Paranasal sinus leiomyosarcoma after cyclophosphamide and irradiation

Leiomyosarcoma of the Nasal Cavity and Paranasal Sinuses: A Case Report and Comprehensive Review of the Literature

Sinonasal leiomyosarcoma (LMS) is a rare and aggressive mesenchymal tumor with smooth muscle differentiation. The sinonasal tract is an unusual primary site for LMS, as scant smooth muscle exists in this location, with only 75 cases reported in the English literature including the case presented herein. Sinonasal LMS is considered an aggressive head and neck tumor with significant potential for recurrence and metastasis. Since recurrence is high and the potential for late metastasis exists, lifelong follow-up in these patients would be beneficial, especially among those with previous history of RB.

[Radiation induced leiomyosarcoma. Review of literature and case report]

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.

Sinonasal leiomyosarcoma: review of literature and case report

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.

Oropharyngeal leiomyosarcoma

A unique case of Oropharyngeal leiomyosarcoma in a 32 years old male is presented with the review of literature The details of clinical, radiological, histopathological and operative findings are discussed The treatment of choice is complete tumor removal The patient was symptom free with no evidence of loco regional or distant metastasis at one-year follow up.

Leiomyosarcoma of the sinonasal tract: a case report and literature review

Leiomyosarcoma of the paranasal sinuses is uncommon and has an aggressive clinical behavior. Only 28 cases have been described in the literature, and, of these, only 3 patients treated with surgery had a disease-free survival. In this report, we describe the clinical history of a 57-year-old woman with a leiomyosarcoma of the paranasal sinuses successfully treated with a combination of surgery, radiation therapy, and chemotherapy. We obtained a total response with ifosfamide, doxorubicin, dacarbazine, and epirubicin. This case report emphasizes the possibility of treating this aggressive tumor with chemotherapy in accordance with the same therapy used in the treatment of uterine leiomyosarcomas.

[Leiomyosarcoma of the paranasal sinuses with intracranial involvement: report of a clinical case and review of the literature]

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.

Leiomyosarcoma of the base of the tongue treated with radiotherapy: a case report

Soft tissue sarcomas of the oral cavity are uncommon malignancies; those of smooth-muscle origin are extremely rare. The world literature reveals about 80 leiomyomas and 26 cases of leiomyosarcoma. Only 4 of the cases with leiomyosarcoma occurred in the tongue. This report of leiomyosarcoma of the base and dorsum of the tongue adds 1 case which was primarily treated with irradiation and achieved an excellent response. A 1.5-year follow-up after radiation-therapy is included and a review of the literature is presented.