A Rare Tumor in the Adrenal Region: Neuron-specific Enolase (NSE)-Producing Leiomyosarcoma in an Elderly Hypertensive Patient

Goto, Junko; Otsuka, Fumio; Kodera, Ryo; Miyoshi, Tomoko; Kinomura, Masaru; Otani, Hiroyuki; Mimura, Yukari; Ogura, Toshio; Yanai, Hiroyuki; Nasu, Yasutomo; Makino, Hírofumi

doi:10.1507/endocrj.k07e-020

Cited by 18 publications

(26 citation statements)

References 36 publications

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“…Some studies have reported that radiation therapy is particularly important in cases where a large tumor locally redevelops or a tumor is located at a site that makes its complete removal difficult [12][13][14]. Doxorubicin and ifosfamide have been the most effective chemotherapy for soft tissue sarcomas in monotherapy and combination therapy for the past 4-5 years.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Primary Adrenal Leiomyosarcoma in an Aged Japanese Woman: A Rare Case Report

Aoki¹,

Tanaka²,

Suzuki³

et al. 2017

J Clin Case Rep

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Primary adrenal leiomyosarcoma is an extremely rare tumor. Here, we report the case of a primary adrenal leiomyosarcoma in an 81-year-old woman. Computed tomography showed a right adrenal tumor (7 cm). There were no abnormal findings on physical examination and her serum adrenal hormone levels were normal. However, 67Gallium scintigraphy showed gallium accumulation at the site of a right adrenal tumor, and malignancy was suspected. The right adrenal tumor was surgically removed and histological examination revealed that it was a leiomyosarcoma. After surgical treatment, the patient was administered different types of chemotherapy but she died of local recurrence 1 year later.

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Section: Discussionmentioning

confidence: 99%

“…Radiotherapy was not used in this case, but its use in cases of localized recurrence has been reported to be effective. It is possible that its use in addition to chemotherapy should also have been considered in the treatment of our patient [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Primary Adrenal Leiomyosarcoma in an Aged Japanese Woman: A Rare Case Report

Aoki¹,

Tanaka²,

Suzuki³

et al. 2017

J Clin Case Rep

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“…Metastases in bilateral femurs were found by PET, and a liver metastasis was found by PET before it was found by CT. A recent report showed strong uptake in an ALMS by PET. 9 PET may therefore be useful for the early detection of ALMS metastasis.…”

Section: Discussionmentioning

confidence: 99%

Bilateral adrenal leiomyosarcoma treated with multiple local therapies

et al. 2009

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A 62-year-old woman presented with right flank pain, and computed tomography (CT) showed bilateral adrenal tumors (right, 8 cm; left, 4 cm). There were no abnormal findings on physical examination, and adrenal hormone levels in serum and urine were within normal limits. Radiological studies showed a right adrenal tumor with intratumoral hemorrhage, a cystic tumor in the left adrenal gland, and no sign of distant metastasis. Because laboratory tests showed normal levels of adrenal hormones, we considered the tumors to be nonfunctioning adrenal tumors. The right adrenal tumor was surgically removed because it was thought to be malignant, and histological examination revealed that it was a leiomyosarcoma. Postoperative CT showed a pleural metastasis in the right chest wall. The patient received combination chemotherapy with cyclophosphamide, vincristine, adriamycin, and dacarbazine. The metastasis was also treated with radiofrequency ablation (RFA). Because the left adrenal tumor grew rapidly despite two courses of the chemotherapy, it too was surgically removed. After the operation, metastasis in the right iliac bone was treated with RFA and radiotherapy. Positron emission tomography detected bilateral femoral metastases, and these were treated with radiotherapy in combination with a low dose of cisplatin. A liver metastasis and a small metastasis in the left kidney were treated with RFA and a metastasis in the pancreatic tail was removed surgically. Sixteen months after the right adrenalectomy, the patient died due to systemic spread of the disease. Multiple local treatments including RFA, radiotherapy, and resection were effective for the local control of metastatic lesions of adrenal leiomyosarcoma.

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“…A causa não está bem esclarecida, porém sabe-se que tem seu crescimento a partir de alguma estrutura ou órgão que contenha mús-culo liso (1). Foi proposta a origem do tumor a partir da veia central da glândula adrenal ou alguma de suas tributárias (2)(3)(4). O leiomiossarcoma primário de adrenal não apresenta fatores de risco bem defi nidos.…”

Section: Discussionunclassified

“…As técnicas imunoistoquímicas junto com o estudo ultra-estrutural contribuem, de maneira efi caz, para o diagnóstico desse tipo de tumor (4). O estudo imunoistoquímico revela positividade para marcadores mesenquimais, como desmina e vimentina, e também de músculo liso como a actina (1)(2)(3).…”

Section: Leiomiossarcoma Primário De Adrenalunclassified

Leiomiossarcoma primário de adrenal

Tomasich

Luz

Kato

et al. 2008

Arq Bras Endocrinol Metab

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Leiomiossarcoma Primário de Adrenal RESUMOO leiomiossarcoma da glândula adrenal é uma neoplasia extremamente rara, cuja origem provém da veia central da adrenal ou de suas tributárias. Estes tumores são vistos com incidência aumentada em pacientes infectados pelo vírus da imunodefi ciência humana adquirida (HIV) e também pelo vírus Epstein-Barr (EBV). Relata-se o caso de uma paciente de 48 anos diagnosticada, por meio de exames de imagem, massa ocupando loja adrenal esquerda, próxima ao pâncreas. Foi submetida à ressecção cirúrgica com achados histopatológicos e imunohistoquímico compatíveis com leiomiossarcoma primário de adrenal. A paciente foi a óbito após 53 meses da adrenalectomia. Concluiu-se que, não obstante a raridade desta neoplasia, sabe-se que, bem como os demais sarcomas de partes moles, o leiomiossarcoma de adrenal se comporta de maneira agressiva e tem na adrenalectomia o tratamento de escolha, não sendo necessário o emprego de quimio ou radioterapias de rotina, exceto em doença metastática ou irressecável. ABSTRACT Primary Adrenal Leiomyosarcoma.Leiomyosarcoma of adrenal gland is an extremely rare tumor originating from the central adrenal vein or its tributaries. Patients with human immunodefi ciency virus (HIV) and Epstein-Barr infection have a higher incidence of these tumors, but even in those, the overall incidence is very low. In this paper we report a case of a 48 year-old woman whose diagnosis was made by image exams that had suggested a mass in adrenal area. This patient was submitted to surgery for resection of the mass. The histopathologic and immunohistochemistry exams were compatible with primary leiomyosarcoma of adrenal gland. Fifty-three months after adrenalectomy the patient died with recurrent disease. Despite of the rarity of this tumor, leiomyosarcoma of adrenal gland has an aggressive behavior, such as the others soft tissue sarcomas. The adrenalectomy is the primary treatment, while chemotherapy or radiotherapy is not prescribed except in metastatic or bulky and not operative disease. (Arq Bras Endocrinol Metab 2008; 52/9:1510-1514)

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A Rare Tumor in the Adrenal Region: Neuron-specific Enolase (NSE)-Producing Leiomyosarcoma in an Elderly Hypertensive Patient

Cited by 18 publications

References 36 publications

Primary Adrenal Leiomyosarcoma in an Aged Japanese Woman: A Rare Case Report

Primary Adrenal Leiomyosarcoma in an Aged Japanese Woman: A Rare Case Report

Bilateral adrenal leiomyosarcoma treated with multiple local therapies

Leiomiossarcoma primário de adrenal

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