1/10. Bcl-2 expression in a primary leiomyosarcoma of the ovary: a case report.BACKGROUND: Primary ovarian leiomyosarcoma is an extremely rare malignant smooth-muscle neoplasm with fewer than 30 documented cases worldwide. Immunohistochemically, ovarian leiomyosarcomas are characterized by the expression of alpha-smooth muscle actin (alpha-SMA). Until recently, no report investigated the role of bcl-2 expression in primary ovarian leiomyosarcoma. We report the management and an immunohistochemical analysis of bcl-2 in a patient with primary leiomyosarcoma of the ovary. CASE REPORT: The patient, a 71-year-old woman, presented with a history of lower abdominal pain and a palpable mass in the lower abdomen. Surgical exploration revealed a large left adnexal mass that had developed from the left ovary and infiltrated one part of the omentum adherent to the left adnexa. Microscopically the left adnexal tumor consisted of spindle cells arranged in smooth-muscle bundles and fascicles. The tumor was characterized by high cellularity and nuclear polymorphism, as well as patchy necrosis and large areas of hemorrhage. Mitotic activity exceeded 5 mitoses per 10 high-power fields with many atypical mitoses. The tumor appeared encapsulated, and the capsule was partially disrupted by tumor cells. Immunohistochemically, the tumor showed a strong staining reaction for muscle actin, alpha-SMA and neuron-specific enolase, and also a weak reaction for vimentin. Strong staining of bcl-2 was detected, with more than 80% of sarcoma cells positive. According to the FIGO staging system for ovarian cancer, the tumor was classified as a primary ovarian leiomyosarcoma stage III C, and the patient was treated with an adjuvant chemotherapy regimen consisting of cisplatin and ifosfamide. Two days after the third cycle of cisplatin/ifosfamid she developed an apoplexy spontaneously and chemotherapy was therefore discontinued. The patient remained without evidence of disease until she died as a result of intercurrent pneumonia 14 months after initial surgery. CONCLUSIONS: Beside the routine histological and immunohistochemical characteristics of primary ovarian leiomyosarcoma, strong staining for bcl-2 was detected. In order to understand more about the nature and the behaviour of this highly malignant neoplasm and to be able to improve the treatment, the prognostic value of bcl-2 has to be investigated in additional studies.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/10. Disseminating myxoid leiomyosarcoma of the uterus.CASE REPORT: A 60-year-old female, para 1, menopausal for last 12 years was admitted with complaints of distention and pain abdomen for last 2 months. There was no history of postmenopausal bleeding. On abdominal examination there was a vague mass in lower abdomen reaching upto umbilicus. On vaginal examination, uterus was eight weeks size and a vague mass was felt around it through all fornices. On exploratory laparotomy uterus was studded with multiple friable hemorrhagic growths perforating from fundus and filling the peritoneal cavity. TREATMENT: Total abdominal hysterectomy with bilateral salpingo-oophorectomy with debulking of tumour and omentectomy was performed followed by postoperative adjuvant radiotherapy. CONCLUSION: Histopathology report confirmed it to be uterine myxoid leiomyosarcoma which is an extremely rare variant of uterine sarcoma with poor prognosis exhibiting malignant biologic behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/10. Development of leiomyosarcoma from primary leiomyoma?kidney leiomyosarcoma represents a rare variety of malignant kidney tumours. In this paper, we report on a patient with an inoperable leiomyosarcoma. Since this neoplasm is very rare, there is very little information on this type of malignancy. We present the symptoms, radiological findings, diagnostic criteria and differential diagnosis of the tumour. leiomyosarcoma exhibits aggressive biological behaviour and has a poor prognosis. We have found that the treatment of choice is a radical nephrectomy.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
4/10. Primary leiomyosarcoma of the fallopian tube: a case report.A primary leiomyosarcoma (LMS) arising from the left fallopian tube in a perimenopausal 48-year-old woman is reported. Primary tubal LMS is an uncommon, exceedingly rare neoplasm, accounting for only a few reported cases so far. To our knowledge, the present case is the 17th tubal LMS reported in the English-language literature. The diagnosis is usually made at the time of laparotomy for a pelvic or adnexal mass or other gynaecological indications. As in ovarian neoplasms, the mainstay of treatment is represented by debulking surgery consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy, random biopsies, peritoneal washing and excision of all the abdominal tumour masses. Although the approach is radical, the clinical behaviour is very poor. The role of adjuvant radio- or chemotherapy still remains unsolved.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
5/10. leiomyosarcoma of the spermatic cord. Case report and review of the literature.An additional case of leiomyosarcoma of spermatic cord which brings the total reported number to 49, is described. The case is compared with the others and further data on histogenesis and histological behaviour of the tumor, are given. Surgical treatment and role of radiotherapy and chemotherapy, are discussed.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
6/10. Retroperitoneal leiomyosarcoma.The clinical history, radiological investigations, pathologic findings and treatment of four patients affected by retroperitoneal leiomyosarcoma were compared with data of the literature. These tumors have a great tendency to develop local recurrences after excision, but metastases to lymph nodes and distant organs usually occur lately. CT examination of the retroperitoneal space is a sensitive tool in the diagnosis and follow-up. Complete excision of the tumor followed by radiotherapy improves significantly the prognosis. Chemotherapy is advisable only when disseminated metastases appear. No correlation was found between the histologic appearance and the clinical behaviour.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
7/10. Primary leiomyosarcoma of the breast.The history of a 50-year-old female patient with a primary leiomyosarcoma of the breast is described. A survey of the literature is given. Surgery remains the treatment of choice. The biologic behaviour of the tumour has a favourable effect on prognosis.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
8/10. Late cutaneous and muscular metastases of a uterine leiomyosarcoma after an initial simultaneous presentation with an adenocarcinoma.A case is reported of late cutaneous and muscular metastases of a uterine leiomyosarcoma following an initial simultaneous presentation with an endometrial adenocarcinoma. Such behaviour is discussed in view of the prognostic features of the original sarcoma.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
9/10. leiomyosarcoma of the oesophagus: a case report and literature review of leiomyosarcoma.Leiomyosarcomas are uncommon tumours. Oesophageal leiomyosarcomas are even rarer. A case is presented of this rare tumour which on review of the literature seems to be the first patient surviving 22 years from the original treatment. We include a literature review of the clinical behaviour and management of leiomyosarcoma.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
10/10. Molecular characterization and liposomal transfection of a p53-mutated cell line established from a poorly differentiated leiomyosarcoma.A human cell line LMS6-93 has been established from a leiomyosarcoma (LMS). Characteristics for ultrastructure, growth characteristics, cell cycle distribution, karyotype, protein expression detected by immunohistochemistry (IHC), p53 mutational status and liposomal transfection behaviour were studied and determined. The primary tumor was clearly positive for a-smooth muscle type actin and desmin in moderately differentiated areas and indicated a loss of myogenic differentiation in other regions and therefore was classified as a poorly differentiated LMS. The cell line LMS6-93 contains mainly polymorphic spindle shaped or polygonal tumor cells which possess the characteristics of primitive mesenchymal cells, based on their morphology and positive reaction with an antibody to vimentin. IHC staining for S100, synaptophysin A, NSE, neurofilament proteins and cytokeratins were negative. cytogenetic analysis revealed in the cell line diploid karyotypes comparatively close to several structural and numerical aberrations for chromosomes 2, 5, 6, 9, 10, 12, 14, 17, 18, 20, 22, and Y. IHC positivity was found for the tumor suppressor protein Rb and the oncogene product MDM2. In a p53 mutational analysis a 1 bp insertional mutation in exon 6 (G insertion in codon 215) was detected and confirmed in the original primary tumor. The other p53 allele appears to be wild-type as indicated in Western hybridization. Using different cationic lipid formulations complexed with a reporter expression vector (GFP) successful transfection into LMS6-93 cells was observed. The highest transfection rates (20-30% GFP expression in the viable cell population) were obtained with lipofectin. These results suggest that LMS6-93 functions as a good in vitro model for transfection studies on an LMS cell line carrying a heterozygous p53-frameshift mutation.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
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