High-grade leiomyosarcoma of the transverse colon presenting with bowel perforation

Abstract

It is widely recognized that eosinophils are found in tumor infiltrates and that their mechanism of action is associated with particular symptoms and prognosis. However, the causes of and reasons for this process remain unclear, as does the exact mechanism by which it occurs. We report on the case of a 71-year-old woman with cholangiocellar carcinoma (CCC) with a marked eosinophilia. When the patient presented at the hospital, she said she was suffering from fatigue, depression, and pain. That triad of symptoms, indicative of peripheral eosinophilia (TABE, or tumor-associated blood eosinophilia) and tissue eosinophilia (TATE, or tumor-associated tissue eosinophilia), are recurrent in oncology. We also conducted a structured review of literature on eosinophilia associated with biliary tumors to try to answer 3 questions: Is eosinophilia (TABE or TATE) associated with solid tumors, with particular reference to the tumor of the bile duct? Is eosinophilia in biliary tumors associated with specific symptoms? Does eosinophilia (TABE or TATE) predict a specific prognosis?

Leiomiossarcoma de cólon

“…Os leiomiossarcomas são tumores mesenquimais originados das fibras musculares da musculatura própria da parede do trato digestivo ou da muscular da mucosa 4,5 . Eles representam apenas 1% dos tumores do sistema digestório 5 . A localização colônica da doença é ainda mais rara, representando 0,1 % dos tumores malignos do intestino grosso 3 .…”

“…No cólon encontramos os leiomiossarcomas mais frequentemente no cólon sigmoide, seguido por cólon transverso e cólon direito 3,6 . Não apresentam predileção por sexo 5 , e acometem pacientes a partir da quinta década de vida 4, 5 .…”

“…O exame definitivo para diagnóstico dos leiomiossarcomas é o anatomopatológico com imuno-histoquímica , fundamental para diferenciação dos tumores mesenquimais do trato digestivo [3][4][5]8 . A característica imuno-histoquímica dos leiomiossarcomas é a presença de marcadores positivos para actina e desmina de músculo liso, e negativos para CD 37, CD 117, proteína S-100, presentes em outras lesões mesenquimais como GISTs e Schwanomas 3,4 .…”

“…O tratamento é sempre cirúrgico com ressecção oncológica das lesões. A disseminação preferencial da doença se faz por via hematogênica e raramente linfática 3 , sendo frequente lesões secundárias durante o ato cirúrgico [3][4][5] .…”

Adenosquamous carcinoma of the uterine cervix displaying tumor-associated tissue eosinophilia

“…TATE has been reported in various organs, including the oral cavity, esophagus, larynx, bile duct, lung, gastrointestinal tract, genitourinary tract, and other rare sites. 3–11 Many reported cases of TATE are often associated with squamous cell carcinoma (SqCC), but there are also reports of adenocarcinoma-, urothelial carcinoma-, and large cell carcinoma-induced TATE. To our knowledge, however, no studies have examined the detailed cytological findings of TATE.…”