Myosarcoma of the uterus.A Clinicopathological Study

Spiro, Ronald H.; Koss, Leopold G.

doi:10.1002/1097-0142(196505)18:5<571::aid-cncr2820180506>3.0.co;2-h

Cited by 48 publications

(4 citation statements)

References 20 publications

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“…Although pleomorphic liposarcomas often disseminate, well differentiated and myxoid types are more common and a reduced incidence of metastasis in this series is consistent with other reports (Reszel et al, 1966, Enzinger & Weiss, 1983. Leiomyosarcomas of the uterus, particularly those of high grade, have a dismal prognosis (Spiro & Koss 1965, Hart & Billman 1978, confirmed in this series. Uterine mixed mesodermal sarcomas seemed to do particularly badly whereas endometrial stromal sarcomas fared better, but numbers were small.…”

Section: Resultssupporting

confidence: 72%

Combined modality management of local and disseminated adult soft tissue sarcomas: A review of 257 cases seen over 10 years at the Christie Hospital & Holt Radium Institute, Manchester

Bramwell¹,

Crowther²,

Deakin³

et al. 1985

Br J Cancer

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Summary Over a 10 year period, between 1974-1984, 257 adult cases of tissue sarcoma have been evaluated in the Department of Medical Oncology, Christie Hospital, Manchester. At registration locally advanced or metastatic diseases was present in 162 (63%). The male/female ratio was 1.5:1 and median age 54 years (range 14-85). The commonest sites were lower limb (33%), visceral (21%), trunk (13%), retroperitoneum (12%) and upper limb (10%). Leiomyosarcoma (27%), liposarcoma (14%) malignant fibrous histiocytoma (10%) and neuro plus fibrosarcomas (15%) were the most frequent histological subtypes. A high proportion of uterine sarcomas (17%) is a point of distinction from many other series. Histological grade was specified in 72% of cases and the distribution (Grade 1-27%; 11-6%; 111-67%) reflected a referral bias towards advanced disease. Local resection of the primary tumour was performed in 76% of cases.In many instances this only amounted to 'shelling out' and true compartmental excisions were rare. Amputation was performed in 31% of patients with limb sarcomas. Ninety-eight patients (38%) had experienced one or more local recurrences prior to referral and the overall local recurrence rate was 56%. Suitable patients (78%) received chemotherapy, 50% entering multicentre trials in collaboration with the EORTC. The commonest regime used in patients with advanced disease was CYVADIC which produced an overall response rate of 37%. Ifosfamide, used as a single agent in 16 patients, induced 3CR and 5PR for an overall response rate of 50%.When used in combination with MTX and VADIC, there was no difference in response rate, but numbers in these pilot studies were small. Seventeen high risk patients received adjuvant chemotherapy with VAC, but the results (11 relapses) were disappointing. An EORTC trial, comparing adjuvant CYVADIC chemotherapy with control has acrrued 307 patients, 49 of these from the Christie Hospital.Preliminary results within this centre -13/25 relapses in the control arm, 5/23 in the chemotherapy armsuggest an advantage for chemotherapy but the data are statistically not significant. Post-operative radical radiotherapy after resection of the primary tumour or local recurrence was performed in 51 patients, with local control in 65% of cases, although metastases developed in 41%. At the time of analysis (1st April 1984) 98 (38%) were alive, of whom 72 showed no evidence of disease and 52 had never relapsed. Malignant disease was the cause of death in 92%. Overall survival was not influenced by sex, but patients less than 40 years of age fared significantly better (P<0.001). Survival was better for patients with sarcomas of the extremities and trunk than for visceral tumours, whereas those in the head, neck, thorax and peritoneum did significantly worse (P<0.001). As shown in many other series, histological grade had a highly significant influence on survival (P<0.001), in favour of low grade (I) tumours, whereas histological subtype was unimportant (P=0.22). Although the incidence of local recurrence ...

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Section: Resultssupporting

confidence: 72%

Combined modality management of local and disseminated adult soft tissue sarcomas: A review of 257 cases seen over 10 years at the Christie Hospital & Holt Radium Institute, Manchester

Bramwell¹,

Crowther²,

Deakin³

et al. 1985

Br J Cancer

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“…Several reports do not include LMS arising in LM and authors believed uterine LMS occurred de novo 12,13 . However, some articles mention LMS within LM of the uterus and broad ligament 2–9,14–17 . Although, some cases in these studies may not fulfill recent diagnostic criteria of uterine LMS.…”

Section: Discussionmentioning

confidence: 98%

Uterine leiomyosarcoma arising in leiomyoma: Clinicopathological study of four cases and literature review

Yanai

Wani

Notohara

et al. 2010

Pathology International

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In this study we examined four cases of leiomyosarcoma (LMS) arising in leiomyoma (LM). The patients ranged from 40 to 64 years old. Symptoms were unspecific and preoperative diagnosis of LMS had not been made. Size of the tumors ranged from 4 cm to 20.5 cm. All patients were in stage I and no patients developed recurrent disease. Histologically, the LMS component showed moderate to severe cytological atypia and an increased mitotic count in all cases. Tumor cell necrosis in the LMS was seen in three cases. Associated LM component was cellular in one case. The LMS component showed p53 expression in three of four cases and p16 expression was seen in two cases. The LM component lacked p53 expression in all cases and demonstrated p16 expression in two cases, including one case of cellular LM. In all cases, Ki-67-positive cells were less than 5% in the LM component and more than 25-30% in the LMS component. This study reveals that: (i) malignant transformation can occur even in relatively small LM; (ii) patients with LMS with an LM component have a favorable prognosis; and (iii) immunohistochemical examination of p53, p16 and Ki-67 is useful for identification of malignant focus.

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“…Leiomyosarcomas are a rare group of tumours arising from smooth muscle cells and most commonly occur in the uterus or gastrointestinal tract 5. They can be classified into three categories depending on site of origin: (1) intraperitoneal or retroperitoneal smooth muscle cells; (2) intracutaneous or subcutaneous smooth muscle cells; (c) vascular smooth muscle cells 6.…”

Section: Discussionmentioning

confidence: 99%

Primary vertebral leiomyosarcoma masquerading as a nerve sheath tumour

Ahmad¹,

Goyal²,

Bhatt

et al. 2017

BMJ Case Reports

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A 47-year-old woman presented with symptoms of low back pain and weakness in bilateral lower limbs. MRI of the spine revealed a mass arising from T11 vertebra involving neural foramina at bilateral T11-12 and right T10-11 levels with extension to the right paravertebral region. Suspecting a nerve sheath tumour, she underwent posterior spinal decompression, stabilisation and debulking, following which her neurological symptoms resolved. Histopathological and immunohistochemical evaluation revealed a leiomyosarcoma. A month later she developed sudden paraparesis and MRI revealed an increase in size of the tumour with cord compression and displacement. She underwent a repeat spinal decompression and debulking procedure after which she received adjuvant radiotherapy via volumetric modulated arc therapy, to a total dose of 45 Gy in 25 fractions over 5 weeks. MRI performed 2 months later revealed complete response and she is disease free for the past 5 months.

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Myosarcoma of the uterus.A Clinicopathological Study

Cited by 48 publications

References 20 publications

Combined modality management of local and disseminated adult soft tissue sarcomas: A review of 257 cases seen over 10 years at the Christie Hospital & Holt Radium Institute, Manchester

Combined modality management of local and disseminated adult soft tissue sarcomas: A review of 257 cases seen over 10 years at the Christie Hospital & Holt Radium Institute, Manchester

Uterine leiomyosarcoma arising in leiomyoma: Clinicopathological study of four cases and literature review

Primary vertebral leiomyosarcoma masquerading as a nerve sheath tumour

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