Primary Adrenal Leiomyosarcoma

Wei, Jianguo; Sun, Aihua; Tao, Jian; Wang, Cheng; Liu, Fang

doi:10.1177/1066896914526777

Cited by 8 publications

(15 citation statements)

References 16 publications

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“…Five cases out of 45 presented with leg swelling (32,49,59,67,69) 1 with cold feet sensation (35) and 2 cases had skin varices at the time of diagnosis (67,69). One case presented with weight gain (32), 1 had back pain related with bone metastases (34), 1 had urinary track symptoms (70) and 3 were asymptomatic (71)(72)(73). 1 case was diagnosed during follow-up for previously resected adrenal leiomyosarcoma (31) and two cases were diagnosed postmortem due to HIV-related infections (3).…”

Section: Symptoms Diagnosismentioning

confidence: 99%

“…Two cases described by Boman et al that presented positive EBER hybridization in the autopsy specimen, were found negative for EBV latent membrane protein 1 (LMP1) in the tumor cells (3). From the remaining literature 6 cases were tested negative for HIV infection (44,49,58,61,66,71). From these, one case was also tested for EBV in situ hybridization of the surgical specimen and was found negative (71) and another case was found negative for EBV LMP1 in the tumor cells (56).…”

Section: Risk Factorsmentioning

confidence: 99%

“…In a patient that underwent laparoscopic excision the tumor was resected en bloc with the infiltrated liver capsule (72). One patient underwent en bloc resection of infiltrated diaphragm (43) and another underwent resection of the tumor along with part of the posterior wall of the stomach (71). Tumor thrombus was removed in 6 patients (33,35,44,(67)(68)(69), infiltrated IVC wall was removed and reconstructed in 6 patients (37,41,53,54,64,69).…”

Section: Risk Factorsmentioning

confidence: 99%

“…Two cases underwent further operations for metastases (42) and local recurrence (71). One case that was deemed inoperable underwent thoracic surgery for metastases (38) and three cases underwent autopsy examination (3, 59).…”

Section: Risk Factorsmentioning

confidence: 99%

“…One case that was deemed inoperable underwent thoracic surgery for metastases (38) and three cases underwent autopsy examination (3, 59). One patient received preoperative chemotherapy (65), 5 patients received combination chemotherapy with radiotherapy postoperatively (39,44,45,50,73), 5 patients received adjuvant chemotherapy (36,49,54,61,71), 2 patients received radiotherapy postoperatively (35,64) and one patient received combination chemotherapy RT and radiofrequency ablation (RFA) postoperatively (42). One patient received combination chemotherapy and RT only in vivo 34: 2233-2248 (2020) (51), 2 cases underwent chemotherapy only (32,38) and one patient received RT only (34).…”

Section: Risk Factorsmentioning

confidence: 99%

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Review of the Literature on Leiomyoma and Leiomyosarcoma of the Adrenal Gland: A Systematic Analysis of Case Reports

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Dellaportas

Peppa

et al. 2020

In Vivo

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Background/Aim: To date few cases of smooth muscle-derived tumors of the adrenal gland have been reported and their treatment remains a medical challenge. The aim of this manuscript was to systematically review the literature and present the tumor characteristics and their management in order to provide a standardized approach to their diagnosis and management. Materials and Methods: We searched five databases (PubMed, Scopus, Elsevier, ResearchGate, Google scholar) for relevant articles published until March 2020. Results: Twenty-two cases of adrenal leiomyoma, four cases of adrenal smooth muscle tumor and forty-five cases of adrenal leiomyosarcoma were included. Conclusion: We present the demographic, clinical, radiological, pathological and oncological characteristics and prognosis of tumors of the adrenal gland arising from smooth muscle cells, as well as describe the common clinical investigations and therapeutic modalities that have been reported as part of their management.Adrenal tumors can be detected either incidentally or after investigation of signs and symptoms that they evoke. Generally, they can be histologically categorized as primary tumors of the adrenal cortex or medulla, metastases from other primary malignancies and other tumors of the adrenal gland which originate from connective tissue cells. Adrenal cortical tumors are comprised by (asymmetric) adrenal cortical hyperplasia, adenoma, myelolipoma, adrenocortical carcinoma, oncocytic adrenocortical neoplasms; medullary tumors are comprised by pheochromocytoma, ganglioneuroma, neuroblastoma, ganglioneuroblastoma and teratoma. Connective tissue origin tumors are rarer and are comprised mainly by haemangioma and lymphangioma with a few cases of leiomyoma, lipoma, hemangiosarcoma, lymphoma, leiomyosarcoma and liposarcoma, as reported in the literature. Patients with primary malignancies in lung, breast, kidney, colon, oesophagus, pancreas, liver, stomach or with melanoma can present with adrenal metastases spread from these tumors, which can commonly be found bilaterally (1).Leiomyomas (LM) and leiomyosarcomas (LMS) are mesenchymal tumors that derive from smooth muscle cells. Their benign -leiomyoma or malignant -leiomyosarcoma characterization depends on nuclear atypia and/or pleomorphism, mitotic activity and tumor cell necrosis (2). Leiomyomas and leiomyosarcomas of the adrenal gland comprise a very small percentage of the gland's pathology with very little data available in the literature. The aim of this manuscript was to systematically review the literature and present demographic, clinical, radiological, pathological and oncological characteristics and prognosis of tumors of the adrenal gland arising from smooth muscle cells, as well as describe the common clinical investigations and therapeutic modalities that have been reported as part of their management.

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Section: Symptoms Diagnosismentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

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Review of the Literature on Leiomyoma and Leiomyosarcoma of the Adrenal Gland: A Systematic Analysis of Case Reports

Σακελλαρίου

Dellaportas

Peppa

et al. 2020

In Vivo

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Primary adrenal leiomyosarcoma with inferior vena cava extension in a 70-year-old man

et al. 2019

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Primary adrenal leiomyosarcoma, a malignant soft tissue tumour originating from the smooth muscle of the inferior vena cava and adrenal vein, is rarely described in the literature. Cases are often diagnosed at an advanced stage as the tumour is not hormone-producing. We describe a 70-year-old man who presented with lower extremity swelling and abdominal varices and was subsequently found to have a large adrenal mass on imaging. Our case is among the few reported primary adrenal leiomyosarcomas in which a CT-guided biopsy was used to aid in diagnosis.

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The challenge to differentiate between sarcoma or adrenal carcinoma—an observational study

et al. 2021

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Background Adrenal sarcomas are rare malignant tumors with structural and clinical similarities to sarcomatoid adrenocortical carcinoma. Preoperative diagnosis of tumors of the adrenal gland can be challenging and often misleading thus detaining patients from appropriate oncological strategies. Objective This analysis of a case series evaluated the predictive capability of the primary clinical diagnosis in case of malignancies of the adrenal gland. Methods Thirty two patients were treated from 2009 to 2015 at our clinic and analyzed retrospectively. All patients had computed tomography and/or magnet resonance imaging and a primary histopathological examination at our institution after surgery. Ten questionable cases were surveyed by a reference pathologist. Results Twelve out of 32 diagnoses had to be revised (37.5%). Only 15 out of 24 tumors primarily classified as adrenocortical carcinoma were finally described as primary adrenal cancer. We found two leiomyosarcomas, one liposarcoma, one sarcomatoid adrenocortical carcinoma, and one epitheloid angiosarcoma among 12 misleading diagnoses. Other tumors turned out to be metastases of lung, hepatocellular, and neuroendocrine tumors. Larger tumors were significantly more often correctly diagnosed compared to smaller tumors. Four patients of the group of revised diagnoses died whereas all patients with confirmed diagnoses survived during the follow-up. Conclusion Preoperative assessment of tumors of the adrenal gland is still challenging. In case of wrong primary diagnosis, the prognosis could be impaired due to inadequate surgical procedures or insufficient preoperative oncological treatment.

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Primary Adrenal Leiomyosarcoma

Cited by 8 publications

References 16 publications

Review of the Literature on Leiomyoma and Leiomyosarcoma of the Adrenal Gland: A Systematic Analysis of Case Reports

Review of the Literature on Leiomyoma and Leiomyosarcoma of the Adrenal Gland: A Systematic Analysis of Case Reports

Primary adrenal leiomyosarcoma with inferior vena cava extension in a 70-year-old man

The challenge to differentiate between sarcoma or adrenal carcinoma—an observational study

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