Smooth muscle tumors of the gastrointestinal tract: an analysis of prognostic features in 407 cases

Alpert, Lindsay; Al-Sabti, Ram; Graham, Rondell P.; Pai, Rish K.; González, Raúl; Zhang, Xuefeng; Smith, Vanessa L.; Wang, Hanlin L.; Westbrook, Lindsey; Goldblum, John R.; Bakhshwin, Ahmed; Shetty, Sindhu; Klimstra, David S.; Shia, Jinru; Aşkan, Gökçe; Robert, Marie E.; Thomas, Clayton L.; Frankel, Wendy L.; Alsomali, Mohammed; Hagen, Catherine; Mostafa, Mohamed; Feely, Michael; Assarzadegan, Naziheh; Misdraji, Joseph; Shih, Angela R.; Agostini-Vulaj, Diana; Meis, Jeanne M.; Tang, Sherry; Chatterjee, Deyali; Kang, Liang‐I; Hart, John; Lee, Sang Mee; Smith, Theresa J.; Yantiss, Rhonda K.; Hissong, Erika; Gao, Zu-Hua; Wu, Jing; Resnick, Murray B.; Wu, Elizabeth; Pai, Reet; Zhao, Lei; Doyle, Leona A.; Chopra, Shefali; Panarelli, Nicole C.; Hu, Shaomin; Longacre, Teri A.; Raghavan, Shyam S; Lauwers, Gregory Y.; Ghayouri, Masoumeh; Cooper, Harry S.; Nagarathinam, Rajeswari; Bellizzi, Andrew M.; Kakar, Sanjay; Hosseini, Mojgan; Rong, Juan; Greenson, Joel K.; Lamps, Laura W.; Dong, Zachary M.; Bronner, Mary P.

doi:10.1038/s41379-020-0492-5

Cited by 19 publications

(26 citation statements)

References 17 publications

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“…Microscopically, both exhibit spindle cell morphology although a minority of GISTs have epithelioid morphology [ 4 ]. Although in our case there were no cytological atypia and no increase in mitosis, smooth muscle tumours of the small bowel larger than 10 cm have been found to have 33% risk of progressive disease warranting a follow-up of at least 2 years [ 3 ]. It is clinically important to differentiate leiomyoma from GISTs as the latter is 40–50% malignant and these patients may benefit from tyrosine kinase inhibitors.…”

Section: Discussionmentioning

confidence: 94%

“…This tumour is classified as mesenchymal neoplasms of gastrointestinal tract which are divided into two groups: gastrointestinal stromal tumours (GISTs) and other smooth muscle tumours. The latter group consists of a spectrum of diseases such as lipomas, liposarcomas, leiomyomas, leiomyosarcoma, desmoid tumors, schwannomas and peripheral nerve sheath tumors [ 3 ]. There has been a shift in nomenclature to separate GISTs from the smooth muscle tumours due to the discovery of expression of an KIT protein in GISTs by immunohistochemistry in the late 1990s [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…There has been a shift in nomenclature to separate GISTs from the smooth muscle tumours due to the discovery of expression of an KIT protein in GISTs by immunohistochemistry in the late 1990s [ 4 ]. Smooth muscle tumours are most commonly encountered in middle-aged patients and have a slight female predominance (ratio 1.3:1) [ 3 ]. We report a 30-year-old male who presented with a painful right iliac fossa mass, diagnosed as an intestinal leiomyoma following surgical resection.…”

Section: Introductionmentioning

confidence: 99%

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An oncological curiosity of a male patient with a huge leiomyoma of the terminal ileum

Zainudin

Rajanthran

Azizan

et al. 2020

Oxford Medical Case Reports

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Leiomyoma is a smooth muscle tumour that can arise in any part of the body especially the uterus. Even though it is traditionally linked with hormonal influence, it can also develop in extrauterine organs with a slight female predominance. It is indistinguishable with gastrointestinal stromal tumour (GIST) histologically. We report a case of a 30-year-old gentleman who presented with a huge painful mass in the right iliac fossa. Computed tomography revealed a 10 × 10 cm homogeneous mass arising from the terminal ileum; he subsequently underwent an open right hemicolectomy. Histology showed a well-circumscribed lesion composed of interlacing bundles of smooth muscle fibres of the submucosa with positive smooth muscle actin and H-Caldesmon stains but negative for DOG-1 and CD117 (c-kit) stains which were consistent with leiomyoma. Despite its rarity, this hormone-related tumour needs to be considered regardless of gender. Immunohistochemistry is paramount as it is histologically identical to GIST.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An oncological curiosity of a male patient with a huge leiomyoma of the terminal ileum

Zainudin

Rajanthran

Azizan

et al. 2020

Oxford Medical Case Reports

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“…Focal areas of necrosis and scarce or rare mitotic figures have also been reported ( 8 , 11 , 18 ). A recent study on gastrointestinal smooth muscle tumors, including esophageal, gastric, small bowel, and colorectal tumors suggested a novel approach in classifying these tumors according to progression risk, akin to gastrointestinal stromal tumors (GIST) into low risk, intermediate risk and high risk groups based on the location of the tumor, size, and frequency of mitotic activity ( 22 ). Nevertheless, such an approach has not yet been validated for primary smooth muscle neoplasms of the liver.…”

Section: Discussionmentioning

confidence: 99%

Primary Hepatic Leiomyoma in a Healthy Middle-Aged Woman: Literature Review and Case Report

et al. 2021

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Introduction: Primary hepatic leiomyoma (PHL) is a rare benign hepatic tumor with unclear pathogenesis. It more commonly occurs in immunosuppressed patients, while only 24 cases have been described among immunocompetent individuals. To date, only one successful preoperative diagnosis of PHL has been achieved.Case Presentation: Here we report a case of PHL in a middle-aged woman with no history of immunosuppression. Preoperative diagnosis of PHL was established using ultrasound-guided fine needle trucut biopsy (FNTB). Nevertheless, due to the growing nature of tumor and patient's symptoms, we proceeded with surgical resection, which confirmed the diagnosis of PHL. At 6-month follow up, the patient is in good condition with no evidence of tumor recurrence.Conclusions: PHL is an uncommon tumor that should be considered in the differential diagnosis of rare liver tumors. Image guided FNTB appears to be effective in achieving preoperative diagnosis of PHL. Surgical resection, however, remains both diagnostic and curative in the management of PHL.

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“…2 They are more common in women and despite representing the second most common mesenchymal mural tumor of the digestive tract, anorectal location is very rare, representing less than 0.1% of all anorectal neoplasms. [3][4][5] Histologically, they are characterized by a pattern of coiled smooth muscle bundles separated by connective tissue, spindle cells (elongated), with eosinophilic and occasionally fibrillar cytoplasm and distinct cell membranes (Figure 2). 6 GILM can be confused with GISTs, so the immunohistochemical study becomes relevant for the differential diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Transanal excision of anorectal leiomyoma, a rare location pathology: case report and review

et al. 2022

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Gastrointestinal leiomyomas (GILM) are benign tumors truly originated in the smooth muscle of the digestive tract, therefore, they are mesenchymal tumors and can come from the muscularis propria, muscularis mucosae or from the smooth muscle of the blood vessels. These tumors occur more frequently in women and despite being the second most common mesenchymal mural tumor of the digestive tract, anorectal location is very rare, representing less than 0.1% of all anorectal neoplasms. In the present case, we reported a patient with a rectal submucosal leiomyoma that was excised using a transanal approach.

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Smooth muscle tumors of the gastrointestinal tract: an analysis of prognostic features in 407 cases

Cited by 19 publications

References 17 publications

An oncological curiosity of a male patient with a huge leiomyoma of the terminal ileum

An oncological curiosity of a male patient with a huge leiomyoma of the terminal ileum

Primary Hepatic Leiomyoma in a Healthy Middle-Aged Woman: Literature Review and Case Report

Transanal excision of anorectal leiomyoma, a rare location pathology: case report and review

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