Leiomyosarcoma of the vagina: case report and literature review

Abstract

Leiomyosarcoma of the vagina is quite rare. Extensive search of the literature discloses 137 case reports published over the past 40 years. Collectively, these reports give only cursory guidelines for diagnosis, management, and prognosis. We add another case to the sparse literature on leiomyosarcoma of the vagina. Treatment consisted of surgical excision. Tumor was found to extend to the margin of the excised specimen. The malignancy quickly recurred with lung metastases and the patient died. The very poor prognosis associated with this lesion emphasizes the critical need for early diagnosis and expeditious therapy. In the interest of improving salvage by prompt recognition and intervention, it is important for health-care professionals to be knowledgeable about and alert to this condition.

Stage IV Primary Vaginal Leiomyosarcoma with Lung and Breast Metastases

“…The onset age of vaginal sarcoma has 2 peak periods: embryonal rhabdomyosarcoma in children under 5 years and leiomyosarcoma in adults between 30 and 60 years [2]. Until 2006, only 138 cases of vaginal leiomyosarcoma had been reported [3]. We present another rare case of stage IV vaginal leiomyosarcoma with metastases to the lung and breast.…”

Leiomyosarcoma of the vagina: a case report and review from the literature

“…In addition, leiomyosarcoma has to be differentiated from gestational trophoblastic tumor, uterine endometrial cancer, and vaginal metastasis of malignant tumors developing in adjacent organs, including the uterine cervix, rectum, and bladder. 2 Due to their rarity, risk for development of smooth muscle tumors have not been determined. These tumors can recur locally, and have a tendency to show hematogeneous metastasis into adjacent organs.…”

“…4 Vaginal smooth muscle tumors most frequently develop in the anterior vaginal wall, in contrast, malignant tumors most frequently develop in the posterior vaginal wall, although they can also develop elsewhere. 2 Differential diagnosis of these vaginal masses include Gartner's cyst, granuloma, epithelial inclusion cyst, other neurofibroma, rhabdomyoma, capillary hemangioma, squamous epithelial carcinoma, adenocarcinoma, rhabdomyosarcoma, melanoma, small cell carcinoma, and primary malignant tumors such as mixed müllerian sarcoma that can develop in the vagina. In addition, leiomyosarcoma has to be differentiated from gestational trophoblastic tumor, uterine endometrial cancer, and vaginal metastasis of malignant tumors developing in adjacent organs, including the uterine cervix, rectum, and bladder.…”

“…The most frequently observed vaginal tumors are squamous cell carcinomas (75-90%), followed by adenocarcinoma (5-10%), melanoma, and leiomyosarcoma. 1 Since only about 140 leiomyosarcomas in the vagina have been reported during the past 40 years, 2 guidelines for the determination of disease stage and treatment have not yet been established. Vaginal leiomyosarcomas usually originate from the smooth muscle of the vaginal wall, but they may also develop from smooth muscle cells in tissues near the vagina.…”

Array-CGH Shows Amplification of 8q Including <b><i>MYC</i></b> as the Sole Aberration in a Leiomyosarcoma of the Female Lower Genital Tract

“…Leiomyosarcomas (LMS), which are more often found in the uterus, are estimated to comprise no more than 1% of all vaginal neoplasms. The literature on vaginal LMS consists mostly of case reports, and only about 140 cases have been reported over a span of about 40 years [Ahram et al, 2006;Suh and Park, 2008]. Due to its rarity, the diagnosis of vaginal LMS is seldom considered preoperatively; there is very little by way of characteristic presenting manifestations, clinical history, or physical findings to suggest its diagnosis [Ahram et al, 2006].…”