Intra‐abdominal metastases from soft tissue sarcoma

Behranwala, Kasim A; Roy, Pratik; Giblin, Victoria; A’Hern, Roger; Fisher, Cyril; Thomas, J.M.

doi:10.1002/jso.20105

Cited by 20 publications

(33 citation statements)

References 11 publications

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“…Intra-abdominal metastasis from non-visceral STS is rare and affected only 0.9% of STS patients in one large study [7]. Myxoid liposarcoma was the most frequent histological type, and only 2 of 19 were MFH [7]. GI metastasis from STS usually presents months to years after diagnosis but may be present initially as in the current study.…”

Section: Discussionsupporting

confidence: 51%

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Primary and metastatic high-grade pleomorphic sarcoma/malignant fibrous histiocytoma of the gastrointestinal tract: an approach to the differential diagnosis in a series of five cases with emphasis on myofibroblastic differentiation

et al. 2007

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Primary and metastatic so-called malignant fibrous histiocytoma/undifferentiated high-grade pleomorphic sarcoma (MFH) is rare in the gastrointestinal (GI) tract with approximately 50 primary and five metastatic cases reported so far. We evaluated two primary gastric and three metastatic intestinal high-grade pleomorphic sarcomas with features of storiform-pleomorphic MFH. Gastric tumours occurred in a 79-year-old man and a 68-year-old woman. One patient died post-operatively, and the other was disease-free at 6 months. Three patients presented with GI metastasis 24, 60 and 0 months after diagnosis of MFH of the heart (n = 1) and the thigh (n = 2). Metastases were located in the small (n = 1) and large bowel (n = 2) and were characteristically pedunculated and polypoid with oedematous haemorrhagic stroma. Concurrent metastases (brain, lung, bone) were present in all three cases. Tumours expressed alpha-smooth muscle actin (four of five), platelet-derived growth factor receptor (PDGFR) alpha (three of three) and PDGFRbeta (two of three) but were negative for CD117, CD34 and other lineage-specific markers. Ultrastructural examination revealed myo/fibroblastic features. Both gastric MFH were wild type for KIT and PDGFRalpha. In conclusion, primary and metastatic MFH of the GI tract commonly express PDGFRalpha and show a myo/fibroblastic phenotype. They should be distinguished from a variety of primary and metastatic pleomorphic neoplasms, in particular high-grade sarcomatous GI stromal tumours (GIST), pleomorphic leiomyosarcoma, sarcomatoid carcinoma and other mimics.

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Section: Discussionsupporting

confidence: 51%

“…Metastases/local recurrence developed in 35% of cases. Intra-abdominal metastasis from non-visceral STS is rare and affected only 0.9% of STS patients in one large study [7]. Myxoid liposarcoma was the most frequent histological type, and only 2 of 19 were MFH [7].…”

Section: Discussionmentioning

confidence: 98%

Primary and metastatic high-grade pleomorphic sarcoma/malignant fibrous histiocytoma of the gastrointestinal tract: an approach to the differential diagnosis in a series of five cases with emphasis on myofibroblastic differentiation

et al. 2007

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“…About 15% of STS‐patients develop local recurrences and 30% distant metastases at 5 years, most commonly to the lungs 2‐5 . Other metastatic sites are described (bone and lymph nodes), however abdominal metastases (AM) from STS, are very uncommon 6,7 . AM carry a poor prognosis with 2‐year survival rates of 43% 7 .…”

Section: Introductionmentioning

confidence: 99%

“…Other metastatic sites are described (bone and lymph nodes), however abdominal metastases (AM) from STS, are very uncommon 6,7 . AM carry a poor prognosis with 2‐year survival rates of 43% 7 . Diagnosis can be difficult as AM may be asymptomatic for a long time or may only cause vague discomfort 8 .…”

Section: Introductionmentioning

confidence: 99%

Incidence, treatment and outcome of abdominal metastases in extremity soft tissue sarcoma: Results from a multi‐centre study

Smolle

Schaffler

Leithner

et al. 2020

Journal of Surgical Oncology

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Background and Objectives Abdominal metastases (AM) from soft tissue sarcoma (STS) are rare and prognosis is poor. The aims of the study were to (a) identify risk factors for the development of AM and to (b) investigate the outcome of AM‐patients. Methods Seven‐hundred‐sixty‐nine STS‐patients with localised disease at diagnosis treated at three tumour centres (2000‐2016) were retrospectively included (409 males; mean age, 55.6 years [range, 8‐96 years]; median follow‐up, 4.1 years [interquartile‐range, 2.5‐6.6 years]). Results Two‐hundred‐two patients (26.3%) developed secondary metastases, and 24 of them AM (3.1%). Ten patients developed first AM (FAM) after a mean of 2.4 years and 14 patients late AM (LAM, after being diagnosed with metastases to other sites) after a mean of 2.0 years. Patients with liposarcoma had a significantly higher risk of developing AM (P = .007), irrespective of grading. There was no difference in post‐metastasis‐survival (PMS) between patients with AM at any time point and those with metastases to other sites (P = .585). Patients with LAM or FAM showed no difference in post‐abdominal‐metastasis‐survival (P = .884). Conclusions Survival in patients with AM is poor, irrespective of whether they develop secondarily to other metastases or not. Patients at high‐risk of AM (ie, liposarcoma) may be followed‐up regularly by abdominal‐ultrasound/CT.

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“…However, bowel metastasis via lymphatic or haematogeneous route from the primary site in somatic soft tissues is not very rare [9]. …”

Section: Resultsmentioning

confidence: 99%

Perforated intestinal leiomyosarcoma as a metastasis of uterine leiomyosarcoma: a case report

Saylam

Özozan

Düzgün

et al. 2009

Cases J

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IntroductionUterine leiomyosarcomas are relatively uncommon soft tissue neoplasms and rarely metastases to small bowel. In the current case; a patient is suffering from intestinal perforation due to metastatic leiomyosarcoma of the small bowel.Case presentationA 59-year-old woman underwent a modified radical mastectomy for infiltrating ductal cancer of the breast six years ago and a total abdominal hysterectomy for leiomyosarcoma of the uterus two years ago. About 2400 cGy total dose radiotherapy has also been applied after total hysterectomy for bone metastasis of breast cancer. She admitted to our clinic with the complaints of acute abdomen due to perforated small bowel metastasis of leiomyosarcoma during the radiotherapy. Laparotomy was performed and leiomyosarcoma of the ileum was removed totally. Histopathologic examination of the specimen confirmed the presence of the leiomyosarcoma in intestinal tissue samples.ConclusionWe aimed to present this unusual case which perforated presentation of the intestinal metastasis of uterine leiomyosarcoma.

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Intra‐abdominal metastases from soft tissue sarcoma

Abstract: Although abdominal metastasis is rare, vigilance is warranted. Symptomatic patients should be examined and investigated thoroughly for metastases. Surgery is the treatment of choice for patients with an acute presentation; however, survival is dismal.

Cited by 20 publications

References 11 publications

Primary and metastatic high-grade pleomorphic sarcoma/malignant fibrous histiocytoma of the gastrointestinal tract: an approach to the differential diagnosis in a series of five cases with emphasis on myofibroblastic differentiation

Primary and metastatic high-grade pleomorphic sarcoma/malignant fibrous histiocytoma of the gastrointestinal tract: an approach to the differential diagnosis in a series of five cases with emphasis on myofibroblastic differentiation

Incidence, treatment and outcome of abdominal metastases in extremity soft tissue sarcoma: Results from a multi‐centre study

Perforated intestinal leiomyosarcoma as a metastasis of uterine leiomyosarcoma: a case report

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