A huge abdominal mass mimicking ovarian cancer: p53-negative but aneuploid myxoid leiomyosarcoma of the uterus

Massive myxoid leiomyosarcoma of the uterus

“…Immunohistochemistry is a widely accepted and useful tool in confirming the myogenic phenotype (4,7,8) , and a number of uterine myxoid leiomyosarcoma studies have investigated its suitability as an indicator of malignancy and guide for treatment planning (see Table 1). Ki-67 contributed toward indicating malignancy in our patient, in line with the findings of Mittal et al (6) , but it was not useful in two premenopausal women described by Sprogoe-Jakobsen and Holund (9) and Toki et al (8) ; p53 expression was examined by five authors but added no diagnostic information (6,(8)(9)(10) . Toki et al (8) found positive progesterone and estrogen receptor staining in a young patient with uterine myxoid leiomyosarcoma and suggested the possible therapeutic role of hormone therapy with gonadotropin-releasing hormone (GnRH) agonists and progesterone (8) .…”

“…Sprogoe-Jakobsen and Holund (9) 4%-11% 0%-20% Mittal et al (6) 60% 10% Toki et al (8) Few nuclei Few nuclei Positive Positive Kaleli et al (10) 2% Ng et al (4) Negative Negative Vigone et al (present study) 40% 5% Negative (5%) Negative…”

“…After surgery, adjuvant chemotherapy was administered to five patients (including ours); in a further five cases, chemotherapy was used to treat relapse (2)(3)(4)(5) . Although King et al (2) postulated that uterine myxoid leiomyosarcomas might not be responsive to chemotherapy or radiotherapy because of their low mitotic rate and the copious amount of intercellular myxomatous tissue, the effect of adjuvant therapy on preventing recurrence is still unclear (7,10) . Despite an aggressive therapeutic approach, local and systemic control is still a major problem, and recurrence is common: 17 of 24 followed-up patients experienced a recurrence from 3 months to 10 years after treatment, and the follow-up was longer than 3 years in only two of the seven women with no evidence of disease (2)(3)(4)(5) (3 years and 5 years 10 months in the patients reported by Sprogoe-Jakobsen and Holund (9) and Takano et al (5) , respectively).…”

Massive myxoid leiomyosarcoma of the uterus

“…Immunohistochemistry is a widely accepted and useful tool in confirming the myogenic phenotype (4,7,8) , and a number of uterine myxoid leiomyosarcoma studies have investigated its suitability as an indicator of malignancy and guide for treatment planning (see Table 1). Ki‐67 contributed toward indicating malignancy in our patient, in line with the findings of Mittal et al (6) , but it was not useful in two premenopausal women described by Sprogoe‐Jakobsen and Holund (9) and Toki et al (8) ; p53 expression was examined by five authors but added no diagnostic information (6,8–10) . Toki et al (8) found positive progesterone and estrogen receptor staining in a young patient with uterine myxoid leiomyosarcoma and suggested the possible therapeutic role of hormone therapy with gonadotropin‐releasing hormone (GnRH) agonists and progesterone (8) .…”

“…After surgery, adjuvant chemotherapy was administered to five patients (including ours); in a further five cases, chemotherapy was used to treat relapse (2–5) . Although King et al (2) postulated that uterine myxoid leiomyosarcomas might not be responsive to chemotherapy or radiotherapy because of their low mitotic rate and the copious amount of intercellular myxomatous tissue, the effect of adjuvant therapy on preventing recurrence is still unclear (7,10) . Despite an aggressive therapeutic approach, local and systemic control is still a major problem, and recurrence is common: 17 of 24 followed‐up patients experienced a recurrence from 3 months to 10 years after treatment, and the follow‐up was longer than 3 years in only two of the seven women with no evidence of disease (2–5) (3 years and 5 years 10 months in the patients reported by Sprogoe‐Jakobsen and Holund (9) and Takano et al (5) , respectively).…”