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Thaung C. Orbital pathology - Iatrogenic findings and artefacts. Saudi J Ophthalmol 2018; 32:17-22. [PMID: 29755266 PMCID: PMC5944018 DOI: 10.1016/j.sjopt.2018.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 02/01/2018] [Accepted: 02/08/2018] [Indexed: 12/01/2022] Open
Abstract
The relationship between the ophthalmologist and ophthalmic pathologist is particularly important in orbital disease, as diagnosis is heavily dependent on correlation with clinical context. If the patient has previously had treatment to the orbit or an adjacent area, whether for the same or a different condition, tissue changes may occur which affect the histological appearance of any specimen taken. This article is an overview of therapeutic interventions which may cause either orbital pathology or an altered appearance of the tissue, either of which can pose a diagnostic challenge. The problem of artefact is also addressed as another factor which may alter the appearance of a specimen. It is hoped that the information provided in this brief review will help clinicians better evaluate what information may be relevant when submitting a specimen.
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2
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A Case of Orbital Metastasis of Uterine Leiomyosarcoma With Intracranial Extension Presenting With Proptosis. Ophthalmic Plast Reconstr Surg 2014; 32:e51-2. [PMID: 25147935 DOI: 10.1097/iop.0000000000000229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A 57-year-old woman presented with protrusion of the OS 2 months in duration and decreased vision 1 month in duration. The patient was diagnosed with uterine leiomyosarcoma approximately 3 years before presentation. Lung and liver metastases were diagnosed by biopsy 1 year prior to this visit. CT revealed a solid mass with central necrosis in the left lateral orbit that resulted in orbital shifting, bony destruction, and intracranial extension. The diagnosis was left orbital metastatic leiomyosarcoma, and the patient died 2 months after receiving the diagnosis.
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3
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Abraham JA, Weaver MJ, Hornick JL, Zurakowski D, Ready JE. Outcomes and prognostic factors for a consecutive case series of 115 patients with somatic leiomyosarcoma. J Bone Joint Surg Am 2012; 94:736-44. [PMID: 22517390 DOI: 10.2106/jbjs.k.00460] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Leiomyosarcoma is an uncommon tumor that affects 500 to 1000 patients in the United States annually. The purpose of our study was to further define survival rates as well as to identify multivariable predictors of disease-specific mortality, local recurrence, and development of distant metastasis following surgical resection. METHODS We studied a consecutive series of patients treated for leiomyosarcoma at our institution (a tertiary-care referral center) over a ten-year period. Only patients with leiomyosarcoma of soft tissues, vasculature, or bone were included. Those with uterine, gastrointestinal, or cutaneous forms of the disease were excluded. This yielded a cohort of 115 patients with complete follow-up data on which statistical analysis was performed. RESULTS One-year, five-year, and ten-year disease-specific survival rates were 87%, 57%, and 19%, respectively. Tumor depth (p < 0.01), histological grade (p < 0.01), and metastasis at presentation (p = 0.03) were found to be multivariable predictors of mortality. Both retroperitoneal location (p = 0.01) and mitotic rate (p < 0.001) were predictive of distant metastasis. Resection margin was the only multivariable significant predictor of local recurrence in the group treated with surgical resection (p < 0.001). CONCLUSIONS Leiomyosarcoma is an aggressive disease, with a generally poor prognosis. Depth of tumor and high histological grade are indicators of a poor prognosis. Retroperitoneal tumors have a particularly high potential to metastasize.
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Affiliation(s)
- John A Abraham
- Brigham and Women's Hospital, Boston, Massachusetts, USA.
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4
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Abstract
The diagnosis and treatment of orbital and periorbital malignancies are challenging. These tumors can result in blindness, death, and significant cosmetic deformities. Herein, we present the most common ocular malignancies and a systematic approach to diagnosis. Further, we integrate the seventh edition American Joint Committee on Cancer staging system, biomarkers, and multidisciplinary approaches to treatment.
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Affiliation(s)
- Robert M Schwarcz
- The Department of Ocular Tumor and Orbital Disease, The New York Eye Cancer Center, New York City, NY, USA
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5
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Chen J, Wei R, Ma X. Orbital metastasis of retroperitoneal leiomyosarcoma. Med Oncol 2011; 29:392-5. [PMID: 21264539 DOI: 10.1007/s12032-010-9809-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 12/27/2010] [Indexed: 11/28/2022]
Abstract
Leiomyosarcoma is a relatively rare form of cancer most commonly found in the uterus, stomach, small intestine, retroperitoneum, and vascular tissue. Metastasis is common and surgery with a wide margin of resection is generally considered the most effective management. Leiomyosarcomas, metastatic or primary, of the orbit have rarely been reported. Herein, we report the case of a 51-year-old female with metastatic orbital leiomyosarcoma. The diagnosis was based on her history of leipmyosarcoma, orbital ultrasonography, and computed tomography and confirmed by postoperative histochemistry. She was treated with surgical excision and has remained without recurrence 1 year after surgery.
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Affiliation(s)
- Juan Chen
- Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, 19th floor, Fengyang Road 415#, Shanghai 200003, People's Republic of China
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6
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Fitzpatrick SG, Woodworth BA, Monteiro C, Makary R. Nasal sinus leiomyosarcoma in a patient with history of non-hereditary unilateral treated retinoblastoma. Head Neck Pathol 2010; 5:57-62. [PMID: 20803265 PMCID: PMC3037458 DOI: 10.1007/s12105-010-0207-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Accepted: 08/18/2010] [Indexed: 10/19/2022]
Abstract
Hereditary patients with a history of treated retinoblastoma (RB) have a greatly increased risk of a broad spectrum of secondary malignancies appearing many years later, with a high incidence in the head and neck region. Leiomyosarcomas (LMS) account for up to 58% of these tumors. LMS in the sinonasal region generally are uncommon and are associated with a locally aggressive course and have a poor prognosis. RB may occur in two forms. The hereditary form is generally bilateral but can present unilaterally with a positive family history and typically exhibits a germline mutation in the RB1 gene on chromosome 13. The non-hereditary form is usually unilateral but can show the same germline mutation in up to 10% of cases. Patients with hereditary RB have been shown to have a significantly higher cumulative risk of developing secondary malignancies than those with the non-hereditary form (28 vs. 1.44% respectively). Most reported cases of sinonasal LMS are in patients with a history of the bilateral hereditary form of treated RB. We report a case of LMS of the nasal sinus area in a 35-year-old African American male with a history of non-hereditary unilateral RB and radiation therapy. To the best of our knowledge, this is the first reported case of sinonasal LMS arising in a patient with a history of non-hereditary unilateral RB. The clinical history, radiology, and pathology are presented along with a brief discussion of the literature.
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Affiliation(s)
- Sarah G. Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1600 SW Archer Drive Rm D8-6, Gainesville, FL 32610 USA
| | - Bradford A. Woodworth
- Department of Surgery/Division of Otolaryngology, University of Alabama, Birmingham, AL USA
| | - Carmela Monteiro
- Department of Pathology, University of Florida College of Medicine, Jacksonville, FL USA
| | - Raafat Makary
- Department of Pathology, University of Florida College of Medicine, Jacksonville, FL USA
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7
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Alkatan HM, Maktabi A. Malignant fibrous histiocytoma in a patient with history of treated retinoblastoma. Saudi J Ophthalmol 2010; 24:23-6. [PMID: 23960869 DOI: 10.1016/j.sjopt.2009.12.004] [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] [Received: 03/16/2009] [Accepted: 06/23/2009] [Indexed: 10/20/2022] Open
Abstract
Retinoblastoma is one of the most important childhood tumors with genetic implications and necessity for family counseling and long term follow up. We are presenting a 22 year-old Saudi male with history of bilateral retinoblastoma, who was initially treated by enucleation of his left eye. The histopathology showed a moderately differentiated tumor with vitreous seeding and he received chemotherapy in addition to radiotherapy to his right eye. He presented 20 years later with a right orbital tumor, frozen globe and proptosis. The excisional biopsy of his orbital mass revealed a spindle cell sarcoma with features of malignant fibrous histiocytoma. His clinical and radiological findings are presented together with the histopathologic features of his orbital tumor and brief review of secondary tumors in retinoblastoma patients.
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Affiliation(s)
- Hind M Alkatan
- Department of Pathology and Laboratory Medicine, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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8
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Grabowska SZ, Zimnoch L, Hubert E, Duraj E, Wincewicz-Pietrzykowska A. [Radiation induced leiomyosarcoma. Review of literature and case report]. Otolaryngol Pol 2008; 61:744-9. [PMID: 18552011 DOI: 10.1016/s0030-6657(07)70517-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Post-irradiation sarcomas of head and neck appear seldom, and among them leiomyosarcoma (LMS) is exceptionally rare. 11 cases of this tumour, associated with previous irradiation and situated in this anatomical area have been described so far. The aim of this study was to describe 56 year-old patient with LMS and to compare this case with the others described in the literature. What brought our attention were scanty clinical symptoms coexisted with extensive radiological changes. Radiotherapy can give rise to the development of LMS in different moments of time after the treatment of primary tumor has been finished. In this aspect patients who undergone radiotherapy in the early stage of live and who are more susceptible to this kind of treatment should be followed up more closely and carefully.
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Affiliation(s)
- S Z Grabowska
- Klinika Chirurgii Szczekowo-Twarzowej Akademii Medycznej w Białymstoku
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9
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Ulrich CT, Feiz-Erfan I, Spetzler RF, Isaacs JD, Hott JS, Nakaji P, Coons SW, Joganic EJ, Kresl JJ, Milligan JM, Lettieri SC. Sinonasal leiomyosarcoma: review of literature and case report. Laryngoscope 2006; 115:2242-8. [PMID: 16369174 DOI: 10.1097/01.mlg.0000183767.97518.09] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine prognosis of primary sinonasal leiomyosarcomas after treatment. STUDY DESIGN Literature review and case report. METHODS Review of English literature from MEDLINE and independent sources with the addition of our case. RESULTS Including our case, 63 cases have been reported. Primary treatment includes resection with or without radiation. Chemotherapy has not been reported to be effective. In our case, however, chemotherapy, consisting of etoposide and high-dose ifosfamide, caused the tumor to shrink significantly. On the basis of a review of all reported cases, the overall survival rate at a mean follow-up of 38.24 month is 66%. The minimal overall survival rates at 5 and 10 years are 20% and 6%, respectively. CONCLUSION The prognosis for primary sinonasal leiomyosarcomas is poor. However, a 10-year survival has been reported in a few patients. Chemotherapy may be a useful adjunct when managing extensive lesions unamenable to curative resection.
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Abstract
An 84-year-old woman presented with a right upper eyelid nodule, first noted 1 month earlier. Incisional biopsy revealed leiomyosarcoma, which was subsequently treated with wide excision and adjunctive radiotherapy. There has been no evidence of tumor recurrence in 3 years of follow-up.
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Affiliation(s)
- I-Chan Lin
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
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11
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Okada K, Hasegawa T, Tateishi U, Itoi E. Second primary osteosarcoma with rosette-like structure in a patient with retinoblastoma. Virchows Arch 2004; 445:421-4. [PMID: 15480771 DOI: 10.1007/s00428-004-1082-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2004] [Accepted: 06/15/2004] [Indexed: 10/26/2022]
Abstract
A Japanese male patient developed bilateral retinoblastomas at the age of 1 year, but remained continuously disease-free after enucleation of the left eye and radiation therapy to the right eye. He noticed a painless hard mass around the right temporal bone when he was 25 years old. Biopsy specimen showed a small multi-nodular proliferation of tumor cells with prominent rosette-like structures. Eosinophilic material with focal mineralization was seen in the center of the rosettes. Immunostaining of the tumor cells showed positive reactions for epithelial membrane antigens CD 56 and CD 99. The patient was treated with systemic chemotherapy, and the tumor partially diminished. It is well known that a few osteosarcomas show a rosette-like appearance with production of osteoid in the center, but this is the first case of second primary osteosarcoma with prominent rosette-like features.
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Affiliation(s)
- Kyoji Okada
- Department of Orthopedic Surgery, Akita University School of Medicine, Hondo 1-1-1, Akita 010-8543 Akita, Japan.
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12
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Sedghizadeh PP, Angiero F, Allen CM, Kalmar JR, Rawal Y, Albright EA. Post-irradiation leiomyosarcoma of the maxilla: Report of a case in a patient with prior radiation treatment for retinoblastoma. ACTA ACUST UNITED AC 2004; 97:726-31. [PMID: 15184855 DOI: 10.1016/j.tripleo.2003.11.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Post-irradiation sarcoma is a well-defined complication of radiation therapy, yet few reports document such lesions in the head and neck. A 30-year-old man presented for evaluation of an expansile lesion of the left posterior maxilla. His medical history was significant for a childhood ocular malignancy - unilateral retinoblastoma - which was treated with a combination of surgical enucleation of the eye and external beam radiation therapy. Biopsy of his maxillary lesion revealed a spindle cell malignancy that was morphologically and immunohistochemically consistent with a diagnosis of leiomyosarcoma. Further investigation into the case revealed that the patient had three children, every one of whom developed unilateral retinoblastoma in infancy. Compared to the more frequent presentation of bilateral tumors in hereditary cases of retinoblastoma, such cases of heritable unilateral retinoblastoma are exceptional. Importantly, heritable forms of retinoblastoma confer a significant risk for development of second primary cancers, necessitating long-term clinical follow-up in these patients.
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Affiliation(s)
- Parish P Sedghizadeh
- Department of Oral and Maxillofacial Pathology, College of Dentistry, The Ohio State University, Columbus 43218-2357, USA.
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13
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Ryan RS, Gee R, O'Connell JX, Harris AC, Munk PL. Leiomyosarcoma of the distal femur in a patient with a history of bilateral retinoblastoma: a case report and review of the literature. Skeletal Radiol 2003; 32:476-80. [PMID: 12759785 DOI: 10.1007/s00256-003-0649-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2002] [Revised: 04/01/2003] [Accepted: 04/08/2003] [Indexed: 02/02/2023]
Abstract
We report a case of primary leiomyosarcoma of the distal femoral shaft arising in a patient who had undergone bilateral orbital enucleation for bilateral retinoblastoma several years previously. Radiography demonstrated an osteolytic, expansive lesion with cortical destruction anteriorly in the distal femoral shaft, and these findings were confirmed on CT. MR imaging revealed an expansive intramedullary lesion with cortical breakthrough and soft tissue extension. The occurrence of a second malignancy in patients with a history of bilateral retinoblastoma is well documented. Many different histological types have been described, with osteosarcoma and leiomyosarcoma occurring with the greatest frequency.
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Affiliation(s)
- R S Ryan
- Department of Radiology, Vancouver General Hospital, 899 W. 12th Avenue, Vancouver, BC, V5Z 1M9, Canada
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14
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Venkatraman L, Goepel JR, Steele K, Dobbs SP, Lyness RW, McCluggage WG. Soft tissue, pelvic, and urinary bladder leiomyosarcoma as second neoplasm following hereditary retinoblastoma. J Clin Pathol 2003; 56:233-6. [PMID: 12610106 PMCID: PMC1769895 DOI: 10.1136/jcp.56.3.233] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This report describes two patients who developed leiomyosarcomas, one involving the subcutaneous tissue of the thigh and the pelvic soft tissues and the other the urinary bladder, following hereditary retinoblastoma 36 and 38 years earlier, respectively. There is an increased risk of the development of sarcoma, most commonly osteosarcoma, as a second malignancy following hereditary retinoblastoma. Leiomyosarcoma developing as a second malignancy has rarely been reported and most have occurred in the field of previous radiotherapy. The literature on leiomyosarcoma occurring as a second neoplasm following retinoblastoma is reviewed.
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Affiliation(s)
- L Venkatraman
- Department of Pathology, Belfast City Hospital Trust, Belfast BT9 7AD, Northern Ireland, UK
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15
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Ortega JM, Gómez-Angulo JC, Aragonés P, Jerez P, Alcázar L, Rodríguez-Barbero JM, Salazar F, del Pozo JM. [Leiomyosarcoma of the paranasal sinuses with intracranial involvement: report of a clinical case and review of the literature]. Neurocirugia (Astur) 2001; 12:331-7. [PMID: 11706678 DOI: 10.1016/s1130-1473(01)70690-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We describe a 53 year old man with a two months history of frontal headache and right visual loss, with complete right blindness at the moment of diagnosis. Neither nasal obstruction nor endocrine symptoms were found. Computerized Tomography showed a neoplasm involving both paranasal sinuses and sellar region, with bilateral orbital extension. The patient underwent a bifrontal craniotomy with apparent complete excision. Histopathologic examination proved smooth muscle cells sarcoma (leiomyosarcoma). Clinical evolution was unfavorable, with rapid local recurrence. The patient died of cerebellar metastasis 4 months after the initial diagnosis and treatment. Leiomyosarcoma of the sinonasal tract is an unusual tumor, and we have found only 63 cases previously reported. The most frequent clinical presentation is nasal obstruction. Surgery is the treatment of choice, as far as radiotherapy or chemotherapy do not appear to slow disease progression. No relationship has been found between the aggressiveness of leiomyosarcoma of the sinonasal tract and morphologic parameters; instead, prognosis is dependent on the distribution of disease at clinical onset. Leiomyosarcoma of the sinonasal tract may be regarded as a locally aggressive neoplasm with only limited metastatic potential.
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Affiliation(s)
- J M Ortega
- Servicio de Neurocirugía, Hospital Universitario de Getafe, Getafe, Madrid
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16
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Antonescu CR, Erlandson RA, Huvos AG. Primary leiomyosarcoma of bone: a clinicopathologic, immunohistochemical, and ultrastructural study of 33 patients and a literature review. Am J Surg Pathol 1997; 21:1281-94. [PMID: 9351566 DOI: 10.1097/00000478-199711000-00003] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Leiomyosarcoma of bone is a rare tumor in an unusual location. Previous analysis of this entity mostly involved small numbers of cases with limited follow-up. Thirty-three patients with leiomyosarcoma of bone between 1977 and 1996 were studied, and the histologic appearance and grade were correlated with subsequent treatment and clinical behavior. To be included in this study the tumor had to be intraosseous, with other primary sites of origin clinically excluded. Also, most of the sarcomatous tissue (> or =70%) had to be of intramedullary location with only limited extraosseous extension. The patient's age at diagnosis ranged from 13 to 77 years (average 44.4). The gender distribution was equal. The long bones were preferentially affected (64%), with the lower extremity, around the knee joint, predominantly involved. Five patients (15%) developed postradiation leiomyosarcomas. The histologic analysis showed that the osseous leiomyosarcomas are most commonly of the classic type, followed by the epithelioid, myxoid, and pleomorphic variants. Immunoreactivity for smooth muscle markers (smooth muscle actin, common muscle actin, desmin) was positive in all tumors, and ultrastructural confirmation was obtained in 21% of cases. All sarcomas were histologically graded, which accurately reflected the subsequent prognosis. Seventy-five percent of the lesions were high-grade and the rest low-grade. The histologic grade of the tumors correlated with both the recurrence as well as the metastatic rates and together with the clinicopathologic stage of disease represented the cornerstone on which prudent therapy should be based.
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Affiliation(s)
- C R Antonescu
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
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17
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Abstract
A 47-yr-old man with history of metastatic low-grade rectal leiomyosarcoma presented with progressive protrusion of his left eye due to an enlarging orbital mass. The differential diagnosis included tumor metastasis or orbital infection due to an unknown infectious agent. Diagnostic fine-needle aspiration (FNA) of the orbit was performed on an urgent basis to institute proper therapy and to save the patient's eyesight. Cytomorphologic examination of the material demonstrated a spindle-cell neoplasm consistent with metastatic leiomyosarcoma. It is a rare event for leiomyosarcoma to occur in the orbit. On our review of the literature, the cytology of primary orbital leiomyosarcoma on FNA has only been reported once. To our knowledge, this is the first report of the FNA cytomorphology of metastatic leiomyosarcoma to the orbit.
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Affiliation(s)
- R Logrono
- Wisconsin State Laboratory of Hygiene, Madison, USA
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18
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Okuläre Adnexe: Lider, Tränenapparat und Orbita. ACTA ACUST UNITED AC 1997. [DOI: 10.1007/978-3-642-60402-7_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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19
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Affiliation(s)
- T R Guse
- Division of Orthopedic Surgery, Ohio State University Hospitals, Columbus 43210
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20
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Das DK, Das J, Kumar D, Bhatt NC, Banot K, Natarajan R. Leiomyosarcoma of the orbit: diagnosis of its recurrence by fine-needle aspiration cytology. Diagn Cytopathol 1992; 8:609-13. [PMID: 1468338 DOI: 10.1002/dc.2840080615] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
An 8 1/2-yr-old boy with proptosis was diagnosed to have low-grade leiomyosarcoma of the orbit following lateral orbitotomy and histology of an incompletely excised intraconal mass. He received chemotherapy but had recurrence of proptosis at the age of 12 yr. Ultrasonography revealed a solid mass and its fine-needle aspiration cytology features were consistent with recurrence of leiomyosarcoma. A year later, the cytodiagnosis was confirmed by histology of the excised tumor from a second lateral orbitotomy. Masson's trichrome stain confirmed the smooth muscle nature of the neoplasm and ultrastructural features were in favor of leiomyosarcoma. The patient received intermittent chemotherapy, and is clinically free from disease at the age of 17 yr.
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Affiliation(s)
- D K Das
- Institute of Cytology and Preventive Oncology (ICMR), Maulana Azad Medical College, New Delhi, India
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21
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Lalwani AK, Kaplan MJ. Paranasal sinus leiomyosarcoma after cyclophosphamide and irradiation. Otolaryngol Head Neck Surg 1990; 103:1039-42. [PMID: 2126121 DOI: 10.1177/019459989010300627] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- A K Lalwani
- Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco 94143
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22
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Stevens GN, Tattersall MH, Stalley P, Stalley P. Leiomyosarcoma following therapeutic irradiation for ankylosing spondylitis. Br J Radiol 1990; 63:730-2. [PMID: 2400902 DOI: 10.1259/0007-1285-63-753-730] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- G N Stevens
- Department of Radiation Oncology, Royal Prince Alfred Hospital, Camperdown, Australia
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23
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Craft AW, Malcolm AJ, Farndon JR. Intestinal leiomyosarcoma following treatment of osteosarcoma in a teenage girl. Pediatr Hematol Oncol 1989; 6:341-8. [PMID: 2641704 DOI: 10.3109/08880018909034305] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A teenage girl is described who had an osteogenic sarcoma of the tibia at 11 years of age, a pulmonary metastasis at 13 years, and an intestinal leiomyosarcoma at 15 years. She remains well at the age of 18 years. Leiomyosarcoma is extremely rare in children either as a primary or secondary tumor.
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Affiliation(s)
- A W Craft
- Department of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne, England
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24
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Abstract
The clinicopathologic features of 53 cases of postradiation soft tissue sarcoma (PRS) were correlated with the physical characteristics of the administered radiation. All but three patients received radiation for malignant processes. Of the secondary sarcomas, malignant fibrous histiocytoma (MFH) accounted for 36 cases (68%), followed by seven extraskeletal osteosarcomas (13%), six fibrosarcomas (11%), two malignant Schwannomas (4%), one extraskeletal chondrosarcoma, and one angiosarcoma. The sex incidence, age of the patient at time of diagnosis, and location of the PRS correlated only with the clinical characteristics of the initial treated condition. The latency period (mean 10 years) showed an indefinite relationship to patient survival but no definite relationship to the patient's age at the time of the initial radiation. There was no difference between patients treated with megavoltage radiation (39 patients) and with orthovoltage radiation (seven patients) in the type of sarcoma, location, or survival, although the orthovoltage group received a lower mean radiation dose (3880 rads) than the megavoltage group (4446 rads). Megavoltage radiation, however, produced deeper tissue radiation changes and was associated with a shorter latency period. Most PRS were poorly differentiated, produced abundant collagen, and had a dismal prognosis.
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Affiliation(s)
- W B Laskin
- Department of Soft Tissue Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306
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Shurbaji MS, Olson JL, Kuhajda FP. Thorotrast-associated hepatic leiomyosarcoma and cholangiocarcinoma in a single patient. Hum Pathol 1987; 18:524-6. [PMID: 3032766 DOI: 10.1016/s0046-8177(87)80039-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A 66-year-old man developed two distinct primary malignant hepatic neoplasms (leiomyosarcoma and cholangiocarcinoma) 50 years after Thorotrast administration. This is the first case report of Thorotrast-associated primary hepatic leiomyosarcoma. Ultrastructural and immunohistochemical studies are discussed.
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