Mesenchymal Lesions of the Uterine Cervix

Fadare, Oluwole; Ghofrani, Mohiedean; Stamatakos, Michael D.; Tavassoli, Fattaneh A.

doi:10.1097/01.pcr.0000217868.84282.77

Cited by 28 publications

(34 citation statements)

References 117 publications

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“…A variety of uterine sarcomas with a primary line of differentiation that is not native to the uterus have been reported (27,28,(36)(37)(38). Included in this group of ''heterologous'' sarcomas are chondrosarcoma, liposarcoma, osteosarcoma, fibrosarcoma, primitive neuroectodermal-type tumors, gastrointestinal-type stromal tumors, and rhabdomyosarcoma, among others (27,28,(36)(37)(38)(39).…”

Section: Discussionmentioning

confidence: 97%

“…As in most other locations, embryonal rhabdomyosarcoma is the most frequent subtype in the gynecologic tract, nearly all in the lower genital tract (8,12). In the cervix uteri, in which they are the most common sarcoma (27,28), embryonal rhabdomyosarcoma is primarily a neoplasm of girls and young women (12). Contemporary multimodal approaches to the management of these patients has resulted in somewhat improved outcomes, although this is largely dependent on stage at initial presentation (29)(30)(31).…”

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confidence: 99%

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Pleomorphic Rhabdomyosarcoma of the Uterine Corpus: A Clinicopathologic Study of 4 Cases and a Review of the Literature

Fadare

Bonvicino

Martel

et al. 2010

International Journal of Gynecological Pathology

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We report the clinicopathologic features of 4 cases of pure pleomorphic rhabdomyosarcoma of the uterine corpus with an emphasis on their frequent expression of CD10 and CD56, review the relevant literature, and discuss differential diagnostic considerations. The patients ranged from 51 to 79 years (mean 68 y). All were FIGO stage IIIC to IV at initial surgical staging, and 3 were dead from the disease at an average of 8.6 months follow-up. In addition to the expected findings, other notable morphologic features included tumor giant cells (4/4), osteoclast-like giant cells (1/4), patchy myxoid stroma (4/4), and only infrequent cytoplasmic cross striations (1/4). The tumors in all 4 cases were positive for myogenin, myo-D1, smooth muscle actin, desmin, muscle-specific actin (HHF-35), and CD10; 3 (75%) of 4 cases were positive for calponin and CD56; all cases were negative for cytokeratin 7, synaptophysin, epithelial membrane antigen, placental-like alkaline phosphatase, chromogranin, and a pan-keratin. Twenty-three cases have been reported earlier in the English-language literature between 1969 and 2009. In combination with the current 4, the 27 patients had an age range of 35 to 87 years (mean 66.33 y). Only 1 patient was deemed inoperable; most had staging operations. Following their initial evaluations, 16 (59%) were found to have extrauterine extension of disease. At follow-up, 73% (19/27) were dead from the disease and 19.2% had no evidence of recurrence. Ten (53%) of the 19 deaths occurred within 6.5 months of initial evaluation. Stage at presentation did not have any significant impact on outcome: 73% of the 11 patients with uterus-confined disease at presentation were dead from the disease at follow-up, a rate of disease-associated death that was nearly identical to the 75% in the 16 patients with extrauterine disease at presentation. A wide variety of neoadjuvant and adjuvant therapies were administered, which did not appear to significantly impact outcomes. These data indicate that pleomorphic rhabdomyosarcoma of the uterine corpus is a highly aggressive, rapidly progressive tumor with a high case-fatality rate.

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Section: Discussionmentioning

confidence: 97%

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confidence: 99%

Pleomorphic Rhabdomyosarcoma of the Uterine Corpus: A Clinicopathologic Study of 4 Cases and a Review of the Literature

Fadare

Bonvicino

Martel

et al. 2010

International Journal of Gynecological Pathology

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“…To avoid misdiagnosis of such neoplasms, immunohistochemical features are necessary to support the diagnosis of epithelioid leiomyosarcoma [11]. Typically, melanomas are positive for S-100 protein, HMB-45, Melan-A, and tyrosinase but negative for cytokeratins, desmin, smooth muscle actin, epithelial membrane antigen, and CD68 [13].…”

Section: Discussionmentioning

confidence: 99%

“…The current approach is to simply extrapolate diagnostic criteria from the corpus tumours and apply them to their cervical counterparts, incorporating various combinations of cytologic atypia, coagulative necrosis and mitotic activity to predict their malignant potential [11]. However, it is unclear if this is entirely appropriate in all cases [12].…”

Section: Discussionmentioning

confidence: 99%

“…Typically, melanomas are positive for S-100 protein, HMB-45, Melan-A, and tyrosinase but negative for cytokeratins, desmin, smooth muscle actin, epithelial membrane antigen, and CD68 [13]. Malignant melanoma, and metastatic carcinoma are generally excluded due to the immunohistochemical absence of HMB-45 and cytokeratin expression [11]. In contrast to epithelioid leiomyosarcoma, epithelioid sarcoma shows strong and diffuse expression of keratin markers [14].…”

Section: Discussionmentioning

confidence: 99%

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Epithelioid leiomyosarcoma of the uterine cervix: a case report and review of the literature

et al. 2012

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Background : Epithelioid leiomyosarcoma arising from the uterine cervix is extremely rare, with only few cases reported in the world literature Case presentation : The case concerns a 41-year-old female patient who was admitted to our hospital, with worsening menorrhagia during the past 6 months. Pelvic examination revealed a large tumour of the uterine cervix extended into the upper vagina. Pelvic magnetic resonance imaging confirmed the presence of a cervical uterine tumour. Cervical biopsy and immunohistological study concluded leiomyosarcoma (grade 2). Radiological workup revealed the presence of pulmonary metastasis. A bilateral nephrostomy was performed before treatment because of obstructive renal failure. The treatment of this case consisted of ifosfamide and doxorubicin-based chemotherapy. After three cycles, the assessment of the disease showed partial response. The treatment was continued for three other cycles. But, the second evaluation of the patient revealed tumour progression. The treatment was then stopped, and best supportive care was provided. The patient is still alive. Conclusion : Although exceedingly rare, leiomyosarcoma can arise on the uterine cervix. Management of cervical leiomyosarcoma is extrapolated from the currently accepted management of uterine leiomyosarcoma. It is difficult to develop optimal management strategies and to predict prognosis of the disease. Pour citer cette revue : J. Afr. Cancer 4 (2012).Keywords Leiomyosarcoma · Uterine cervix · Chemotherapy · Cervical biopsy Résumé Introduction: Le léiomyosarcome épithélioïde du col utérin est une tumeur extrêmement rare, avec seulement quelques cas rapportés dans la littérature mondiale. Cas clinique: Il s'agit d'une patiente de 41 ans admise dans notre hôpital pour métrorragies datant de six mois. L'examen gynécologique a retrouvé une grosse tumeur du col utérin étendue à la partie supérieure du vagin. L'imagerie par réso-nance magnétique a confirmé la présence d'une tumeur du col utérin. La biopsie cervicale avec étude immunohistochimique a conclu : un léiomyosarcome (grade 2). Le bilan d'extension radiologique a révélé la présence de métastases pulmonaires. Une néphrostomie bilatérale a été réalisée avant le traitement en raison d'une insuffisance rénale obstructive. Le traitement de ce cas consistait en une chimiothérapie à base d'ifosfamide et de doxorubicine. Après trois cycles, l'évaluation de la maladie a montré une réponse partielle. Le traitement a été poursuivi pendant trois autres cycles. Mais, la seconde évaluation de la patiente a révélé une progression tumorale. Le traitement a été arrêté et la malade a été confiée aux soins palliatifs. La patiente est actuellement toujours en vie. Conclusion: Bien que très rare, un léiomyosarcome peut survenir au niveau du col utérin. Le traitement du léiomyosar-come du col utérin est extrapolé sur le traitement du léiomyo-sarcome du corps utérin. Il est difficile d'élaborer des stratégies thérapeutiques optimales et de prédire le pronostic de la maladie.

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Soft Tissue Lesions Involving Female Reproductive Organs

Fetsch¹,

Laskin²

2011

Blaustein’s Pathology of the Female Genital Tract

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Mesenchymal Lesions of the Uterine Cervix

Cited by 28 publications

References 117 publications

Pleomorphic Rhabdomyosarcoma of the Uterine Corpus: A Clinicopathologic Study of 4 Cases and a Review of the Literature

Pleomorphic Rhabdomyosarcoma of the Uterine Corpus: A Clinicopathologic Study of 4 Cases and a Review of the Literature

Epithelioid leiomyosarcoma of the uterine cervix: a case report and review of the literature

Soft Tissue Lesions Involving Female Reproductive Organs

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