Leiomyosarcoma metastatic to the back and scalp from a primary neoplasm in the uterus

Alessi, Elvio; Innocenti, M.; Sala, F.

doi:10.1097/00000372-198510000-00012

Cited by 30 publications

(26 citation statements)

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“…Another case involved disseminated intra-abdominal metastases and multiple cutaneous lesions [29]. A further case was described with cutaneous metastases involving both scalp and back [30]. In 2010 a case of primary ULMS with histologically confirmed scalp metastasis was published [31], but in this case there was also a history of disseminated disease from the primary uterine tumor and the patient had undergone pulmonary lobectomy for metastatic lung nodules.…”

Section: Discussionmentioning

confidence: 99%

Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature

et al. 2012

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A 54 year old lady presented for routine excision of a scalp lesion thought clinically to represent a sebaceous cyst of the right occiput. 4 years earlier she underwent total abdominal hysterectomy and right salpingo-oophorectomy for 3 large uterine fibroids. Histo-pathological examination of the hysterectomy specimen revealed an incidental low-grade leiomyosarcoma. Staging imaging was negative for metastatic disease. She made an uneventful recovery and was treated further by adjuvant pelvic radiotherapy.She noticed an uncomfortable and unsightly cystic swelling on her occiput four years after hysterectomy and was referred for routine excision of what was believed to be a benign lesion. The lesion was excised and sent for histopathological examination. Microscopic analysis including immuno-histochemistry demonstrated an ER and PR positive metastatic deposit of leiomyosarcoma. The margins of excision were histologically clear of disease.At Multi-Disciplinary Team (MDT) discussion a diagnosis of metastatic scalp deposit from previous uterine leiomyosarcoma was made. Re-staging CT brain, thorax, abdomen and pelvis and MRI brain were negative for local recurrence or distant metastases. She is currently undergoing radiotherapy to the scalp and surrounding tissues and will be followed up closely by the involved teams.To the best of our knowledge, this is the first case described in the worldwide literature of isolated cutaneous metastasis to the scalp of uterine leiomyosarcoma without evidence of disseminated disease at other sites.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1311834987345566.

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Section: Discussionmentioning

confidence: 99%

Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature

et al. 2012

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“…317 Clinically, skin metastases from these tumors present as multiple nodules, or, more rarely, as an isolated lesion on the back, 316 and in that case is crucial to rule out primary cutaneous leiomyosarcoma because its prognosis is much better. [315][316][317] Rhabdomyosarcoma is a malignant mesenchymal tumor showing skeletal muscle differentiation that usually arises on the head, neck, and genitourinary tract. They are arranged haphazardly or as interweaving fascicles.…”

Section: Cutaneous Metastases From Soft Tissue Sarcomasmentioning

confidence: 99%

Cutaneous Metastases From Internal Malignancies

Alcaraz

Cerroni

Rütten

et al. 2012

The American Journal of Dermatopathology

219

104

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Skin metastases occur in 0.6%-10.4% of all patients with cancer and represent 2% of all skin tumors. Skin metastases from visceral malignancies are important for dermatologists and dermatopathologists because of their variable clinical appearance and presentation, frequent delay and failure in their diagnosis, relative proportion of different internal malignancies metastasizing to the skin, and impact on morbidity, prognosis, and treatment. Another factor to take into account is that cutaneous metastasis may be the first sign of clinically silent visceral cancer. The relative frequencies of metastatic skin disease tend to correlate with the frequency of the different types of primary cancer in each sex. Thus, women with skin metastases have the following distribution in decreasing order of frequency of primary malignancies: breast, ovary, oral cavity, lung, and large intestine. In men, the distribution is as follows: lung, large intestine, oral cavity, kidney, breast, esophagus, pancreas, stomach, and liver. A wide morphologic spectrum of clinical appearances has been described in cutaneous metastases. This variable clinical morphology included nodules, papules, plaques, tumors, and ulcers. From a histopathologic point of view, there are 4 main morphologic patterns of cutaneous metastases involving the dermis, namely, nodular, infiltrative, diffuse, and intravascular. Generally, cutaneous metastases herald a poor prognosis. The average survival time of patients with skin metastases is a few months. In this article, we review the clinicopathologic and immunohistochemical characteristics of cutaneous metastases from internal malignancies, classify the most common cutaneous metastases, and identify studies that may assist in diagnosing the origin of a cutaneous metastasis.

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“…Another case was described with cutaneous metastases involving both scalp and back [25]. In our case patient had multiple cutaneous metastasis over scalp, back, arm from primary uterine leiomyosarcoma along with evidence of spread to multiple organs The most plausible explanation for pathogenesis in this case was metastatic dissemination of low-grade or undetected sarcoma of the uterus initially removed; however, the leiomyosarcomas may have arisen (a) from smooth muscle and/or the smooth muscle cells of blood vessel walls, or (b) from the malignant transformation of a leiomyoma.…”

Section: Discussionmentioning

confidence: 99%

Extensively Metastatic Vaginal Stump Leiomyosarcoma after Total Hysterectomy: A Rare Presentation—A Case Report with Review of Literature

Singhal

Jain

Saxena

et al. 2015

Indian J Gynecol Oncolog

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The incidence of leiomyosarcoma in uterine leiomyomas is estimated to be between 0.13 and 0.29 % [1]. However, the exact incidence of leiomyosarcoma in uteri removed with a pre-operative diagnosis of benign uterine leiomyomas has not been previously reported. In our study, we describe a case of a 58-year-old female who underwent total hysterectomy 10 years back for uterine leiomyoma and now presented to us with complaints of multiple body swellings over abdomen, arms, neck, scalp, and proptosis. On computed tomography, it was seen that there was a mass in abdomen arising from vaginal stump involving bladder, rectum with skin, muscle, omental, lung, liver, adrenal, and retroperitoneal metastases. Excisional biopsy from a parietal wall swelling and punch biopsy from the vaginal stump were taken. The final histopathological report confirmed it to be leiomyosarcoma with metastases all over the body. Combination chemotherapy of gemcitabine and docetaxel was given to patient. Patient responded to treatment on a 6 month follow-up.

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Leiomyosarcoma metastatic to the back and scalp from a primary neoplasm in the uterus

Cited by 30 publications

References 0 publications

Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature

Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature

Cutaneous Metastases From Internal Malignancies

Extensively Metastatic Vaginal Stump Leiomyosarcoma after Total Hysterectomy: A Rare Presentation—A Case Report with Review of Literature

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