Primary leiomyosarcoma of the distal fibula: A case report and review of the literature

Hanafy, M.; Schwonzen, Martin; Kühnen, C.; Schley, Bernhard; Wilke, Axel

doi:10.4081/or.2017.7236

Cited by 4 publications

(16 citation statements)

References 23 publications

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“…Definitive diagnosis is achieved via pathology and immunochemistry staining. Immunochemistry of smooth muscle actin (SMA), desmin, or vimentin, is an objective marker of smooth muscle origin [5] , [6] , [7] , [8] .…”

Section: Discussionmentioning

confidence: 99%

“…The survival rate for Stage 3 or greater, which are classified as high grade, is no more than 2 years. Most primary leiomyosarcoma of bone are high grade in nature [8] . Antonescu found among 33 cases of primary leiomyosarcoma that 66% were classified as high grade, 21% were intermediate, and 12% were low grade.…”

Section: Discussionmentioning

confidence: 99%

“…The tumor's sensitivity to radiation is limited. As such, pre- and post-operative chemotherapy is advised [8]

Fig. 2 Contrast enhanced MRI of the left tibia fibula.…”

Section: Discussionmentioning

confidence: 99%

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Primary leiomyosarcoma of the distal tibia: A case report

Dheer

Gekas

Schick

et al. 2021

Radiology Case Reports

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The authors present an unusual case of a leiomyosarcoma of the distal tibia. Leiomyosarcoma tumors typically originate from smooth muscle tissue. It is rare for it to derive from bone and even rarer to be found in a bone of the lower limb. Given this extreme rarity in addition to nonspecific findings on plain film radiographs and magnetic resonance imaging (MRI), biopsy was needed in this case. It was only through immunochemistry staining that a definitive diagnosis was made. As such, this case is an illustrative example of an aggressive, though rare, primary lesion of the bone which should be considered in the differential diagnosis of a lytic intramedullary lesion. This case also highlights the need for careful evaluation of imaging features suggesting a potentially aggressive lesion requiring appropriate work up in a timely fashion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary leiomyosarcoma of the distal tibia: A case report

Dheer

Gekas

Schick

et al. 2021

Radiology Case Reports

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“…Aunque no es muy frecuente, se han reportado casos en los huesos craneofaciales, el radio, la clavícula, el peroné, la pelvis, las falanges, los metatarsianos, y las vertebras. 1,5,[8][9][10][11]14 Los síntomas suelen ser inespecíficos y de aparición insidiosa; sin embargo, en algunos estudios 5,8,11 se ha identificado el dolor como síntoma principal, lo que es concordante con el caso descrito.…”

Section: Discussionunclassified

“…En general, se presenta en el retroperitoneo y el tracto gastrointestinal. [1][2][3] Su presentación ósea es rara; en la literatura, la información respecto al LMS intraóseo es escasa, y la mayoría corresponde a reportes de caso. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Se presenta el caso de una paciente con un LMS primario óseo en fémur distal izquierdo primario, tratado quirúrgicamente y con quimioterapia, en quien posteriormente, durante el seguimiento, se identificó una lesión metastásica en clavícula con fractura patológica manejada con resección quirúrgica.…”

Section: Introductionunclassified

Leiomiosarcoma primario de hueso en fémur distal metastásico a clavícula. Reporte de un caso

MARTIN

2021

Revista Chilena de Ortopedia y Traumatología

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ResumenEl leiomiosarcoma (LMS) es un tipo de tumor de células fusiformes de muy baja incidencia, que tiene un comportamiento agresivo, con alta tasa de mortalidad, por lo que el manejo debe ser quirúrgico, con una resección amplia de la lesión. No está claro el papel de la radio ni de la quimioterapia en su manejo. Presentamos a una paciente de 28 años que consultó por dolor de 2 meses en la rodilla derecha. Radiográficamente, se caracterizó como una lesión osteolítica pura en el fémur distal. La resonancia nuclear magnética (RNM) contrastada mostró áreas hipervasculares dentro del tumor. La gammagrafía mostró un marcado aumento en la captación de radiotrazadores. Se tomó una biopsia, con un informe de patología de LMS óseo bien diferenciado. Se trató con 3 ciclos de quimioterapia neoadyuvante preoperatoria con ifosfamida 1.000 mg/m2 en los días 1 a 3, además de doxorrubicina 70 mg/m2, y resección quirúrgica de la lesión y salvamento de la extremidad con endoprótesis de rodilla. Una vez que se resecó la lesión, la paciente recibió quimioterapia adyuvante con 4 ciclos de gencitabina 1.000 mg/m2 entre los días 1 y 8, y doxetacel 70 mg/m2 el día 1. Durante los dos meses de seguimiento, la paciente presenóa una fractura en el tercio medio de la clavícula, compatible con una lesión patológica en radiografías y tomografía por emisión de positrones (TEP). La biopsia reveló una lesión metastásica de LMS óseo que fue tratada mediante resección quirúrgica de la clavícula. Este es un caso único, dado que, durante el seguimiento, recibió tratamiento adyuvante con quimioterapia y se evaluó con una TEP, con una evolución clínica satisfactoria y sin evidencia de nuevas lesiones. Nivel de evidencia IV.

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Reconstructive surgery after distal fibular resection due to bone tumors: a technical report on surgical strategies and results from the PROSPERO international register of systematic reviews

Angelini,

Bohacek,

Plecko

et al. 2024

EFORT Open Reviews

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Purpose Primary bone tumors of the fibula are rare. Distal fibular resection has a significant impact on ankle biomechanics and gait, possibly leading to complications such as ankle instability, valgus deformity, and degenerative changes. Question: Is there a need for reconstructive surgery after distal fibular resection, and what reconstructive procedures are available? Materials and methods The review is registered with the PROSPERO International Register of Systematic Reviews. Inclusion criteria consisted of all levels of evidence, human studies, patients of all ages and genders, publication in English, and resection of the distal portion of the fibula due to tumor pathology. The reviewers defined four different categories of interest by method of treatment. Additional articles of interest during full-text review were also added. Results The initial search resulted with a total of 2958 records. After screening, a total of 50 articles were included in the study. Articles were divided into ‘No reconstruction’, ‘Soft tissue reconstruction’, ‘Bone and soft tissue reconstruction’, and ‘Arthrodesis, arthroplasty or other reconstruction options’ groups. Conclusion Limb salvage surgery should be followed by reconstruction in order to avoid complications. Soft tissue reconstructions should always be considered to stabilize the joint after fibular resection. Bone reconstruction with reversed vascularized fibula is the preferred technique in young patients and in cases of bone defects more than 3 cm, while arthrodesis should be considered in adult patients. Whenever possible for oncologic reason, if a residual peroneal malleolus could be preserved, we prefer augmentation with a sliding ipsilateral fibular graft.

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Primary leiomyosarcoma of the distal fibula: A case report and review of the literature

Cited by 4 publications

References 23 publications

Primary leiomyosarcoma of the distal tibia: A case report

Primary leiomyosarcoma of the distal tibia: A case report

Leiomiosarcoma primario de hueso en fémur distal metastásico a clavícula. Reporte de un caso

Reconstructive surgery after distal fibular resection due to bone tumors: a technical report on surgical strategies and results from the PROSPERO international register of systematic reviews

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