Metastasis of uterine leiomyosarcoma to the pancreas

Iwamoto, Ichiro; Fujino, Toshinori; Higashi, Yutaro; Tsuji, Takahiro; Nakamura, Noboru; Komokata, Teruo; Douchi, Tsutomu

doi:10.1111/j.1447-0756.2005.00344.x

Cited by 25 publications

(23 citation statements)

References 14 publications

(10 reference statements)

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“…However, a few cases of leiomyosarcoma with metastases to the pancreas have been reported. Primary sites of leiomyosarcomas included the uterus [6,7] , ovary [8] , veins [9] , spermatic cord [10] , intestine [3,10] , retroperitoneum [2,11] , and soft tissue [11,12] . To the best of our knowledge, including the present case, only 16 cases of pancreatic metastasis from leiomyosarcoma have been reported to date in the English language literature [7,8,12] .…”

Section: Discussionmentioning

confidence: 99%

Pancreatic metastasis of leiomyosarcoma in the right thigh: A case report

Koh¹

2007

WJG

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tumors is 1.6%-11% at autopsy [1,2] . The majority of patients with pancreatic metastasis have widespread diseases. Isolated, potentially resectable pancreatic metastasis is detected infrequently. Therefore, resection of metastatic tumors of the pancreas has been occasionally reported, and its role in improving the survival or quality of life is not clearly defined [3,4] . However, some recent studies have reported that surgical resection can be performed in selected patients with isolated pancreatic metastases, achieving long-ter m sur vival and good palliation [1,5] . We report here a case of pancreatic metastatic from leiomyosarcoma of the right anterior thigh, which was treated by surgical resection, and review the literature about pancreatic metastasis. CASE REPORTA 66-year-old woman was referred to our hospital with a mass in the right thigh (Figure 1). In September 2005, she had undergone surgical resection for this mass. Malignant mesenchymoma (70% osteosarcoma and 30% leiomyosarcoma) was diagnosed histologically. In the postoperative period, abdominal computed tomography (CT) identified a pancreatic mass. The patient complained of non-specific abdominal discomfort. Laboratory findings were all within normal limits. The levels of the tumor markers including carcinoembryonic agent and carbohydrate antigen 19-9, were within the normal ranges. Abdominal CT revealed a mass at the head of the pancreas. Magnetic resonance imaging of the abdomen showed a low-intensity mass on T1-weighted images and a non-homogeneous high-intensity mass on T2-weighted images. No evidence of other distant metastases was seen (Figure 1). At laparotomy, a fixed mass of 4 cm or so in length was palpated at the head of the pancreas, displacing the surrounding duodenum. Therefore, pyloruspreserving pancreaticoduodenectomy was performed. Macroscopic examination of the operative specimen showed a 4 cm × 3 cm lobulated solid mass with a thin wall. Microscopic examination revealed a malignant neoplasm with predominance of spindle cells. The tumor cells were immunoreactive for desmin. Metastatic leiomyosarcoma was diagnosed histologically (Figure 2). The postoperative course was uneventful. We recommended systemic chemotherapy to the patient, but she declined. Nine months after the first pancreatic resection, a followup abdominal CT showed development of a new 1-cm mass in the remnant tail of the pancreas (Figure 1). Distal In the postoperative period, a pancreatic mass was identified radiologically by abdominal computed tomography. Pylorus-preserving pancreaticoduodenectomy was performed. The surgical specimen revealed leiomyosarcoma metastasized to the pancreas. A metastatic nodule on the remnant pancreatic tail was discovered 9 mo after the first pancreatic resection, and distal pancreatectomy was performed. Cases of pancreatic metastasis from leiomyosarcoma are extremely rare, especially when the tumor was resectable. We report here a unique case of pancreatic metastasis from a leiomyosarcoma in the right thigh that had been treated su...

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Section: Discussionmentioning

confidence: 99%

Pancreatic metastasis of leiomyosarcoma in the right thigh: A case report

Koh¹

2007

WJG

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“…Leiomyosarcoma of the right leg was diagnosed following examinations performed in the department of orthopedic surgery. In addition, preoperative 18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) showed strong accumulation in the pancreatic body and tail (Figs.1b-d). Surgery of the right leg revealed the presence of leiomyosarcoma.…”

Section: Case Reportmentioning

confidence: 99%

Multiple Metastatic Leiomyosarcoma of the Pancreas: A First Case Report and Review of the Literature

et al. 2013

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A 60-year-old woman was referred to our hospital with swelling of the right leg. After surgery, leiomyosarcoma of the right leg was diagnosed. Computed tomography showed two hypovascular masses in the pancreatic body and tail that were heterogeneously enhanced compared with the pancreatic parenchyma. On endoscopic ultrasonography, the tumors in the pancreatic body and tail both exhibited regular margins and were visualized as well-circumscribed masses with uneven interiors. Distal pancreatectomy was performed under a presumptive diagnosis of metastatic pancreatic leiomyosarcoma diagnosed based on the findings of EUS-FNA. On laparotomy, peritoneal washing cytology yielded negative results, and no dissemination was observed. Ultimately, metastatic pancreatic leiomyosarcoma was histologically diagnosed.

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“…The uterus is the most frequent site, and there the tumour has a high rate of recurrence and metastasis. The commonly reported sites of metastasis from leiomyosarcoma are the lung, kidney and liver; metastasis to the pancreas is extremely rare [1,2]. Primary tumours that most commonly cause metastases to the pancreas are breast, lung, kidney and colon cancers or, more rarely, gastric cancer, melanoma and sarcoma Resection of metastatic tumour to the pancreas has occasionally been reported.…”

Section: Introductionmentioning

confidence: 99%

Pancreaticoduodenectomy for metastasis of uterine leiomyosarcoma to the pancreas

et al. 2010

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Metastasis of uterine leiomyosarcoma to the pancreas is rare. A 46-year-old woman was diagnosed with uterine leiomyosarcoma and underwent surgery. Thereafter, recurrences in the lung and subsequently in the pancreas were diagnosed. These lesions were resected and diagnosed as metastasis of uterine leiomyosarcoma. We report a rare case of uterine leiomyosarcoma with metastasis to the lung and pancreas, both of which were resected using aggressive surgery.

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Metastasis of uterine leiomyosarcoma to the pancreas

Abstract: We report an extraordinarily rare case of uterine leiomyosarcoma with metastasis to the pancreas following initial metastasis to the lung, both of which were diagnosed using histology and immunohistochemistry of the specimens obtained at surgery.

Cited by 25 publications

References 14 publications

Pancreatic metastasis of leiomyosarcoma in the right thigh: A case report

Pancreatic metastasis of leiomyosarcoma in the right thigh: A case report

Multiple Metastatic Leiomyosarcoma of the Pancreas: A First Case Report and Review of the Literature

Pancreaticoduodenectomy for metastasis of uterine leiomyosarcoma to the pancreas

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