We have compiled all the reported cases of smooth muscle (stromal) tumors of the oral cavity and pharynx from 1884 through 1996. Our collective data included 139 leiomyomas (LM) and 68 leiomyosarcomas (LMS); but because we did not have sufficient information for 13 cases of LM, we report on only 126; and we report on only 66 of 68 cases of LMS. The peak age of incidence was 40 to 49 years for benign tumors and 50 to 59 years for malignant lesions, with the incidence in men slightly predominating over that in women. The most common sites of LM of the oral cavity and pharynx were the lips, tongue, and hard and soft palate. The most common sites of LMS included the maxilla and mandible. More than 40% of LMs presented as an intraoral mass, and more than half were known to be present for longer than 1 year. About 10% presented with pain, difficulty chewing or swallowing, swelling, toothache or loose teeth, or a combination of these symptoms. Patients with LMS were much more likely to have obvious symptoms of shorter duration, and one-third presented with pain or swelling (or both). Other relatively common symptoms of LMS included tenderness, interference with dentures, or an intraoral mass. In this review, there were almost twice as many LMs as LMSs, which was consistent with smooth muscle tumors found in other areas of the gastrointestinal tract.

This collective review includes all available case reports of smooth muscle (stromal) tumors of the rectum and anal canal in the world literature. When compiling this review we endeavored to present cumulative and recently collected data of both benign and malignant smooth muscle tumors found in the literature spanning the period from 1881 to 1996, which totaled 432 leiomyomas (LMs) and 480 leiomyosarcomas (LMSs) of the anus and rectum. The peak age of frequency for LMs was 40 to 59 years and 50 to 69 years for LMSs; men were slightly more likely to develop both benign and malignant anorectal smooth muscle tumors than women. Intraluminal growth of both LMs and LMSs was more frequently seen than extraluminal or intramural patterns, and tumors were more likely to be found in the rectum than in the anus. Patients with LMs presented most commonly with gastrointestinal (GI) bleeding, a palpable mass, or anorectal pain. As with smooth muscle tumors in other areas of the alimentary tract, symptoms likely persisted for less than 1 year prior to diagnosis. As was also the case for these neoplasms in other GI locations, LMSs tended to be larger than LMs. Approximately 20% of LMSs reported from 1881 to 1996 had metastasized at diagnoses. The local recurrence rate for resectable tumors was more than 80%, exceeding the propensity of LMSs in other areas of the GI tract to recur.

This collective review includes all available case reports of smooth muscle (stromal) tumors of the appendix and large intestine in the world literature. When compiling this review, we endeavored to examine cumulative as well as recently collected data on both benign and malignant smooth muscle tumors spanning the period 1875 to 1996. In total, there were reports of 331 leiomyomas (LMs) and 263 leiomyosarcomas (LMSs). The peak age of incidence of LM was 30 to 39 years, and the peak age of incidence of LMSs was 50 to 59 years. The female/male ratio was slightly higher for LM, and the male/female ratio was higher for LMS. The descending colon and sigmoid colon were the most common sites of both benign and malignant smooth muscle tumors. The growth of LMs most often occurred extraluminally, whereas LMSs tended to grow within the lumen of the colon. With both tumor types pain was the most frequent presenting complaint, followed less commonly by complaints of a palpable mass or gastrointestinal bleeding. LMSs tended to be larger at diagnosis than LMs, though the duration of symptoms for both types of tumor was most often reported to be between 1 month and 1 year. Finally, LMSs were found to metastasize mo

This collective review includes all available case reports of smooth muscle (stromal) tumors of the esophagus in the world literature. Compiling this review, we endeavored to examine cumulative and recently collected data of both benign and malignant esophageal smooth muscle tumors found in the literature spanning the period from 1875 to 1996, which totaled 1679 leiomyomas (LMs) and 165 leiomyosarcomas (LMSs). The peak age of occurrence of benign smooth muscle tumors in the esophagus was found to be between the ages of 30 and 59, whereas the highest frequency of malignant tumors was seen later in life, during the decade from age 60 to 69. The most common location of both LMs and LMSs was the lower third of the esophagus. Their patterns of growth differed; LMs were more likely to grow intramurally, and LMSs were predominantly intraluminal. Most patients with LMs presented with dysphagia and pain or discomfort; patients with LMSs additionally commonly complained of weight loss. As with smooth muscle tumors of other areas of the gastrointestinal tract, the duration of symptoms averaged 1 month to 1 year, and malignant tumors grew to larger sizes than benign neoplasms. Approximately one-third of LMSs had metastasized at diagnosis, and there was a 5-year survival rate of approximately 20%.

This collective review includes all available case reports of smooth muscle (stromal) tumors of the stomach in the world literature from 1762 to 1996. It updates our previous review from 1767 to 1959. Overall, we identified 2189 patients with leiomyoma (LM) and 1594 with leiomyosarcoma (LMS). The peak age of incidence of LM was 50 to 59 years, while LMS was most frequently seen between ages 60 and 69. Women were more likely to develop LM, and men more commonly presented with malignant smooth muscle tumors of the stomach. Concerning the patterns of growth, LMs were more likely to grow intraluminally (endogastric), whereas LMSs were predominantly exogastric. The most common site of LMs was on the anterior or posterior wall of the body of the stomach; LMSs were most likely found along the greater curve. The presenting symptoms of both types of smooth muscle tumors were similar; in decreasing order of frequency they were bleeding, pain, palpable mass, and weight loss. Interestingly, there was no correlation between the size of the tumor and signs or symptoms of bleeding, pain, weight loss, or ulceration, although patients with LMSs were more likely to report weight loss than patients with benign tumors. For LMS, there seemed to be no correlation between tumor size or location and rate of metastasis, although the tumors that grew in a dumbbell shape (i.e., both intraluminally and extraluminally) had a higher frequency of metastasis than other growth patterns. Overall, the rate of metastasis at diagnosis was 35.4%, with the liver, spleen, and regional lymph nodes the most common sites.

This column reviews the general features of PHT3D Version 2, a reactive multicomponent transport model that couples the geochemical modeling software PHREEQC-2 (Parkhurst and Appelo 1999) with three-dimensional groundwater flow and transport simulators MODFLOW-2000 and MT3DMS (Zheng and Wang 1999). The original version of PHT3D was developed by Henning Prommer and Version 2 by Henning Prommer and Vincent Post (Prommer and Post 2010). More detailed information about PHT3D is available at the website http://www.pht3d.org.The review was conducted separately by two reviewers. This column is presented in two parts.