Primary adrenal leiomyosarcoma treated by laparoscopic adrenalectomy

Quildrian, Sergio Damián; Califano, Inés; Carrizo, Fernando; Daffinoti, Anabella; Calónico, Néstor

doi:10.1016/j.endonu.2015.05.008

Cited by 10 publications

(16 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As for the risk of local recurrence, Quildrian et al reported 36 months recurrence free survival after complete surgical resection of the mass, which was the longest reported period (57). Regarding HIV-positive patients the longest recurrence free survival (RFS) was reported by Zetler et al, being 20 months after surgery (55). Others reported significantly smaller RFS, accompanied by distant metastases.…”

Section: Discussionmentioning

confidence: 96%

“…Regarding leiomyosarcomas our literature review showed that 5 patients were deemed inoperable and other treatment options were considered. From the 38 patients that proceeded with a surgical operation 5 had laparoscopic adrenalectomy (31,47,55,58,72) with maximum reported survival being 3 years (55) and 2 had laparoscopic converted-to-open adrenalectomy (62,70) with maximum reported survival being 8 months (70). Although the kidney was removed in several cases due to suspicion of infiltration from imaging or intra-operative findings, only one case had microscopic confirmation of infiltration (42).…”

Section: Discussionmentioning

confidence: 99%

“…Seventeen tumors were tested for the Ki-67 proliferation marker. Of them two were expressing the marker in <10% (39,70), four in 20-30% (55,60,63,64), one moderately expressed the marker ( 43 (32,35,43,47,69,71). Three cases commented in the differentiation of the tumors, two as well-differentiated (57,73) and one as poorly-differentiated (33).…”

Section: Risk Factorsmentioning

confidence: 96%

“…From these cases, 5 patients proceeded with surgical excision, one of them was deemed inoperable during exploratory laparotomy (59), and the remaining 4 were not qualified as surgical candidates due to either local extension or metastatic disease (32,34,38,51). Regarding diagnosis through biopsy specimen, 5 specimens revealed the presence of a spindle cell neoplasm, with (57) or without smooth muscle differentiation (43,55,47,49) and in 4 cases the diagnosis of a malignant spindle cell neoplasm was rendered (30,32,36,67).…”

Section: Risk Factorsmentioning

confidence: 99%

“…Thirty-eight cases were submitted to surgical resection, while 4 were deemed inoperable (32,34,38,51), one was subjected to exploratory laparotomy but the tumor was found unresectable due to fixation to the right lobe of the liver (59), and two were found post-mortem in autopsy findings (3). Four patients were submitted to laparoscopic adrenalectomy (46,55,58,72), one in bilateral laparoscopic adrenalectomy (31) and two were converted from laparoscopic to open procedure (62,70).…”

Section: Risk Factorsmentioning

confidence: 99%

See 4 more Smart Citations

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

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 96%