1/39. leiomyosarcoma of the pulmonary veins.Primary sarcomas of the great vessels are rare, but the most common site is the inferior vena cava. Herein are reported five new cases arising from the pulmonary veins with clinicopathologic correlation and comparison to previously reported cases. All new cases occurred in women ranging in age from 23 to 64 years at diagnosis (mean, 56 years). They had symptoms suggestive of left heart failure, including three patients with dyspnea, one with hemoptysis, and one with cough. Three cases showed tumor extension along the pulmonary veins into the left atrium. Tumors ranged in size from 2.8 to 7 cm in greatest dimension. Histologically, all were leiomyosarcomas. They were highly cellular tumors. Three cases had predominantly spindle cell morphology and two were predominantly epithelioid; one had foci of calcification. Most showed extensive necrosis. All tumors were reactive with antibodies to actin and desmin. Two cases were reactive with antibodies to MIC-2 (dotlike); two cases showed reactivity to keratin antibodies; and two showed reactivity for estrogen, progesterone receptor protein, or both. None were positive for antibodies to S-100 protein. All cases were treated with surgical excision. Follow-up ranged from 2 months to 21 years (mean, 4.8 years). Two patients were alive and well; two were alive with metastases; and one died of disease. Pulmonary vein sarcomas represent intermediate- to high-grade leiomyosarcoma. Although often lethal, complete surgical excision can lead to long-term survival. They occur predominantly in women and may express hormone receptors. Therefore, hormonal manipulation may offer promise as adjuvant therapy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/39. Leiomyosarcomas of great vessels.Sarcomas of the great vessels are rare. Altogether 400 such cases have been described in the aorta, the pulmonary artery, and inferior vena cava. The clinical symptoms are generally related to embolic phenomena, aneurysm formation, and widespread metastases, especially to bones. With improved diagnostic modalities more cases are diagnosed and treated surgically. Resection of the tumor may prolong the patient s life. In this paper authors present two cases of such rare sarcomas. In our first case a tumor has developed in the thoracic aorta with symptoms of imminent aortic dissection. The tumorous nature of the lesion was revealed only histologically, since neither the operation, nor macroscopic picture gave any clue to its tumorous nature. The second case was a male patient with a huge retroperitoneal tumor arising from the inferior vena cava, which was clinically suspected to be a carcinomaarising in the adrenal gland.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
3/39. leiomyosarcoma of the long saphenous vein.An unusual instance of primary leiomyosarcoma of the left long saphenous vein, possibly the tenth recorded case, is presented. leiomyosarcoma of large veins appears to be a distinct entity, in contrast to the benign counterpart, leiomyoma. The origin of the tumor from the vessel wall, its intraluminal growth, and its ultrastructure are demonstrated. incidence, sex and age distribution, fate and therapy of patients who have leiomyosarcomas of the large veins gleaned from reported cases in the literature are included.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/39. leiomyosarcoma of the vulva. A case report.BACKGROUND: leiomyosarcoma of the vulva is a rare mesenchymal tumor. Biologic features of a low grade tumor were investigated by an immunohistochemical workup. CASE: A 38-year-old woman presented with a slowly growing vulvar mass. Surgical treatment was performed, and a low grade leiomyosarcoma of the vulva was diagnosed. Immunohistochemical reactions were performed with monoclonal antibodies against desmin, vimentin, smooth muscle actin, cytokeratin, S-100 protein, estrogen, progesterone and androgen receptor, p53 protein, ki-67 antigen, leukocyte common antigen and polyclonal antibodies to factor viii-related antigen. Expression of estrogen, progesterone and androgen receptor was present in addition to a moderate number of Ki-67-positive cells and absence of p53 protein overexpression and lymphatic cell infiltration besides adequate microvessel density for smooth muscle tumors. Since the immunohistochemical markers indicated a less aggressive tumor, any further adjuvant therapy was rejected. The patient was without recurrence 24 months later. CONCLUSION: The immunohistologic profile proved the low histologic grade of vulvar leiomyosarcoma. The findings helped to estimate prognosis and plan therapy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/39. An extraluminal leiomyosarcoma of the iliac vein without thrombosis--a case report.Vascular leiomyosarcoma (LMS)is a rare malignant tumor arising from the muscle cells of the media of the vessels. Vascular LMS is often diagnosed as a result of the clinical manifestations of impaired venous flow such as edema and phlebothrombosis. The authors present a case of an LMS in a 72-year-old woman. physical examination revealed a round mass deep in the left inguinal region close to the inguinal vessels, fixed and not pulsating. There was no sign of left lower-limb edema nor of articular impairment of the hip. Inguinal and distal pulses were normal. Results of laboratory analysis, including values for the oncologic markers, were normal. An ultrasound scan of the left inguinal fossa showed a 50-by-30 mm mass of mixed aspect that adhered to the left common iliac artery. An echo color Doppler showed conservative arterial flow. Thus, a thrombotic aneurysm of the left iliac artery was diagnosed. Chest x-ray showed no pathological findings. An abdominal computerized tomograph (CT) scan confirmed the location of the neoplasm and revealed a narrowing of the left iliac vein compressed behind the mass. The finding was interpreted as a colliquative lymph node. The patient underwent explorative laparotomy with midline incision. The finding was a neoplastic bilobed mass compressing and infiltrating the left iliac vein with no cleavage surface between the mass itself and the venous wall. An intraoperative frozen section revealed a necrotic mass with a cortex of ambiguous interpretation. Surgical procedure was then finished with no further venous resection. Histologic examination revealed the presence of leiomyosarcomatous tissue with nuclear pleomorphisms inside necrotic material limited by a thin fibrotic capsule. According to Coindre's classification the tumor was a G3. After six months the patient is fit and a CT scan showed no evidence of recurring disease.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
6/39. leiomyosarcoma of the uterus with a florid intravascular component ("intravenous leiomyosarcomatosis").A leiomyosarcoma of the uterus in a 54-year-old woman exhibited striking involvement of large vessels of the myometrium and broad ligament on both gross and microscopic examination. The pattern of vascular involvement resembled that seen in intravenous leiomyomatosis. Imaging studies showed recurrent tumor within the inferior vena cava 3 months after hysterectomy. To our knowledge, this is the first reported such case in the literature, for which we propose the designation intravenous leiomyosarcomatosis of the uterus.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/39. Spindle cell fragments in focal nodular hyperplasia of the liver. A case report.BACKGROUND: There are only few reports on the fine needle aspiration cytology (FNAC) findings of focal nodular hyperplasia (FNH) of the liver. CASE: A 30-year-old woman who had undergone surgery for a leiomyosarcoma of the calf, was found to have a hepatic mass five years later on imaging during routine follow-up. Fine needle aspiration was performed to rule out metastasis. Cytology revealed a few fragments of bland-looking spindle cells in a metachromatic stroma along with benign hepatocytes and bile duct cells. It was interpreted as "consistent with metastasis of leiomyosarcoma." The excised mass showed histologic features typical of FNH. CONCLUSION: Spindle cell fragments have not been previously observed in the FNAC of FNH. These fragments probably represent the muscular wall of the abnormal blood vessels of FNH. If smooth muscle fragment is seen accompanying benign hepatocytes and bile duct cells, one should consider the diagnosis of FNH in the needle aspirate.- - - - - - - - - - ranking = 12.332053229463keywords = blood vessel, vessel (Clic here for more details about this article) |
8/39. Primary leiomyosarcoma of the anterior mediastinum.Primary mediastinal leiomyosarcoma are extremely rare tumors, which develop from smooth muscle, usually in the esophagus or main vessels. Very few cases have been reported in the literature and only two of these developed from small vessels in the soft tissue of the anterior mediastinum. We report on a 45-year-old man who presented with a huge anterior mediastinal tumor. The tumor was surgically removed with right thoracotomy and the diagnosis of well-differentiated leiomyosarcoma was established. It probably originated from the anterior mediastinal tissue, so at operation a continuity was not found between the tumor and neighboring structures. This rare and interesting histopathology is discussed and the literature is reviewed.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
9/39. leiomyosarcoma in the maxilla: a case report.We describe a rare case of leiomyosarcoma of the maxilla arising in a 71-year-old Japanese woman. The lesion was treated successfully by surgical resection with external irradiation of 70 Gy. No sign of recurrence or distant metastasis was present 3 years after operation. Histogenetically, this maxillary leiomyosarcoma apparently arose from the medial muscle of blood vessels or from primitive mesenchyme in the maxilla.- - - - - - - - - - ranking = 12.332053229463keywords = blood vessel, vessel (Clic here for more details about this article) |
10/39. Surgical treatment of retroperitoneal leiomyosarcoma invading the inferior vena cava: report of three cases.Retroperitoneal leiomyosarcoma is a rare neoplasm for which complete surgical removal provides the only effective treatment, as local recurrence adversely affects prognosis. However, invasion of major vessels may occur, making complete resection difficult. This report describes the cases of three patients who required concomitant resection of parts of the inferior vena cava because of direct tumor invasion. The major vessels should be isolated in preference to the tumor capsule during surgery to prevent sudden exsanguination or incomplete tumor resection. Resection of a recurrent sarcoma or a solitary metastasis can be effective in selected patients.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
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