Primary Metastatic Leiomyosarcoma of the Fallopian Tube: A Rare Case Report

Abstract

Background: Leiomyosarcoma of the fallopian tube is an extremely unusual gynecologic neoplasm. Since 1886, only 19 of about 35 sarcomas of the fallopian tube have been identified as leiomyosarcomas. As such, clinical diagnosis and therapy management are difficult. Case Report: We report on the case of a 59-year-old woman with leiomyosarcoma of the fallopian tube and liver metas-tases at the time of diagnosis. After initial tumor debulk-ing, she received palliative chemotherapy with gemcitabine 900 mg/m² (d1+8) and docetaxel 100 mg/m² (d8) (q21). For additional bone metastases, she started local radiation plus bisphosphonates (q28). After 2 cycles of chemotherapy, the disease progressed, and the patient died within 8 months of diagnosis. A review of the literature is given. Conclusions: Primary metastatic leiomy-osarcoma of the fallopian tube is a progressive disease with limited therapy options. For better prognostic evaluation and disease management in such rare cases, it is important to report and compare more cases regarding course of disease and outcome.

Giving birth after fertility‐sparing treatment for primary leiomyosarcoma of the fallopian tube

“…PLFT is rare and there are limited data on its treatment. Only 12 clearly identified cases have been reported over the past 30 years (Table 1), [1][2][3][4][5][6][7][8][9][10] and the precise cause and pathogenesis of PLFT are still incompletely understood. This gynecological neoplasm is characterized by local recurrence and distant metastases.…”

“…Primary leiomyosarcoma of the fallopian tube (PLFT) is a very rare and aggressive malignancy with poor documentation in the literature. [1][2][3][4][5][6][7][8][9][10] Despite the dire prognosis, there is no specific established treatment modality for PLFT. Most patients with PLFT undergo radical surgery 2,3,[6][7][8][9] or debulking surgery.…”

A Case Report of Incidental Primary Leiomyosarcoma of the Fallopian Tube and a Review of the Recent Literature

“…Immunohistochemical analysis forms an important part of the diagnostic work up of LMS to exclude potential morphologic mimics, including extragastrointestinal stromal tumors (6). Over the past 20 yr there have been seven publications describing 9 cases of PLFT confirmed by immunohistochemical analysis (Table 1) (5,(7)(8)(9)(10)(11)(12). The average age of onset of these cases was 51 yr with a range of 33 to 70 yr.…”

“…Given the rarity of this disease, it has previously been suggested that a centralized case registry documenting the course of disease, treatment, and outcome would enable a more comprehensive assessment to guide management of such cases (10). Such an initiative and the continued publication of case reports would be of value.…”

Primary leiomyosarcoma of the fallopian tube

“…Similar to the surgical treatment of ovarian neoplasm, for the nonmetastasized tube LMS (FIGO I,II), the mainstay of operation is represented by complete resection (R0) consisting of peritoneal washing, inspection of peritoneum and the surface of abdominal organs, excision of all the abdominal masses, random biopsies, total abdominal hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy, and pelvic and periaortic selective lymphadenectomy. For the metastasized tube LMS (FIGO III, IV), a debulking surgery should be considered in order to excise all the primary lesion and reduce the metastatic risks as much as possible many different regimens have been reported in published works, including acombination of ifosfamide with pirarubicin, [ 4 ] gemcitabin and docetaxel, [ 7 ] and DTIC-adriablastine-vincristine-cyclophosphamide schedule (CyVADIC). [ 8 ] Of note is the report by Kobayashi et al [ 6 ] involving a case of a stage IIIc patient who survived more than 6 years without any evidence of recurrence with intraperitoneal cisplatin followed by prolonged oral etoposide for 1 year.…”