An uncommon histopathological diagnosis

Bode, H.; Sciot, Raf; Werbrouck, Emilie; Geusens, Eric; Deroose, Christophe M.; Nackaerts, Kristiaan

doi:10.1183/20734735.027418

Cited by 2 publications

(5 citation statements)

References 17 publications

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“…Pulmonary sarcomas are extremely rare, accounting for less than 10% of all soft tissue sarcomas. 1,2,5 Most of PPS are leiomyosarcomas, followed by fibrosarcomas and hemangiopericytomas. 4 Until 2006, there were only 300 cases of PPS that had been reported in the literature.…”

Section: Casementioning

confidence: 99%

“…2,4 The prevalence of PPL was reported to be less than 0.5% of all types of lung cancer. 1,2 This type of tumor mostly occurs in the age over 50 years, with the median age of 51 years. Men are reported to have 2-fold higher risk to develop PPL than women.…”

Section: Casementioning

confidence: 99%

“…Surgery is the most common treatment approach in PPL, especially in cases with no evidence of metastasis. 1,3,4,18 Surgery is considered as the only curative therapy option, with lobectomy as the gold standard therapy in PPL. 5,6 Wedge resections may be performed if the tumor is small and peripherally located, although this approach has shown a higher local recurrence rate.…”

Section: Casementioning

confidence: 99%

“…5 In general, the prognosis of PPL is still poor. 1 In a cohort study with 60.4% of patients undergoing treatment and 14.1%…”

Section: Casementioning

confidence: 99%

“…Primary pulmonary leiomyosarcoma is a very aggressive tumor that has the capability to grow and to cause symptoms very quickly. [1][2][3][4][5] We report a case of pulmonary leiomyosarcoma in a 51-year-old male with the chief complaint of cough in the past 2 weeks before admission. This report will discuss how pulmonary leiomyosarcoma is being treated using Carboplatin/Etoposide chemotherapy based on the existing literatures.…”

Section: Introductionmentioning

confidence: 99%

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Primary Pulmonary Leiomyosarcoma : an Extremely Rare, Difficult-to-Manage Case of Lung Cancer

Binharyanto,

Ngakan Putu Parsama Putra,

Ungky Agus Setyawan

et al. 2023

MRJ

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Background: Primary Pulmonary Leiomyosarcoma (PPL) known as <0.5% of total lung cancer. Histopathological examinations are the pillars of PPL diagnosis as clinical manifestations and radiological features are usually not specific. Treatments of PPL include surgical resection, radiotherapy, and chemotherapy. Case Illustration: A 51-year-old male, smoker, with a productive cough for 2 weeks, accompanied by chest pain, weight loss, and loss of appetite. Imaging studies showed a solid mass in the right lung, which was confirmed through bronchoscopy, cytology, histology, and immunohistochemistry evaluations. Bronchoscopy showed an intraluminal mass in the right main bronchus suggesting malignancy. Immunohistochemistry of Desmin and Smooth Muscle Actin, which were positive, confirmed the diagnosis of PPL of the right lung stage T4N1M1a IVA. Discussion: Surgical resection is the gold standard treatment for PPL whose clinical conditions and tumor spread still allowed for safe operation. Surgical resection did not undergo because already in stage IVA. Radiotherapy and chemotherapy can be added for patients who are unable to have surgery. There are no guidelines regarding chemotherapeutic regimens that are recommended for PPL. Cisplatin/carboplatin and etoposide are two chemotherapeutic agents that are commonly used in other variants of lung cancer. Cisplatin is successful in 5-23% of patients and etoposide is successful in 8%. Doxorubicin and ifosfamide are usually used for soft tissue sarcoma too. After administration of 4 cycles of carboplatin/etoposide, a chest CT scan with contrast recist shows the progression of PPL. Conclusion: Carboplatin and etoposide have been long used as therapy for lung cancer. Currently, available literature shows that their effectiveness in PPL is still considered low. Nevertheless, more studies are needed to further explore the possibilities of using carboplatin and etoposide in PPL patients. Keywords: chemotherapy, lung cancer, primary pulmonary leiomyosarcoma

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Section: Casementioning

confidence: 99%

Section: Casementioning

confidence: 99%

Section: Casementioning

confidence: 99%

“…5 In general, the prognosis of PPL is still poor. 1 In a cohort study with 60.4% of patients undergoing treatment and 14.1%…”

Section: Casementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Primary Pulmonary Leiomyosarcoma : an Extremely Rare, Difficult-to-Manage Case of Lung Cancer

Binharyanto,

Ngakan Putu Parsama Putra,

Ungky Agus Setyawan

et al. 2023

MRJ

View full text Add to dashboard Cite

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Primary Pulmonary Leiomyosarcoma Managed With Pazopanib: A Case Report and Literature Review

Khosravi,

Keshtegar,

Tavakoli Pirzaman

2024

Therapeutic Advances in Pulmonary and Critical Care Medicine

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Primary pulmonary leiomyosarcoma (PPL) arises from pulmonary smooth muscle tissue, with less than 0.5% incidence among pulmonary malignancies and 30% among primary pulmonary sarcomas. Here, we present a case of PPL managed with pazopanib. Moreover, a brief review of relevant literature was conducted. A 65-year-old female presented with chronic cough, weight loss, and recurrent pneumonia, with a medical history including diabetes mellitus, hypertension, and hyperlipidemia, as well as past surgical colectomy and hysterectomy (due to abnormal uterine bleeding with normal pathology and no evidence of uterine leiomyosarcoma). Upon admission, she exhibited fever, cough, dyspnea, and decreased breath sounds over the upper lung lobe. Diagnostic workups revealed a large pulmonary mass, diagnosed as leiomyosarcoma via core needle biopsy and subsequent immunohistochemical staining. Neoadjuvant treatment with ifosfamide and adriamycin followed by chemoradiotherapy was attempted, but surgery for tumor resection was not feasible. Then, gemcitabine and docetaxel were chosen as the new treatment after ifosfamide and adriamycin were not effective. Imaging revealed tumor not reacting to latest treatment, either. Given the disease's persistence and the patient's diminished capacity for chemotherapy, the patient is presently undergoing pazopanib treatment, with ongoing monitoring of its effects. After 3 months of treatment with pazopanib (administered orally at 200 mg twice daily), the patient experienced a significant reduction in tumor size, with a notable decrease from 135 mm to 80 mm, approximating one-third of the initial size, indicating a positive therapeutic effect. This case report provides preliminary evidence suggesting that pazopanib, an oral multi-tyrosine kinase inhibitor, may be a promising therapeutic option for the management of PPL. However, further in-depth and long-term studies are warranted to evaluate the clinical efficacy and superiority of this treatment.

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An uncommon histopathological diagnosis

Cited by 2 publications

References 17 publications

Primary Pulmonary Leiomyosarcoma : an Extremely Rare, Difficult-to-Manage Case of Lung Cancer

Primary Pulmonary Leiomyosarcoma : an Extremely Rare, Difficult-to-Manage Case of Lung Cancer

Primary Pulmonary Leiomyosarcoma Managed With Pazopanib: A Case Report and Literature Review

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