Leiomyosarcoma of the Abdominal Aorta: A Rare Cause of Renovascular Hypertension

Iguchi, Seitaro; Alchi, Bassam; Asakawa, Katsuaki; Izumi, Daisuke; Kashimura, Takeshi; Ueno, Mitsuhiro; Safar, Farah; Nishi, Shinichi; Narita, Ichiei; Gejyo, Fumitake

doi:10.1291/hypres.30.279

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…These cases include renin/proreninproducing leiomyosarcomas derived from uterus [33], lung [34], retroperitoneum [35,36] and ovary [37]; and renovascular hypertension due to leiomyosarcomas located at inferior vena cava [38,39] and abdominal aorta [40]. In the present case, systemic blood pressure was lowered postoperatively although excess of renin, adrenocortical and adrenomedullar hormones was not detected before surgery.…”

Section: Discussionmentioning

confidence: 64%

A Rare Tumor in the Adrenal Region: Neuron-specific Enolase (NSE)-Producing Leiomyosarcoma in an Elderly Hypertensive Patient

et al. 2008

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Abstract.A 73-year-old Japanese woman was referred for examination of right flank pain and progressive hypertension. Abdominal CT incidentally detected a right adrenal mass 8 cm in size. The tumor exhibited isodensity by CT and contained high-intense lesion by T2-weighted MRI. Scintigraphy with 131 I-metaiodobenzylguanidine and 131 I-adosterol showed no abnormal uptake by whole body scan. Positron emission tomography scan with 18 F-2-fluoro-D-deoxyglucose demonstrated an exclusive uptake in the right adrenal mass. Adrenocortical hormone levels and catecholamine secretion were within normal range; however, the level of serum neuron-specific enolase (NSE) was found to be markedly high. After controlling systemic blood pressure with an α1-blocker, the right adrenal tumor was surgically removed, along with the right kidney and inferior vena cava which adhered to it. The tumor was pathologically proven to be leiomyosarcoma, which was immunohistochemically positive with α-smooth muscle actin and negative with CD57, S-100 and c-kit proteins. Notably, NSE protein was massively expressed in the resected tumor. After surgery blood pressure was controlled with regular medication and serum NSE levels have since normalized. The possibility of leiomyosarcoma should be kept in mind in adrenal incidentalomas with rapid growth and atypical radiological images. Our findings suggest that circulating NSE levels may be clinically useful for early detection of recurrence.

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Section: Discussionmentioning

confidence: 64%

A Rare Tumor in the Adrenal Region: Neuron-specific Enolase (NSE)-Producing Leiomyosarcoma in an Elderly Hypertensive Patient

et al. 2008

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“…RVHT caused by any intraluminal sarcoma of the aorta is extremely rare, as there have been only 10 reported cases (3)(4)(5)(6)(7)(8) (Table 2) since the first description by Kattus in 1960 (3). Severe or refractory hypertension was a prominent clinical feature in all 10 cases.…”

Section: Discussionmentioning

confidence: 99%

“…Although the main etiologies of RVHT are atherosclerosis, fibromuscular dysplasia, and aortitis (1), Weinberg et al reported that severe hypertension can be a prominent clinical feature associated with primary tumors of the aorta, causing obstruction of the aorta or renal artery or both (2). In fact, 10 cases of intraluminal sarcoma of the aorta resulting in RVHT have been reported to date (3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Aortic Intimal Sarcoma Contributes to Atherosclerotic Renovascular Hypertension: An Autopsy Case Report and Review of the Literature

et al. 2016

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An autopsy of a 70-year-old man with multiple bone metastases from a malignancy of unknown origin (MUO) and renovascular hypertension revealed an aortic intimal sarcoma (AIS) in the right renal artery accompanied by atherosclerotic changes. AIS appeared as aggregated mutton fat-like translucent particles arising from the intima of the branching portion of the right renal artery and was composed of undifferentiated, fine spindle cells with thicket-like proliferation. AIS was confirmed by immunohistopathology, showing the loss of the lumen lined by CD31-positive endothelium and the expression of CD31, keratin, and vimentin in the viable part of the tumor. In patients with MUO presenting with both bone metastases and an acute or sub-acute onset of renovascular hypertension, AIS in the renal artery may be responsible.

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“…Pain has been a common symptom related to pressure of surrounding tissues. Other symptoms associated with the location of the tumor have been hoarseness of voice in a case involving the aortic arch, 6 hypertension in a case involving the renal arteries, 7 and shock (retroperitoneal hemorrhage/hemothorax) related to aortic rupture. 3,8 Leiomyosarcomas of the aorta are slow growing and very difficult to diagnose.…”

Section: Discussionmentioning

confidence: 99%

Leiomyosarcoma of the Thoracic Aorta in a Patient with Hypertrophic Cardiomyopathy

Athanasopoulos¹,

Bicknell²,

Anderson³

et al. 2015

Annals of Vascular Surgery

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Leiomyosarcoma of the Abdominal Aorta: A Rare Cause of Renovascular Hypertension

Cited by 7 publications

References 14 publications

A Rare Tumor in the Adrenal Region: Neuron-specific Enolase (NSE)-Producing Leiomyosarcoma in an Elderly Hypertensive Patient

A Rare Tumor in the Adrenal Region: Neuron-specific Enolase (NSE)-Producing Leiomyosarcoma in an Elderly Hypertensive Patient

Aortic Intimal Sarcoma Contributes to Atherosclerotic Renovascular Hypertension: An Autopsy Case Report and Review of the Literature

Leiomyosarcoma of the Thoracic Aorta in a Patient with Hypertrophic Cardiomyopathy

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