Gastrointestinal leiomyosarcoma — Unusual sites: Esophagus, colon and porta hepatis

Balthazar, Emil J.

doi:10.1007/bf01890272

Cited by 23 publications

(10 citation statements)

References 36 publications

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“…Leiomyosarcomas are most commonly found in the middle or distal third of the esophagus because smooth‐muscle forms the muscularis propria in these parts of the esophagus 5,6 . They originate from the smooth musculature of the esophageal wall and are divided into two major groups: the more common intraluminal polypoid form and the infiltrative, invasive form 1,6–8 . They consist of interlacing whorls of spindle cells with increased mitoses 8 .…”

Section: Discussionmentioning

confidence: 99%

Leiomyosarcoma of the esophagus

Pramesh¹,

Pantvaidya²,

Moonim

et al. 2003

Diseases of the Esophagus

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Leiomyosarcomas of the esophagus are rare, malignant, smooth-muscle tumors. The presenting symptoms are indistinguishable from other esophageal neoplasms, though the history may be longer due to the slow growth of these tumors. Barium studies may show large intramural masses with ulceration or tracking, expansile intraluminal masses or areas of luminal narrowing. Endoscopic biopsies may give a high false negative rate especially in cases where the mucosa is intact. The treatment of choice is surgical excision. Synchronous and metachronous metastases do not preclude surgery, provided the metastases are also resectable. Prognosis is better than in patients with squamous esophageal cancer. The role of adjuvant radiotherapy and chemotherapy is controversial. We report a 40-year-old man who presented to us with dysphagia and was found to have a leiomyosarcoma of the esophagus. He was treated successfully with esophagectomy and is disease-free after 7 years. We review the literature on esophageal leiomyosarcomas and their management.

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Section: Discussionmentioning

confidence: 99%

Leiomyosarcoma of the esophagus

Pramesh¹,

Pantvaidya²,

Moonim

et al. 2003

Diseases of the Esophagus

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“…In the past, esophageal leiomyosarcoma has been classified as polypoid in 60 of cases and as infiltrative in 40% 16 . 17 As for the radiographic findings in leiomyosarcoma of the esophagus, Levine et al 15 reported that esophageal leiomyosarcoma has radiographic features similar to those of leiomyosarcoma found elsewhere in the GI tract. Barium studies most commonly revealed large intramural masses that had a marked exophytic component and often contained areas of ulceration or tracking.…”

Section: Discussionmentioning

confidence: 99%

Smooth muscle tumors of the esophagus: clinicopathological findings in six patients

Kimura

Konishi

Kawamura

et al. 1999

Diseases of the Esophagus

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Preoperatively, it is difficult to discriminate leiomyoma and leiomyosarcoma of the esophagus, which are rare smooth muscle tumors. The objective of this study was to evaluate the clinicopathological findings of this unusual lesion. A search of the surgery archives of the Toyama Prefectural Central Hospital of Pathology revealed six cases of esophageal smooth muscle tumors. Clinicopathological findings were reviewed retrospectively. Only three patients (50%) presented with dysphagia, and the remaining three patients were asymptomatic. These patients underwent surgical excision. Histologically four of the six tumors were leiomyomas, and the other two tumors were leiomyosarcomas. Two tumors were in the upper to middle esophagus, and the remaining four were in the distal esophagus. On endoscopic examination, all tumors were noted to be polypoid. The two leiomyosarcomas measured over 5 cm and the four leiomyomas less than 4 cm. Neither ulceration nor necrosis proved to be of use in discriminating leiomyoma and leiomyosarcoma. The two patients with leiomyosarcoma died of liver metastasis 10 and 22 months after the treatment. Patients with leiomyosarcoma presented with distant metastasis and/or recurrence, with hematogeneous metastasis being the predominant type of recurrence.

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“…They originate from the smooth musculature of the esophageal wall and are divided into two major groups: the more common intraluminal polypoid form and the infi ltrative, invasive form [4,9,10]. The case in this report was the former, polypoid form, and suitable for endoscopic resection.…”

Section: Discussionmentioning

confidence: 87%

Esophageal leiomyosarcoma: a case treated by endoscopic resection

et al. 2008

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We report a rare case of leiomyosarcoma of the lower esophagus that was treated by endoscopic resection. A 56-year-old man was referred to our hospital in October 2005 because of mild discomfort around the lower esophagus upon swallowing for 2 months. The esophagogram showed a fi lling defect at the lower esophagus. It revealed a giant polyp tumor arising from the right wall of the lower esophagus. The diameter of the top of the tumor was 25 mm. Upper gastrointestinal endoscopic study revealed that the lesion was a tumor with a large stalk at the right side in the lower esophagus. The lesion was at 38 cm from the incisors. Histological study of the biopsy samples revealed the tumor was a leiomyosarcoma by morphological features of the tumor in hematoxylin and eosin stain. Computerized tomographic (CT) scan showed the tumor protruded into the lumen of the lower esophagus but into none of the lymph nodes, nor was distant metastasis seen. Endoscopic resection was performed with an electric snare. The tumor was completely resected without any trouble. The tumor was composed of spindle cells with irregular nuclei and numerous mitotic fi gures were present. The immunohistochemical staining showed positive for p53. The Ki67 labeling index was 8.7%, which was consistent with leiomyosarcoma. It also showed positive for smooth muscle actin, caldesmon, and calponin but negative for c-kit, CD34, and S-100. These histopathological fi ndings disclosed a leiomyosarcoma. The patient is asymptomatic and disease free after a 2-year follow up. We believe that endoscopic resection will be an option for an intraluminal polypoid form of esophageal leiomyosarcoma.

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Gastrointestinal leiomyosarcoma — Unusual sites: Esophagus, colon and porta hepatis

Cited by 23 publications

References 36 publications

Leiomyosarcoma of the esophagus

Leiomyosarcoma of the esophagus

Smooth muscle tumors of the esophagus: clinicopathological findings in six patients

Esophageal leiomyosarcoma: a case treated by endoscopic resection

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