Primary leiomyosarcoma of the thyroid gland with prior malignancy and radiotherapy: A case report and review of literature

Vujosevic, Snezana; Krnjevic, Djordjije; Bogojevic, Milan; Vučković, Ljiljana; Filipović, Aleksandar; Dunđerović, Duško; Sopta, Jelena

doi:10.12998/wjcc.v7.i4.473

Cited by 8 publications

(9 citation statements)

References 27 publications

(59 reference statements)

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“…In a nutshell, primary leiomyosarcoma of the thyroid is very rare, and its diagnosis requires special cautiousness. Thyroid LMS can be diagnosed merely when there is a complete lack of epithelial cell differentiation and on obtaining clear evidence (histology, immunophenotype, or ultrastructure) indicating the presence of speci c sarcoma differentiation, such as the expression of vimentin, SMA, and MSA, and the partial expression of Desmin, whereas CK, TG, calcitonin, S-100, and EMA are generally not expressed [15]. Herein, the tumor grew like a bundle of spindle cells, and the nucleus was obviously atypical and polymorphic.…”

Section: Discussionmentioning

confidence: 99%

A rare primary leiomyosarcoma of the thyroid gland: a case report and literature review

Hao

Huang

Tian

et al. 2020

Preprint

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Background Primary thyroid leiomyosarcoma(LMS) is very rare, with only 30 cases reported worldwide. Thyroid LMS should be diagnosed with caution and comprehensively evaluated considering clinical, imaging, and pathological data. It is a kind of fatal tumor with an extremely poor prognosis and lacks effective treatment regimens, and most patients die within 1 year of diagnosis. Here, we present a case report on a patient with Primary thyroid LMS. Case presentation A 76-year-old woman presented with hoarseness, dysphagia, and dyspnea when lying down for the past 1 month visited our hospital. She had a history of right neck masses in the past 2 years. A hard, irregular tumor of approximately 8 cm × 5 cm × 5 cm was observed on the right lobe of the thyroid, the boundary between which and the surrounding tissues was unclear. The tumor anteriorly invaded the cervical muscles and interiorly invaded the right walls of the trachea and esophagus. Most tumor tissues were excised, a curative operation seemed impossible. Immunohistochemically, the tumor cells were positive for Calponin, vimentin and SMA, but negative for EMA, CK, P53, Desmin and S-100. Tumor recurrence and progression were considered two months after surgery, the patient refused follow-up treatment for personal reasons and died 4 months after surgery. Conclusion Thyroid LMS accounting for merely 0.014% of primary thyroid tumors of unknown etiology. The diagnosis can only be confirmed upon a lack of evidence regarding epithelial differentiation or other types of sarcoma differentiation and when immunohistochemistry yields positive smooth muscle markers. Primary thyroid LMS is primarily surgically resected and no other effective treatment currently available. Disease progression is rapid, the prognosis is poor, and the 1-year survival rate is <10%. In the present study, a rare case of a 76-year-old female patient diagnosed with thyroid LMS was reported and a review of the literature is presented.

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Section: Discussionmentioning

confidence: 99%

A rare primary leiomyosarcoma of the thyroid gland: a case report and literature review

Hao

Huang

Tian

et al. 2020

Preprint

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“…There have only been 29 case reports of primary thyroid leiomyosarcoma in English medical literature. Two recent literature reviews provide concise summaries of these reports [3,4].…”

Section: Discussionmentioning

confidence: 99%

“…The primary presenting complaint for almost all reported adult cases is the rapid growth of a neck mass which may be associated with dysphagia, odynophagia or dysphonia. Obtaining an accurate diagnosis can be difficult, and there are no imaging features on ultrasound, CT, magnetic resonance imaging (MRI) or PET scanning that definitively differentiate LMS from other invasive thyroid malignancies [3,4]. It is also difficult to distinguish between other spindle-cell malignancies on tissue samples, particularly fine needle aspirates.…”

Section: Discussionmentioning

confidence: 99%

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Primary thyroid leiomyosarcoma - case report and literature review

Tj¹,

Tasevski²,

Li³

2019

Surg Rehabil

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Primary thyroid leiomyosarcoma is a rare malignancy. Patients usually present with advanced disease and less than 10% survive beyond one year. In making the diagnosis it is difficult to distinguish cytologically between spindle cell malignancies. We present a 66-year old male patient who required open incisional biopsy to obtain the diagnosis of thyroid leiomyosarcoma and allow for appropriate management.

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“…Leiomyosarcoma (LMS) is a rare and extremely aggressive malignancy derived from or showing evidence of differentiation toward smooth muscle. 1 It can occur in the female reproductive system, especially in the uterus (which is rich in smooth muscle), or in other parts of the pelvic area such as the ovaries, fallopian tube, uterine ligaments, vulva, vagina and other extrauterine sites. Uterine leiomyosarcoma (ULMS) accounts for 1–2% of uterine malignancy.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Preoperative CA125, LDH and HE4 for Leiomyosarcoma of the Female Reproductive System

Zhang¹,

Liu²,

Quan³

et al. 2021

CMAR

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Purpose Leiomyosarcoma (LMS) is a rare and extremely aggressive malignancy that is derived from or shows evidence of differentiation toward smooth muscle. If LMS occurs in the female reproductive system, preoperative diagnosis can be difficult, as LMS is easily mistaken for a uterine leiomyoma, especially a degenerated uterine fibroid (DUF). Thus, we assessed the diagnostic value of the preoperative serum concentrations of cancer antigen 125 (CA125), lactate dehydrogenase (LDH) and human epididymis protein 4 (HE4) for differentiating LMS from DUF. Patients and Methods We enrolled patients with LMS or DUF who were receiving treatment in The First Affiliated Hospital of Chongqing Medical University between 2009 and 2020. If the preoperative serum concentrations of CA125, LDH and HE4 of our study participants had been tested, these data were analyzed. The preoperative serum concentrations of CA125, LDH and HE4 in participants with LMS (n = 37) were compared with those of participants with pathologically diagnosed DUF (n = 102), who served as the control group. Results The preoperative serum concentrations of CA125, LDH and HE4 of participants with LMS of the female reproductive system were significantly higher than those of participants with DUF ( P = 0.009, P < 0.001, P = 0.001, respectively). The cut-off preoperative serum concentrations of CA125, LDH and HE4 were 30.85 U/mL, 186.50 U/L and 50.50 pmol/L, respectively. When these three parameters were used for an analysis of their combined diagnostic utility, the area under the curve (AUC) was 0.892, the sensitivity was 68.4% and the specificity was 95.1% ( P < 0.001). Conclusion A combined analysis of the preoperative serum concentrations of CA125, LDH and HE4 could be a promising method for diagnostically differentiating LMS of the female reproductive system from DUF.

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Primary leiomyosarcoma of the thyroid gland with prior malignancy and radiotherapy: A case report and review of literature

Cited by 8 publications

References 27 publications

A rare primary leiomyosarcoma of the thyroid gland: a case report and literature review

A rare primary leiomyosarcoma of the thyroid gland: a case report and literature review

Primary thyroid leiomyosarcoma - case report and literature review

Diagnostic Value of Preoperative CA125, LDH and HE4 for Leiomyosarcoma of the Female Reproductive System

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