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Pancreatic metastasis of leiomyosarcoma in the right thigh: a case
report.World
J Gastroenterol. 2007 Feb 21;13(7):1135-7.
Pancreatic
tumors are primary in most of the cases. Pancreatic metastases
associated with other primary malignancies, especially pancreatic
metastasis of leiomyosarcoma, are uncommon. A 66-year-old woman
underwent surgical resection of malignant mesenchymoma (70%
osteosarcoma and 30% leiomyosarcoma) in the right thigh. In the
postoperative period, a pancreatic mass was identified
radiologically by abdominal computed tomography. Pylorus-preserving
pancreaticoduodenectomy was performed. The surgical specimen
revealed leiomyosarcoma metastasized to the pancreas. A metastatic
nodule on the remnant pancreatic tail was discovered 9 mo after the
first pancreatic resection, and distal pancreatectomy was performed.
Cases of pancreatic metastasis from leiomyosarcoma are extremely
rare, especially when the tumor was resectable. We report here a
unique case of pancreatic metastasis from a leiomyosarcoma in the
right thigh that had been treated surgically.
Primary
leiomyosarcoma of the pancreas: a case report and review of
literature.
Arch Pathol Lab Med. 2001
Jan;125(1):152-5.
Primary
leiomyosarcoma of the pancreas is a rare tumor for which only 21
reports appear in the world literature. We describe an additional
case of pancreatic leiomyosarcoma in a 76-year-old man, who
complained of persistent high fever. Histologic examination revealed
a pleomorphic spindle cell tumor. Reactivity for muscle-specific
actin, alpha-smooth muscle actin, and basement membrane components,
along with negative staining for epithelial and neural markers, were
consistent with a smooth muscle sarcoma. The patient died of disease
1 year after complete surgical excision. This report highlights the
need to use a complete antibody panel in order to accurately
immunophenotype pleomorphic malignant tumors of the pancreas. A
review of the cases compiled in the literature indicates that
pancreatic leiomyosarcoma, like its counterpart arising in deep soft
tissues, is an aggressive neoplasm characterized by short survival
and a high rate of metastases.
Pancreatic
leiomyosarcoma: clinicopathohistological presentation of a rare
tumor.Hepatogastroenterology.
2000 Mar-Apr;47(32):556-9.
A smooth
muscle tumor originating from the pancreas is an extremely rare
neoplasm characterized by peculiar histopathologic features and
progressive clinical course. We report a case of such a pancreatic
neoplasm occurring in a 57-year-old female who underwent surgical
resection. The tumor was histologically as well as
immunocytochemically analyzed. The spindle cell pattern, vimentin
and actin reactivity confirmed smooth muscle differentiation. On the
basis of the degree of cellular atypias and the mitotic counts, the
malignant potential of the tumor was assessed. Sharp demarcation of
the growth appearing characteristic for this type of pancreatic
neoplasia with no invasion into the surrounding organs enabled
complete excision in spite of the large dimensions of the tumor.
Leiomyosarcoma and stromal tumor of the pancreas.J
Radiol. 2001 Dec;82(12 Pt 1):1723-5.
A tumor of
the head of pancreas was an incidental finding on US of two patients
aged 52 and 61 years presenting with abdominal pain. The tumor was
studied by computed tomography, MRI and endoscopic ultrasonography.
Surgical biopsy of a liver lesion was performed in one case and
partial duodenopancreatectomy was performed in the other case.
Histological evaluation, including immunohistochemistry, showed
leiomyosarcoma and stromal tumor respectively. Whatever the site of
origin, most mesenchymal pancreatic tumors are hypervascular,
heterogeneous and have a necrotic center.
Metastasis
of uterine leiomyosarcoma to the pancreas.J
Obstet Gynaecol Res. 2005
Dec;31(6):531-4.
BACKGROUND:
Metastasis of uterine leiomyosarcoma to the pancreas is extremely
rare. CASE: A 46-year-old woman presented with hypermenorrhea and
dysmenorrhea and underwent surgery. The histologic and
immunohistochemical diagnosis was uterine leiomyosarcoma stage I
with no metastasis to the ovaries or the pelvic lymph nodes. The
mitotic count was very high. Thereafter, recurrences in the lung and
subsequently in the pancreas were detected. The lesions in the lung
and pancreas were resected and diagnosed as metastases of uterine
leiomyosarcoma based on histology and immunohistochemistry.
CONCLUSION: We report an extraordinarily rare case of uterine
leiomyosarcoma with metastasis to the pancreas following initial
metastasis to the lung, both of which were diagnosed using histology
and immunohistochemistry of the specimens obtained at surgery.
Preoperative
diagnosis of pancreatic leiomyosarcoma.Int
J Pancreatol. 2000 Oct;28(2):97-100.
BACKGROUND:
The low incidence of pancreatic leiomyosarcoma is responsible for
the small number of cases correctly diagnosed preoperatively, the
tumor being frequently confused with benign pancreatic lesions.
RESULTS: We describe a symptom free 52-yr-old male bearing an
abdominal mass incidentally found at physical examination. Imaging
techniques revealed a nonhomogenous large mass at the head of the
pancreas that dislodged the portal vein and the superior mesenteric
vein. Increased metabolic activity in the tumor area demonstrated by
18F-fluorodeoxyglicose positron emission tomography scan allowed the
diagnosis of a malignant lesion. The patient was operated on and a
pylorus preserving pancreatoduodenectomy performed. The pathology
diagnosis was a low grade leiomyosarcoma. Immunohistochemistry
revealed positivity for vimentin and smooth muscle specific actin.
The clinical course was uneventful after 2 yr follow-up. CONCLUSION:
Pancreatic leiomyosarcoma may be preoperatively diagnosed by image
techniques and differentiated from benign lesions by means of
fluorodeoxyglicose positron emission tomography scanning (FDGPET).
MR imaging
of primary pancreatic leiomyosarcoma. Br
J Radiol. 1998 May;71(845):561-3.
Primary
leiomyosarcoma of the pancreas is a rare neoplasm with only 17
reported cases in the literature. Although the ultrasonic and
computed tomographic appearances have been described, the magnetic
resonance features of pancreatic leiomyosarcomas have not. In this
report, we describe the MR characteristics of a primary pancreatic
leiomyosarcoma which was an incidental finding on ultrasound. The
unenhanced T1 weighted and T2 weighted images were the most useful
in tumour localization whereas the enhanced images actually obscured
the tumour within the pancreas. Differentiation from the much more
commonly occurring adenocarcinoma was impossible.
Fatty
replacement of the pancreatic body and tail associated with
leiomyosarcoma of the pancreatic head.Pathol
Int. 1997 Sep;47(9):633-6.
A case of
fatty replacement of the pancreatic body and tail associated with
leiomyosarcoma of the pancreatic head is presented.
Clinicopathological features as well as differential diagnoses are
described with a review of the literature on both leiomyosarcoma and
fatty replacement of the pancreas. A possible correlation between
the two lesions is also discussed.
Leiomyosarcoma of the pancreas.Int
J Pancreatol. 1995 Feb;17(1):95-7.
A 45-yr-old
female patient was admitted with signs and symptoms of acute
pancreatitis. She had no history of gallstones, alcohol, or trauma.
Her CT scan was consistent with a cystic lesion of the pancreas.
Because of her presenting symptoms and signs, she was initially
treated as an acute pancreatitis. Followup CT scan showed absolutely
no change in the cyst. Surgical consultation was requested. A
diagnosis of a neoplastic cyst was made, and the patient was taken
to surgery where a distal pancreatectomy and splenectomy was
performed. Pathology revealed a leiomyosarcoma of the pancreas. Only
15 other cases of leiomyosarcoma of the pancreas have been reported
thus far in literature.
Leiomyosarcoma of the pancreas: report of a case diagnosed by fine
needle aspiration biopsy.Jpn
J Clin Oncol. 1994 Feb;24(1):42-5.
We present a
case of pancreatic leiomyosarcoma with liver metastasis diagnosed by
liver tumor biopsy. A 66-year-old man had a pancreatic tumor and
hepatic tumors, which were hypoechoic and mixed echoic on
ultrasonography, respectively. They were stained in enhanced
computed tomography and angiography. A fine needle aspiration biopsy
of the liver tumor was performed, and the pathological examination
of the biopsied specimen suggested the tumor cells to have
originated from smooth muscle. Under a diagnosis of pancreatic
leiomyosarcoma with liver metastasis, the patient was treated with
several anticancer agents. The tumor, however, spread to multiple
organs and he dies of the disease two years nine months after the
start of treatment. The diagnosis of pancreatic leiomyosarcoma was
confirmed by autopsy.
Leiomyosarcoma of the pancreas. Report of a case and review of the
literature.Am
J Surg Pathol. 1981 Sep;5(6):597-602.
A case of
leiomyosarcoma of the pancreas, occurring in a 44-year-old male, is
reported. With a preoperative diagnosis of cystadenocarcinoma, the
patient underwent surgical resection of a cystic tumor in the head
of the pancreas. There were no metastases noted at the time. The
resected specimen was diagnosed histologically as a smooth muscle
tumor originating from the pancreas. It was seemingly benign on the
basis of the mitotic counts and the degree of cellular atypism.
However, the tumor proved to be malignant; the patient died with
metastases to the liver. The tumor at autopsy also had few mitoses
(0-1/10 hpf). The previously reported cases were reviewed and the
limitations of histological diagnosis in assessing malignant
potential of smooth muscle tumors are discussed.
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