the aorta that developed during follow-up for a type II endoleak (T2EL) after thoracic endovascular aortic repair. The presence of the T2EL hindered the diagnosis of the sarcoma at an early stage. These findings suggest that an apparent aneurysm that grows suddenly during follow-up after stent grafting should raise the index of suspicion for a neoplasm as well as an endoleak.

Leiomyosarcoma presenting as unilateral painless testicular mass in a septuagenarian: a case report with review of the literature

BackgroundPrimary testicular leiomyosarcoma has a rare occurrence and the diagnosis is uncertain on pre-operative assessment. It is often seen in the background of chronic inflammation, radiotherapy, and the use of high-dose anabolic steroids.Case presentationWe report a case of a painless testicular lump in a septuagenarian with pre-existing diabetes mellitus and hypertension but without any oncological risk factors. The primary workup did not reveal any elevation of serum tumour markers or any signs of metastatic disease on contrast imaging. The patient underwent a high inguinal orchiectomy due to a suspicion of germ cell tumor, and histopathology and immunohistochemistry confirmed the diagnosis of leiomyosarcoma.ConclusionTesticular leiomyosarcoma in the elderly is a rare malignancy and usually occur without any pre-existing risk factors. Early treatment provides long-term curative oncological control.

Primary Inferior Vena Cava Leiomyosarcoma Presenting with Proximal Occlusion with Deep Venous Thrombosis and Lower Extremity Edema: Reconstruct vs Ligate Post Resection? A Single Retrospective Case Report

Introduction: Primary leiomyosarcomas of the inferior vena cava (IVC) are rare tumors with a poor prognosis. Curative treatment remains surgical resection with clear margins. Reconstruction vs ligation of the IVC is debatable, especially if the proximal IVC is occluded. This report presents the surgical management of a patient presenting with acutely worsening lower extremity edema and biopsy proven IVC leiomyosarcoma. Methods: This is a retrospective chart review, and the patient was followed up at 2 weeks and at 3 months. Patient provided consent for creation of this case report. Results: The patient’s age at presentation was 67 years and she was of female gender. The IVC leiomyosarcoma had a maximum diameter of 4.8cm, involved the infrarenal IVC only, and the proximal segment was occluded due to bilateral iliofemoral deep venous thrombosis (DVT). She underwent an R0 resection, with immediate reconstruction using 14mm ringed PTFE. Postoperatively, she was noted to have worsening lower extremity edema. The plan was to recanalize her DVTs via endovascular thrombectomy and stenting, however the patient’s edema improved with compression alone. At 2 weeks follow up, her edema had completely resolved. At 3 months follow up, postoperative CT scan showed expected occluded infrarenal IVC graft, and no evidence of recurrent disease. Conclusion: Reconstructing the occluded IVC after resection of the primary IVC leiomyosarcoma gives the patient the option for future endovascular recanalization if there is ongoing lower extremity edema. Further follow up and research is warranted to determine if this provides a feasible long-term solution.

An Uncommon Presentation of a Rare Disease- Anterior Mediastinal Leiomyosarcoma Presenting as Anterior Mediastinal Mass

Soft tissue sarcomas are a rare group of malignancies which arise from smooth muscle cells. Leiomyosarcomas arising from anterior mediastinum is rarely reported in the literature. The current COVID-19 pandemic has caused unprecedented havoc worldwide. It is also causing delay in diagnosis of other diseases. Herein we report a case of an elderly male who was managed as a case of COVID pneumonia and on follow-up review in post COVID clinic was diagnosed to have anterior mediastinal leiomyosarcoma and was managed with chemotherapy.

Liver metastasis or a pseudocyst? A rare presentation of leiomyosarcoma’s metastasis in the liver

Gastrointestinal neoplasms most commonly metastasize to the liver, where they are typically found as solid and hypervascular lesions. Here, we describe a case of a 44-year-old man with a leiomyosarcoma of the rectum, who at the time of diagnosis presented with a small (5 mm in diameter) cyst-like lesion in the liver. Positron emission tomography demonstrated no increased metabolism in the area of the cyst, suggesting a benign character of the lesion. However, after 3 years, CT scans revealed enlargement of the cyst, and local surgical excision was performed. The results of histopathological examination of the resected material were consistent with metastatic leiomyosarcoma. Subsequently, the patient developed lung metastases and died within 2 years. Our case describes a very rare presentation of leiomyosarcoma's metastasis that led to an ill-fated misdiagnosis and dismal disease outcome.

Primary leiomyosarcoma of bones – a rare entity in two different presentations

Introduction. Leiomyosarcomas (LMS) originate from smooth muscle cells. They are very rare malignant neoplasms. Bony Leiomyosarcoma is a variant of spindle cell sarcoma, primarily affecting long bones, predominantly the distal femur and the proximal tibia followed by craniofacial skeleton. Aim. To describe clinical presentation and diagnostic approach of primary leiomyosarcoma of bones in two different patients. Description of the cases. Case 1. A 64-year-old male with a fracture of left distal femur after a fall was investigated and found to have a pathological fracture. An open biopsy of the fracture site confirms leiomyosarcoma. Case 2. A 58-year-old previously healthy female presented with a swelling on right side mandibular region. Orthopantomogram radiograph (OPG) of mandible and Cone beam CT (CBCT) mandible was taken initially and revealed a large area of bone destruction of the right side of the mandible associated with a soft tissue mass. Initial incisional biopsy made the diagnosis of spindle cell sarcoma followed by excisional biopsy, which confirms the diagnosis of moderately differentiated leiomyosarcoma. Conclusion. Primary leiomyosarcoma of bones is very rare. Imaging features are helpful in the evaluation of such conditions, but final diagnosis should be based on histopathologic and immunohistochemical features.

Uterine leiomyosarcoma presenting as septic shock in a 43-year-old woman: a case report

Introduction: Sepsis or septic shock, a life-threatening condition, is rarely reported as the initial manifestation of uterine malignancy. Case report: A 43-year-old woman consulted our hospital for pyrexia, anorexia, dyspnea, and a markedly distended abdomen. Computed tomography images showed a large abdominal tumor occupying almost the entire abdominal cavity with an air-fluid level and multiple masses in both lungs. Pelvic examination revealed necrotic tissues with blood, prolapsing from the uterus, and having a putrid odor. Her vital signs indicated a systemic inflammatory response syndrome. Antibiotic, anti-shock, and anti-disseminated intravascular coagulation therapies were administrated, but the patient died of multiple organ failure at 22 hours after admission. Autopsy and histopathological examination revealed that the giant abdominal mass was a uterine leiomyosarcoma, in which the myometrium was extensively necrotic with a putrid odor. The patient’s blood culture was positive for Escherichia coli, and sepsis and septic shock due to intrauterine infection of the uterine leiomyosarcoma was considered as the cause of death. Conclusions: Physicians should be aware that uterine malignancy could present as sepsis in women with an abdominal mass.

Leiomyosarcoma: A Rare Cause of Colocolic Intussusception

Intussusception is an infrequent presentation in adult patients and accounts for less than 1% of all cases of adult bowel obstruction. Colon is most commonly involved site and in 56% cases, the underlying cause is a malignant neoplasm. Leiomyosarcoma of colon is an extremely rare tumour. A 30-year-old male patient presented to the Surgery Department with chief complaints of dull, diffuse and colicky abdominal pain associated with abdominal distension and vomiting for 15 days. On abdominal examination, abdomen was distended with generalised tenderness and rigidity. X-ray abdomen showed features suggestive of bowel obstruction. Contrast Enhanced Computed Tomography (CECT) revealed bowel within bowel appearance of a segment of descending colon suggestive of colocolic intussusception. Exploratory laparotomy revealed colocolic intussusception with a large obstructing growth in the descending colon acting as a lead point. Left hemicolectomy with colocolic anastomosis was done. Final histopathological report confirmed epithelioid leiomyosarcoma. Adjuvant chemotherapy was administered and the patient is disease free at one year of follow-up. Present case report was a rare case of colonic leiomyosarcoma presenting with intussusception. The rarity of this disease and the rare presentation makes this an interesting case. Surgical management remains the mainstay of treatment of these cases.

Primary intracranial leiomyosarcoma presenting with frontal bone mass: a case report

Primary intracranial mesenchymal neoplasms are rare tumors. These tumors are usually metastatic disease from other primary sites. We presented a 31-year-old man with a 6-month history of gradually enlarging frontal mass and positional headache. There was no other symptom demonstrating other organs’ involvement. The patient underwent an uncomplicated craniotomy with clear surgical margins. The pathology review and the immunohistochemistry staining confirmed leiomyosarcoma grade II. We prescribed radiation therapy with tumor dose of 60 Gy in 30 fractions with conformal treatment planning to the tumor bed. As this disease has a high potency for metastasis, we advised four courses of single agent doxorubicin chemotherapy 75 mg/m2 every 4 weeks starting one month after the end of radiotherapy. In the last follow-up visit 34 months later, the patient was disease free in physical exam and imaging findings.

S2075 Rare Case of Leiomyosarcoma Presenting as Gastric Outlet Obstruction With Extramedullary Hematopoiesis

S2075 Rare Case of Leiomyosarcoma Presenting as Gastric Outlet Obstruction With Extramedullary Hematopoiesis

An Unusual Case of Gastric Leiomyosarcoma Presenting as a Giant Polyp

An Unusual Case of Gastric Leiomyosarcoma Presenting as a Giant Polyp

P847 Echocardiographic imaging in primary cardiac tumour-leiomyosarcoma

Abstract Funding Acknowledgements N.A Primary cardiac tumours are rare entities with an incidence rate of 0.0017% to 0.019% of which 25% are malignant. Leiomyosarcomas, a form of primary cardiac sarcoma, accounts for 8-9% of all the cardiac sarcomas (1). Primary cardiac sarcomas typically present late with either quite advanced local cardiac symptoms or non-specific symptoms arising from metastasis (2). We herein report a rare presentation of leiomyosarcoma in a sixty-seven year old female Caucasian female, originally suspected following transthoracic echocardiogram. A large mass filling the Left Atrium(L.A) with a degree obstruction to the Mitral Valve (M.V) was firstly noted on transthoracic echocardiogram. This mass had a broad base, appeared to be originating from the pulmonary veins and was not encapsulated. A small circumferential pericardial effusion was noted. Overall biventricular function was preserved and there was no evidence of pulmonary hypertension. A contrast-enhanced computed tomography scan of the chest, abdomen and pelvis was performed for staging which in addition to known cardiac mass revealed widespread bony metastases. A core biopsy of one of the lumbar paravertebral metastatic deposit was carried out to establish the diagnosis. We hope to add to the pool of increasing overall understanding of primary cardiac sarcomas and share our fascinating echocardiogram findings. In addition, we believe this case supports our recommendation for general practitioners in the United Kingdom to have open access to requesting echocardiograms in order to identify such aggressive cardiac malignancies at an earlier stage, with the hope to improve prognosis. Abstract P847 Figure. Depicting LA mass occupying the whole of

A Case of Retroperitoneal Leiomyosarcoma Presenting as a Cystic Lesion

A Case of Retroperitoneal Leiomyosarcoma Presenting as a Cystic Lesion

Primary hepatic leiomyosarcoma presenting as a thick-walled cystic mass resembling a liver abscess

Rationale:Hepatic leiomyosarcoma is a rare malignant tumor, and in rare instances, its combination with fever may lead to misdiagnosis of liver abscess. In our case, the presence of the tumor was considered by the presence of blood vessels through the observation of hepatic tumor wall.Patient concerns:A 38-year-old woman who had been diagnosed with a liver abscess in a local hospital consulted our institution by complaining left upper quadrant pain and fever. The diagnosis was questioned in our workup, since no obvious inflammatory marker was found in the circulation, and contrast-enhanced computed tomography revealed a huge thick-walled mass in the right liver with multiple tortuous vessels within the wall.Diagnosis:Imaging revealed a neoplastic lesion rather than liver abscess. The enhancement of the solid tumor tissues was reduced during the portal phase and delayed phase, which was consistent with a wash-out enhancement. The histopathologic and immunohistochemical results confirmed the diagnosis was primary hepatic leiomyosarcoma. A pulmonary nodule during the postoperative follow-up was diagnosed as metastatic leiomyosarcoma tumor through surgery.Interventions:A right hepatectomy was performed to cure the hepatic mass. In the follow-up, a metastatic tumor in the lung was resected, followed by chemotherapy.Outcomes:Lung metastasis and liver recurrence occurred at 25 and 39 months after liver surgery, respectively. Then the patient was lost to follow-up.Lessons:Leiomyosarcoma is associated with a dismal prognosis, but outcomes for these patients may be improved by the combined surgical resection and chemotherapy.