Myxoid Leiomyosarcoma of the Uterus with Subsequent Pregnancy and Delivery

Kagami, Seiji; Kashimura, Masamichi; Toki, Naoyuki; Katuhata, Yukiko

doi:10.1006/gyno.2002.6634

Cited by 26 publications

(27 citation statements)

References 15 publications

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“…A number of cases are only retrospectively diagnosed after a malignant course. 48,49 This was also the case in one of the patients in the present study. The crude survival of myxoid LMS patients in the present study was slightly more favourable than the survival rate for patients with ordinary LMS and the reported survival data.…”

Section: Discussionsupporting

confidence: 83%

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Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients

Abeler¹,

et al. 2009

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Section: Discussionsupporting

confidence: 83%

“…It is difficult to distinguish this subtype of LMS from leiomyoma with myxoid changes because the main criteria for malignancy are rarely encountered. A number of cases are only retrospectively diagnosed after a malignant course 48,49 . This was also the case in one of the patients in the present study.…”

Section: Discussionmentioning

confidence: 56%

Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients

Abeler¹,

et al. 2009

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“…Both may arise anywhere in the uterine wall and may involve either the uterine corpus or cervix. 22,32 Expression of myoid markers is more variable in distribution and intensity in IMT than in leiomyosarcoma, with some cases showing only focal or weak expression, particularly for desmin. Leiomyosarcoma is the most important differential diagnostic consideration, and the myxoid variant is particularly difficult to distinguish from IMT.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Myofibroblastic Tumor of the Uterus

Rabban¹,

Zaloudek²,

Shekitka³

et al. 2005

American Journal of Surgical Pathology

146

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Inflammatory myofibroblastic tumor (IMT) is an indolent spindle cell proliferation that can histologically resemble various malignant mesenchymal neoplasms; however, it generally behaves as a benign or locally recurrent tumor. Most IMTs involve the lung, mesentery, omentum, or retroperitoneum. We report the clinical and pathologic features of six IMTs of the uterus, one of which was included in a previous report, and emphasize the histologic and immunohistochemical features that distinguish IMTs from uterine spindle cell neoplasms that require aggressive treatment. Recently, translocations of the anaplastic lymphoma kinase (ALK) gene and immunohistochemical expression of ALK have been reported in IMTs of various anatomic sites. We compared ALK expression in uterine IMTs with that in uterine mesenchymal neoplasms with which it may be confused. Patients with IMT were between 6 and 46 years of age. None had a history of abdominal surgery; three were multiparous. The IMTs ranged from 1 to 12 cm in maximum dimension. Three grew as polypoid masses that arose in the lower uterine segment, and two of these prolapsed through the cervical os. The three other tumors grew as bulky myometrial masses with focally irregular borders and infiltrated the endometrium, parametrium, or cervical stroma. There were three main microscopic patterns: a hypocellular pattern, a fascicular pattern, and a hyalinized pattern. A lymphoplasmacytic infiltrate was present in all of the tumors, and most had a myxoid background. Mitotic activity ranged from 0 to 2 mitotic figures per 10 high power fields (HPF) except in one tumor that focally had up to 8 mitotic figures per 10 HPF. No nuclear atypia or necrosis was present. Immunohistochemical expression of ALK was present in a cytoplasmic pattern in all IMTs tested. No ALK expression was identified in uterine leiomyoma (n = 7), leiomyosarcoma (n = 6), carcinosarcoma (n = 4), endometrial stromal sarcoma (n = 4), or normal uterine tissues. Follow-up ranging from 1.5 years to 5 years in 4 patients with uterine IMTs revealed no recurrence or metastasis. IMTs should be differentiated from aggressive uterine mesenchymal tumors because they can be treated conservatively and have a more favorable prognosis. ALK expression appears to be of diagnostic value in conjunction with other immunohistochemical stains.

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“…Surgery remains the established treatment: total abdominal hysterectomy, with or without bilateral salpingo-oophorectomy, was performed in 24/27 cases (including ours); of the remaining three, two were treated with tumorectomy, and one patient received radiotherapy alone because of her cardiac condition. After surgery, adjuvant chemotherapy was administered to five patients (including ours); in a further five cases, chemotherapy was used to treat relapse (2)(3)(4)(5) . Although King et al (2) postulated that uterine myxoid leiomyosarcomas might not be responsive to chemotherapy or radiotherapy because of their low mitotic rate and the copious amount of intercellular myxomatous tissue, the effect of adjuvant therapy on preventing recurrence is still unclear (7,10) .…”

Section: Discussionmentioning

confidence: 99%

Massive myxoid leiomyosarcoma of the uterus

Vigone

Giana

Surico

et al. 2005

International Journal of Gynecological Cancer

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Uterine myxoid leiomyosarcoma is a very rare and aggressive variant of uterine sarcoma, of which only 26 cases have been described in the literature published in English. A 59-year-old woman, who had been menopausal for 5 years and had a huge abdominal mass underwent laparotomy; histopathology of the bulky tumor revealed the particular characteristics of a myxoid leiomyosarcoma. Immunohistochemically, Ki-67 contributed toward indicating a malignancy, whereas p53 and progesterone and estrogen receptors were negative. The level of serum Ca125 was high at diagnosis, within normal limits after the fifth cycle of chemotherapy, and subsequently increased again at recurrence. Sixteen months after surgery, the patient died of respiratory failure. Immunohistochemistry and Ca125 levels can aid the diagnosis, management, and prognosis of uterine myxoid leiomyosarcoma.

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Myxoid Leiomyosarcoma of the Uterus with Subsequent Pregnancy and Delivery

Cited by 26 publications

References 15 publications

Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients

Uterine sarcomas in Norway. A histopathological and prognostic survey of a total population from 1970 to 2000 including 419 patients

Inflammatory Myofibroblastic Tumor of the Uterus

Massive myxoid leiomyosarcoma of the uterus

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