Primary adrenal leiomyosarcoma with inferior vena cava extension in a 70-year-old man

Doppalapudi, Sai Krishnaraya; Shah, Tejash; Fitzhugh, Valerie A.; Bargman, Vladislav

doi:10.1136/bcr-2018-227670

Cited by 11 publications

(19 citation statements)

References 33 publications

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“…If the tumor extends into the IVC or the large tumor compresses the IVC, patients may present with IVC involvement, and experience obstructive symptoms such as lower extremity edema, spider angiomata, abdominal varices, and even altered sensation in the lower limbs. [6][7][8][9][10] In a rarely case, the tumor ruptured suddenly, and the patient presented with severe and acute abdominal pain. 11 Because tumors are located in the retroperitoneum, and are often nonfunctional, they often grow to large sizes prior to noticeable symptoms.…”

Section: Discussionmentioning

confidence: 99%

<p>Pleomorphic Leiomyosarcoma of the Adrenal Gland in a Young Woman: A Case Report and Review of the Literature</p>

Wang

Teng

et al. 2020

OTT

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Leiomyosarcoma usually arises in the uterus, abdominal and urologic viscera, and walls of large and small blood vessels. However, primary adrenal leiomyosarcoma is extremely rare with only 39 cases previously reported in English-language literature. We report a case of a 29-year-old previously healthy woman with an incidentally found right adrenal-occupying lesion. CT scan revealed a right adrenal mass measuring 3.3×3.4 cm in size. The tumor was successfully removed by laparoscopic adrenalectomy. Postoperative histopathologic examination showed spindle cells arranged in interlacing fascicles with pleomorphism and a high mitotic rate. An immunohistochemical examination showed positive staining for SMA, desmin, vimentin and H-caldesmon, and the diagnosis of a welldifferentiated adrenal leiomyosarcoma was established. The patient received no other oncological treatment after surgery and currently has no evidence of residual disease or tumor recurrence according to imaging follow-up.

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Section: Discussionmentioning

confidence: 99%

<p>Pleomorphic Leiomyosarcoma of the Adrenal Gland in a Young Woman: A Case Report and Review of the Literature</p>

Wang

Teng

et al. 2020

OTT

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“…Seventeen tumors were tested for the Ki-67 proliferation marker. Of them two were expressing the marker in <10% (39,70), four in 20-30% (55,60,63,64), one moderately expressed the marker ( 43 (32,35,43,47,69,71). Three cases commented in the differentiation of the tumors, two as well-differentiated (57,73) and one as poorly-differentiated (33).…”

Section: Risk Factorsmentioning

confidence: 96%

“…A total of 3 cases out of 45 presented as an enlarging abdomen mass (32,65,66), 4 presented with dyspnoea or chest discomfort (32)(33)(34)67), 2 cases had fever at the time of diagnosis (33,56) and nausea (50,68). Five cases out of 45 presented with leg swelling (32,49,59,67,69) 1 with cold feet sensation (35) and 2 cases had skin varices at the time of diagnosis (67,69). One case presented with weight gain (32), 1 had back pain related with bone metastases (34), 1 had urinary track symptoms (70) and 3 were asymptomatic (71)(72)(73).…”

Section: Symptoms Diagnosismentioning

confidence: 99%

“…Biopsy. In 9 cases a preoperative form of adrenal biopsy was performed (32,34,38,45,49,51,57,59,69). Two cases were subjected to percutaneous fine needle aspiration (FNA) (45,57), 6 cases to core biopsy and one to both techniques (51).…”

Section: Risk Factorsmentioning

confidence: 99%

“…One patient underwent en bloc resection of infiltrated diaphragm (43) and another underwent resection of the tumor along with part of the posterior wall of the stomach (71). Tumor thrombus was removed in 6 patients (33,35,44,(67)(68)(69), infiltrated IVC wall was removed and reconstructed in 6 patients (37,41,53,54,64,69). Cardiopulmonary bypass was necessary in 3 cases (33,35,67).…”

Section: Risk Factorsmentioning

confidence: 99%

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Review of the Literature on Leiomyoma and Leiomyosarcoma of the Adrenal Gland: A Systematic Analysis of Case Reports

Σακελλαρίου

Dellaportas

Peppa

et al. 2020

In Vivo

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Background/Aim: To date few cases of smooth muscle-derived tumors of the adrenal gland have been reported and their treatment remains a medical challenge. The aim of this manuscript was to systematically review the literature and present the tumor characteristics and their management in order to provide a standardized approach to their diagnosis and management. Materials and Methods: We searched five databases (PubMed, Scopus, Elsevier, ResearchGate, Google scholar) for relevant articles published until March 2020. Results: Twenty-two cases of adrenal leiomyoma, four cases of adrenal smooth muscle tumor and forty-five cases of adrenal leiomyosarcoma were included. Conclusion: We present the demographic, clinical, radiological, pathological and oncological characteristics and prognosis of tumors of the adrenal gland arising from smooth muscle cells, as well as describe the common clinical investigations and therapeutic modalities that have been reported as part of their management.Adrenal tumors can be detected either incidentally or after investigation of signs and symptoms that they evoke. Generally, they can be histologically categorized as primary tumors of the adrenal cortex or medulla, metastases from other primary malignancies and other tumors of the adrenal gland which originate from connective tissue cells. Adrenal cortical tumors are comprised by (asymmetric) adrenal cortical hyperplasia, adenoma, myelolipoma, adrenocortical carcinoma, oncocytic adrenocortical neoplasms; medullary tumors are comprised by pheochromocytoma, ganglioneuroma, neuroblastoma, ganglioneuroblastoma and teratoma. Connective tissue origin tumors are rarer and are comprised mainly by haemangioma and lymphangioma with a few cases of leiomyoma, lipoma, hemangiosarcoma, lymphoma, leiomyosarcoma and liposarcoma, as reported in the literature. Patients with primary malignancies in lung, breast, kidney, colon, oesophagus, pancreas, liver, stomach or with melanoma can present with adrenal metastases spread from these tumors, which can commonly be found bilaterally (1).Leiomyomas (LM) and leiomyosarcomas (LMS) are mesenchymal tumors that derive from smooth muscle cells. Their benign -leiomyoma or malignant -leiomyosarcoma characterization depends on nuclear atypia and/or pleomorphism, mitotic activity and tumor cell necrosis (2). Leiomyomas and leiomyosarcomas of the adrenal gland comprise a very small percentage of the gland's pathology with very little data available in the literature. The aim of this manuscript was to systematically review the literature and present demographic, clinical, radiological, pathological and oncological characteristics and prognosis of tumors of the adrenal gland arising from smooth muscle cells, as well as describe the common clinical investigations and therapeutic modalities that have been reported as part of their management.

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Adrenal Leiomyosarcoma Presenting with Chest Wall Nodule: a Histological Insight in an Intriguing Case

Bharti

Phulware

Ahuja

et al. 2020

Indian J Surg Oncol

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Primary adrenal leiomyosarcoma with inferior vena cava extension in a 70-year-old man

Cited by 11 publications

References 33 publications

<p>Pleomorphic Leiomyosarcoma of the Adrenal Gland in a Young Woman: A Case Report and Review of the Literature</p>

<p>Pleomorphic Leiomyosarcoma of the Adrenal Gland in a Young Woman: A Case Report and Review of the Literature</p>

Review of the Literature on Leiomyoma and Leiomyosarcoma of the Adrenal Gland: A Systematic Analysis of Case Reports

Adrenal Leiomyosarcoma Presenting with Chest Wall Nodule: a Histological Insight in an Intriguing Case

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