Anorectal leiomyosarcomas

Wang, Teh-Kuang; Chung, Ming-Teng

doi:10.1007/s005350050103

Cited by 15 publications

(12 citation statements)

References 17 publications

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“…One estimate is that less than 300 cases have been reported so far, and anal lesions are even rarer. 23 They tend to occur between 50 to 69 years of age, and approximately 20% of rectal leiomyosarcomas reported from 1881 to 1996 had metastasized at diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Anorectal leiomyomas: report of two cases with different anatomical patterns and literature review

et al. 2004

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Gastrointestinal mesenchymal tumors comprise a rare group of gastrointestinal tract wall tumors that have long been a source of confusion and controversy, especially in terms of pathological classification, preoperative diagnosis, management strategies, and prognosis. This report describes the clinical manifestations and management of 2 rectal leiomyomas and reviews the pertinent literature. Case 1: A 44-year-old woman was admitted reporting a nodule in the right para-anal region for the previous 2 years. At proctological examination, a 4-cm diameter fibrous mass situated in the para-anal region that produced an arch under the smooth muscle on the right rectal wall just above the anorectal ring was noted. Computed tomography and magnetic resonance imaging of the abdomen and pelvis showed the lesion and detected no other abnormalities. Surgical treatment consisted of wide local resection of the tumor through a para-anal incision, with no attempts to perform lymphadenectomy. Case 2: A 40-year-old male patient was admitted reporting constant anal pain for 4 months. He presented a 3-cm submucosal nodule at the anterior rectal wall just above the dentate line. After 2 inconclusive preoperative biopsies, transanal resection of the tumor was performed. Histological analysis of the specimen showed a benign leiomyoma. A review of the literature is presented, emphasizing some clinical and therapeutic aspects of this unusual rectal tumor.

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Section: Discussionmentioning

confidence: 99%

Anorectal leiomyomas: report of two cases with different anatomical patterns and literature review

et al. 2004

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“…Sacrococcygeal lipomas are rare and benign, but they must be recected because of the low possibility of malignant degeneration; when they achieve a diameter greater than 8 cm they should be investigated for malignancy. [36] Fibroma Fibromas are extremely rare and have a high incidence of local recurrence. In the pediatric population it has been described a rare entity called fibromatosis, presented as a sacrococcygeal mass, which is a musculoaponeurotic border line tumor that must be surgically resected.…”

Section: Lipomamentioning

confidence: 99%

Sacrococcygeal neoplastic lesions

et al. 2013

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Sacrococcygeal neoplastic lesions are very rare entities and therefore, a diagnostic and therapeutic challenge. They include developmental cysts, inflammatory, neurogenic, osseous and miscellaneous lesions. In this review, we discuss the incidence, symptoms, characteristics, diagnostic methods and treatment strategies of these enigmatic lesions. We have to highlight the high index of suspicion that is necessary when dealing with chronic sacrococcygeal pain or multiple perianal abscesses or persistent perianal drainage, because any misinterpretation may result in unfavorable outcomes.

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“…However, no criteria have been established to determine the malignity of these tumors 19,21 . Then, certain characteristics suggest the malignity degree, including the tumor size (>5 cm), histological aspect (necrosis of tumor cells, ulceration and cell atypia), and the number of mitotic figures per 10 high-power fields 1,8,14,15,18,19,27,28 . From these, the latter is the most important malignity criterion 7,14,16 ; tumors of less than two mitoses per 10 fields offer good prognosis; however, if two or more mitoses are found, the tumor is usually considered as malign 7,19 .…”

Section: Reportmentioning

confidence: 99%

“…Therefore, a complete analysis of the resected specimens is essential for malignity diagnosis and correct selection of treatment plans 27 . Due to the difficult distinction between benign and malign tumors 2,7-9,13-16,19,21,27 , possibility of recurrence [7][8][9][11][12][13]16,19,21,25,29 and insensitivity of these tumors to adjuvant therapies 7,8,[14][15][16]18,19,28 , most authors recommend the surgical removal of the tumor 3,7,8,[11][12][13][14][15][16][17][18][19][29][30][31] , either through open 15,16,18,21 or endoscopic procedure 1,2,5,10,12,21,32,33 . The surgical treatment should ensure tumor-free margins 1,…”

Section: Reportmentioning

confidence: 99%

“…The options include transanal excision, endoscopic resection, lower anterior resection or abdominoperineal amputation 7,9,15,19 . In both cases, endoscopic resection of the lesion was considered a therapeutic procedure, as the margins were free of neoplasm, and the tumors were smaller than 5 cm, without necrosis, ulceration and cell atypia, and the number of mitoses per 10 highpower fields was less than two 1,8,[14][15]19,27,28 . Some cases using endoscopic resection of rectal leiomyoma have been described 2,10,12,32,33 .…”

Section: Reportmentioning

confidence: 99%

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Treatment of rectal leiomyoma by endoscopic resection

Denadai¹,

Saad-Hossne

Ferraz³

et al. 2011

J. Coloproctol. (Rio J.)

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Leiomyomas of the rectum are rare, with low reported incidence in literature. In most cases, patients are asymptomatic, and are often incidental endoscopic findings. The difficult distinction from leiomyosarcomas, associated with the possibility of recurrence, implies the absence of a standard treatment. Endoscopic resection, if well indicated, may be a therapeutic option. In this study, we report two cases of asymptomatic leiomyoma of the rectum in two patients, discovered incidentally during a routine colonoscopy, removed by conventional polypectomy and discuss its diagnostic and therapeutic aspects based on a literature review.
Os leiomiomas de reto são raros, com baixa incidência relatada na literatura; na maioria dos casos os pacientes são assintomáticos, sendo que em muitos casos são achados incidentais endoscópicos. A dificuldade de distinguí-los dos leiomiossarcomas, aliada a possibilidade de recorrência, implica na inexistência de um tratamento padrão. A ressecção endoscópica desde que bem indicada pode ser uma opção terapêutica. Reportamos dois casos de leiomioma de reto assintomáticos em dois pacientes, descobertos casualmente durante exame colonoscópico de rotina, removidos por polipectomia convencional e discutimos seus aspectos diagnósticos e terapêuticos, através de uma revisão da literatura

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Anorectal leiomyosarcomas

Cited by 15 publications

References 17 publications

Anorectal leiomyomas: report of two cases with different anatomical patterns and literature review

Anorectal leiomyomas: report of two cases with different anatomical patterns and literature review

Sacrococcygeal neoplastic lesions

Treatment of rectal leiomyoma by endoscopic resection

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