1/9. leiomyosarcoma presenting as a spontaneously ruptured renal tumor-case report.BACKGROUND: Ruptured renal neoplasms can be a catastrophic clinical presentation. angiomyolipoma is the commonest renal tumor which presents in this fashion. Renal sarcomas are rare renal neoplasms. Renal leiomyosarcomas are the most common histological subtype of renal sarcomas, accounting for approximately 50-60% of the reported cases. These tumors are usually peripherally located and appear to arise from either the renal capsule or smooth muscle tissue in the renal pelvic wall. CASE PRESENTATION: A 70 years old male, with hypertension and ischemic disease, developed acute left flank pain. The general physician evaluated this using ultrasound, which showed a solid left renal mass. Two weeks later, he presented in the emergency room in a state of shock with a palpable flank mass. CT scan of the abdomen showed a large heterogeneous mass lesion in the left perinephric space with minimal post contrast enhancement. Per-operatively, large retroperitoneal hematoma was found within Gerota's fascia along with spleen plastered to the upper limit of hematoma. nephrectomy and splenectomy were performed. Postoperative course was uneventful and patient was discharged on the 10th post-operative day. Histopathological evaluation of the specimen showed high-grade leiomyosarcoma CONCLUSIONS: Spontaneous rupture of renal neoplasm is a rare clinical presentation. angiomyolipoma is the commonest cause of spontaneous rupture of the kidney. Presentation of a leimyosarcoma as a ruptured renal neoplasm has not been previously reported in the English literature.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/9. leiomyosarcoma of the femoral vein in a marathon runner.leiomyosarcoma of the femoral vein is a rare tumor. physicians involved in the care of athletic patients must not be cavalier in evaluating overuse injuries and should endeavor to make a specific diagnosis. If atypical findings, such as generalized extremity swelling, are present, the physician must consider systemic illness including malignancy in apparently healthy, physically active individuals.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/9. Pancreatic and gastric metastases of leiomyosarcoma arising in the left leg.Pancreatic or gastric metastases from other primary malignancies are rare, especially from leiomyosarcoma. We report a case of leiomyosarcoma in the left lower leg with metastases to the pancreas and stomach. A 61-year-old man had liver cirrhosis caused by hepatitis c virus infection and was followed up by his primary physician. Two years before presentation at our hospital, he had undergone surgical resection of leiomyosarcoma in the left lower leg and systemic chemotherapy for multiple metastatic tumors in the lung. On admission, endoscopic examination and computed tomography were performed for a routine checkup to exclude esophageal varices and liver tumor. Although the patient had no specific symptoms, multiple gastric and pancreatic metastases were identified by endoscopy and computed tomography, respectively. In general, metastases to the pancreas and stomach are rare. We discuss the clinical and diagnostic findings of pancreatic and gastric metastases by reviewing previously reported cases.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/9. Triaditis: nondiagnosis at CT-guided liver biopsy.Percutaneous biopsy plays an important role in the workup of patients with focal hepatic lesions and, with constant advancements in technique, has achieved a high degree of accuracy. However, recently we performed percutaneous liver biopsies on three patients that have resulted in the pathological diagnosis of only portal triaditis. In all three cases, further investigation revealed the existence of focal malignancies. A thorough review of the has failed to reveal other reports of portal triaditis coexisting with focal malignancies or presenting as a focal lesion on radiological imaging studies. We present the three case histories with a discussion of portal triaditis and the possible significance of that diagnosis to physicians pursuing the diagnosis of focal hepatic malignancies.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/9. leiomyosarcoma of the small intestine presenting as a pelvic mass: four cases.Four patients with leiomyosarcoma of the small intestine who presented with a pelvic mass are reviewed. The tumors had clinical and radiographic features resembling ovarian neoplasms. These patients develop sizable tumors and, yet, have relatively few symptoms which would necessarily direct the physician to the intestine as the site of origin. The clinicopathologic features and management of these tumors are reviewed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/9. Vascular tumours in occlusive disease of the iliac-femoral vessels.Two cases of intraluminal tumours of the iliac-femoral vessels are presented. One was a benign haemangioendothelioma of the common femoral vein and the other a leiomyosarcoma of the iliac artery. Their clinical features were similar to those of patients having venous thrombosis and atherosclerotic occlusive disease respectively. Consequently every physician specialized in vascular disease should be aware of intraluminal tumours as an uncommon explanation of these common clinical pictures.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/9. Sonographic findings of uterine leiomyosarcoma.We describe herein various sonographic features of uterine leiomyosarcoma. Transabdominal scanning (TAS) revealed an image indistinguishable from benign leiomyoma, with evidence of degeneration. Transvaginal scanning (TVS) clearly showed the thinness of the myometrium, and the possibility of deep myometrial invasion was suspected at intraoperative open direct ultrasonography (ODU). A very high peak systolic velocity and a slightly increased diastolic component at the periphery of the tumor were evident with pulsed Doppler ultrasound. Thus, TAS, TVS, ODU and Doppler ultrasound will yield useful information for the physician attempting to evaluate the extent and vascularity of uterine leiomyosarcoma.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/9. Sarcomas arising after radiotherapy for peptic ulcer disease.Therapeutic gastric irradiation has been used to reduce peptic juice secretion in patients with peptic ulcer disease. Between 1937 and 1968 a total of 2049 patients received such therapy at the University of chicago. Three of these patients are known to have developed sarcomas in the field of radiation. Two gastric leiomyosarcomas of the stomach were diagnosed 26 and 14 years after treatment and a malignant fibrous histiocytoma of the anterior chest wall was removed six years after gastric irradiation. Of 743 peptic ulcer patients treated without irradiation and constituted as a control group for the study of therapeutic gastric radiation, none is known to have developed sarcoma. As the incidence of sarcoma in these patient groups is known only from the tumor registry of the University of chicago, other cases of sarcoma may exist in the groups. While an increased incidence of sarcoma has not been proven to occur in patients who received therapeutic gastric irradiation for peptic ulcer disease, the possibility of such a risk should be borne in mind by physicians caring for such patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/9. superior vena cava syndrome associated with gynecologic malignancy.superior vena cava syndrome is an infrequently noted complication associated with gynecologic malignancy. Three cases illustrate modern diagnostic and management methods. patients developed superior vena cava syndrome secondary to mediastinal metastatic endometrial carcinoma, uterine leiomyosarcoma, and secondary to thrombosis induced by a subclavian hyperalimentation catheter. awareness of this condition on oncology units and by physicians using central venous catheters is important to afford the prompt diagnosis and appropriate management of this life-threatening condition.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |