Recurrent broad ligament leiomyosarcoma with pancreatic and thigh metastasis: a case report

Abstract

Background: Leiomyosarcoma (LMS) is an uncommon mesenchymal neoplasm, which infrequently metastasizes to pancreas and thigh. Clinical presentation and imaging findings of metastatic broad ligament LMS are often nonspecific. Complete excision plays an important role in treatment of patients with localized LMS. Case presentation: Here, we report a case of a 33-year-old woman with recurrent broad ligament LMS metastasizing to pancreas and thigh. Previously, she was diagnosed with broad ligament LMS and underwent hysterectomy, bilateral salpingo-oophorectomy. The disease-free interval was 2.5 years until metastases were found. Computerized tomography (CT) of abdomen and thighs, magnetic resonance imaging (MRI) of thighs and whole-body 18-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) performed, revealed pancreatic and thigh metastasis. Ultrasonography-guided biopsy and histological examinations confirmed LMS at both the sites. Pancreatic metastasis was completely resected first. Then the patient underwent surgical resection of thigh metastasis when both chemotherapy and radiotherapy failed. She recovered well and remained free of disease recurrence in the 2 years follow-up. Conclusions: Though imaging lacks specificity, it is a valuable asset in assessing the burden of disease and characterizing lesions while histological examination with immunohistochemistry is helpful for the diagnosis of LMS. Complete surgical resection of all metastatic sites where-ever feasible should be strongly considered in a treated case of broad ligament LMS with a durable disease-free interval.

Adrenal gland as first metastasis from broad ligament leiomyosarcoma: case report and literature review

“…Here, the last term was the most important. LMS of the broad ligament is very rare with only 33 cases reported in English literature to date [1][2][3][4][5][6][7][8]. It has been reported that broad ligament LMS metastasis sites include the stomach, pancreas, and neck region[6-8].…”

“…According to the numbers of MFs and the degree of cell differentiation, LMS is divided into well, intermediate and poor differentiation. Positive staining of the immunohistochemical markers Desmin and SMA contributed to the diagnosis [6,7].…”

“…LMS of the gynaecological system can occur in the uterus and ovary [4,5]. Primary LMS of the broad ligament is extremely rare and rarely metastasizes to the adrenal gland in clinical practice [6,7].…”