BACKGROUND Primary hepatic leiomyosarcoma(PHL)is a rare malignant tumor and has non-specific clinical manifestations and imaging characteristics,making preoperative diagnosis challenging.Here,we report a case of PHL p...BACKGROUND Primary hepatic leiomyosarcoma(PHL)is a rare malignant tumor and has non-specific clinical manifestations and imaging characteristics,making preoperative diagnosis challenging.Here,we report a case of PHL presenting primarily with fever,with computed tomography imaging showing a thick-walled hepatic lesion with low-density areas,resembling liver abscess.CASE SUMMARY The patient was a 34-year-old woman who presented with right upper abdominal pain and fever over 4 days before admission.Based on the patient’s medical history,laboratory examinations,and imaging examinations,liver abscess was suspected.Mesenchymal tumor was diagnosed by percutaneous liverbiopsy and partial hepatectomy was performed.Postoperative pathology revealed PHL.The patient is currently undergoing intravenous chemotherapy with the AD regimen and shows no signs of recurrence.CONCLUSION When there is a thick wall and rich blood supply in the hepatic lesion with a large proportion of uneven low-density areas,PHL should be considered.展开更多
BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all leiomyosarcomas.They behave aggressively and often have poor prognoses.They can affect the gastrointestinal tract and retroperitoneum.To date,pleomorphi...BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all leiomyosarcomas.They behave aggressively and often have poor prognoses.They can affect the gastrointestinal tract and retroperitoneum.To date,pleomorphic leiomyosarcoma involving the mesocolon have been reported in nine patients.CASE SUMMARY The patient was a 44-year-old man with a history of pleomorphic leiomyosarcoma of the left maxilla with metastasis to the lung and liver.His most recent positron emission tomography-computed tomography(PET-CT)scan showed uptake in the ascending and transverse colons.A colonoscopy revealed a 5.0 cm×3.5 cm×3.0 cm pedunculated polyp in the ascending colon.The polyp was removed using hot snare polypectomy technique and retrieved with Rothnet.Histopathologic examination of the polyp showed a metastatic pleomorphic leiomyosarcoma.CONCLUSION Uptake(s)on PET-CT in a patient with pleomorphic leiomyosarcoma should raise suspicion for metastasis.展开更多
BACKGROUND Leiomyosarcoma is a subtype of soft tissue sarcoma with adverse outcomes.Leiomyosarcoma accounts for nearly 70%of all uterine sarcomas and is responsible for a considerable proportion of deaths because of u...BACKGROUND Leiomyosarcoma is a subtype of soft tissue sarcoma with adverse outcomes.Leiomyosarcoma accounts for nearly 70%of all uterine sarcomas and is responsible for a considerable proportion of deaths because of uterine cancer.Clinical characteristics and relevant diagnosis of pelvic leiomyosarcoma should be further explored.AIM To identify the outcome and relevant perioperative evaluation of patients with pelvic leiomyosarcoma.METHODS The Kaplan-Meier method was used to determine progression-free survival and overall survival rates.Factors predictive of outcomes were identified using univariate and multivariate Cox proportional hazards models.RESULTS Fifty-one patients with pelvic leiomyosarcoma were enrolled and divided into two groups including uterine leiomyosarcoma and non-uterine leiomyosarcoma.Overall,28.6%and 45.5%of uterine leiomyosarcoma and non-uterine leiomyosarcoma patients,respectively,had elevated carbohydrate antigen 125 levels,whereas 45.7%and 68.8%,respectively,underwent ultrasonography.Although 68.8%of uterine leiomyosarcoma patients were initially diagnosed with hysteromyoma,72.7%of non-uterine leiomyosarcoma patients had pelvic and abdominal masses.Moreover,93.3%of the recurrent lesions were detected using ultrasonography.Patients with International Federation of Gynaecology and Obstetrics(FIGO)stages III–IV disease had poorer progression-free survival values than those with FIGO stages I–II(P=0.027)disease.FIGO stage was significantly associated with poor progression-free survival in the univariate(hazard ratio=2.64,P=0.03)and multivariate(hazard ratio=2.49,P=0.048)analyses.CONCLUSION Serum tumour biomarkers cannot be used for pelvic leiomyosarcoma diagnosis.FIGO stage is critical to predict the outcome of uterine leiomyosarcoma.Ultrasonography is more reliable for postoperative follow-up than preoperative diagnosis.展开更多
BACKGROUND Primary mediastinal leiomyosarcomas are extremely rare.We report a case of leiomyosarcoma around the thoracic and abdominal aorta,mimicking an aortic hematoma,and discuss the diagnostic value of ultrasound....BACKGROUND Primary mediastinal leiomyosarcomas are extremely rare.We report a case of leiomyosarcoma around the thoracic and abdominal aorta,mimicking an aortic hematoma,and discuss the diagnostic value of ultrasound.CASE SUMMARY A 63-year-old female was hospitalized for abdominal pain.Initial computed tomography angiography revealed an enhanced mass around the lower thoracic and upper abdominal aorta.Aortic hematoma was strongly suspected,and stents were placed by interventional surgery.About 1 mo postoperatively,the patient was re-hospitalized because of progressive abdominal pain.Ultrasound showed that the mass had a heterogeneous echo.In contrast-enhanced ultrasound,the hyperechoic regions were filled with contrast medium after the aortic region was,indicating that the blood supply was abundant but had no direct connection with the aorta.There was no obvious contrast medium-filling in the hypoechoic area.These findings were similar to those of malignant tumors with liquefaction and necrosis.Positron emission tomography/computed tomography confirmed that the mass had a high metabolic signal similar to that of a malignant tumor.Leiomyosarcoma was confirmed by postoperative pathology.CONCLUSION Symptoms of mediastinal leiomyosarcoma surrounding the aorta may mimic aortic hematoma.Contrast-enhanced ultrasound can provide valuable and unique diagnostic clues.展开更多
BACKGROUND Leiomyosarcoma(LMS)has a poor prognosis and rarely originates from the colon.If resection is possible,surgery is the first treatment most commonly considered.Unfortunately,no standard treatment exists for h...BACKGROUND Leiomyosarcoma(LMS)has a poor prognosis and rarely originates from the colon.If resection is possible,surgery is the first treatment most commonly considered.Unfortunately,no standard treatment exists for hepatic metastasis of LMS;although,several treatments,such as chemotherapy,radiotherapy,and surgery,have been used.Subsequently,the management of liver metastases remains controversial.CASE SUMMARY We present a rare case of metachronous liver metastasis in a patient with LMS originating from the descending colon.A 38-year-old man initially reported abdominal pain and diarrhea over the previous two months.Colonoscopy revealed a 4-cm diameter mass in the descending colon,40 cm from the anal verge.Computed tomography revealed intussusception of the descending colon due to the 4-cm mass.The patient underwent a left hemicolectomy.Immunohistochemical analysis of the tumor revealed that it was positive for smooth muscle actin and desmin,and negative for cluster of differentiation 34(CD34),CD117,and discovered on gastrointestinal stromal tumor(GIST)-1,which are characteristic of gastrointestinal LMS.A single liver metastasis developed 11 mo postoperatively;the patient subsequently underwent curative resection thereof.The patient remained disease-free after six cycles of adjuvant chemotherapy(doxorubicin and ifosfamide),and 40 and 52 mo after liver resection and primary surgery,respectively.Similar cases were obtained from a search of Embase,PubMed,MEDLINE,and Google Scholar.CONCLUSION Early diagnosis and surgical resection may be the only potential curative options for liver metastasis of gastrointestinal LMS.展开更多
目的子宫肌瘤是女性生殖系统最常见的良性肿瘤,本研究通过文献计量分析,探究子宫肌瘤相关研究的发展趋势。方法使用术语“子宫肌瘤”和该术语的其他同义词,从Web of Science Core Collection(WOSCC)中搜索2000~2022年英文期刊发表的论...目的子宫肌瘤是女性生殖系统最常见的良性肿瘤,本研究通过文献计量分析,探究子宫肌瘤相关研究的发展趋势。方法使用术语“子宫肌瘤”和该术语的其他同义词,从Web of Science Core Collection(WOSCC)中搜索2000~2022年英文期刊发表的论文。使用Excel 2016和VOSviewer(版本1.6.18)分析相关数据,包括年发文量、国家、机构、关键词、作者和期刊。结果共检索到子宫肌瘤相关论文2,448篇,主要来自81个国家及52种期刊,文章数量逐年增加。美国学者对子宫肌瘤领域贡献最大(n=685),同时被引频次也最高(n=16,605)。发文量最多的机构是西北大学(n=68)。发文量最多的期刊是《Fertility and Sterility》,也是被引频次最多的期刊(n=3,678)。2022年最为高产,治疗新方法和预后相关研究是近年研究热点。结论本研究首次采用文献计量方式对子宫肌瘤领域进行文献计量学分析,揭示子宫肌瘤领域的研究现状,预测未来研究趋势,可为相关从业者提供参考。展开更多
基金Supported by the Lishui City Key Research and Development Project,No.2022ZDYF08.
文摘BACKGROUND Primary hepatic leiomyosarcoma(PHL)is a rare malignant tumor and has non-specific clinical manifestations and imaging characteristics,making preoperative diagnosis challenging.Here,we report a case of PHL presenting primarily with fever,with computed tomography imaging showing a thick-walled hepatic lesion with low-density areas,resembling liver abscess.CASE SUMMARY The patient was a 34-year-old woman who presented with right upper abdominal pain and fever over 4 days before admission.Based on the patient’s medical history,laboratory examinations,and imaging examinations,liver abscess was suspected.Mesenchymal tumor was diagnosed by percutaneous liverbiopsy and partial hepatectomy was performed.Postoperative pathology revealed PHL.The patient is currently undergoing intravenous chemotherapy with the AD regimen and shows no signs of recurrence.CONCLUSION When there is a thick wall and rich blood supply in the hepatic lesion with a large proportion of uneven low-density areas,PHL should be considered.
文摘BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all leiomyosarcomas.They behave aggressively and often have poor prognoses.They can affect the gastrointestinal tract and retroperitoneum.To date,pleomorphic leiomyosarcoma involving the mesocolon have been reported in nine patients.CASE SUMMARY The patient was a 44-year-old man with a history of pleomorphic leiomyosarcoma of the left maxilla with metastasis to the lung and liver.His most recent positron emission tomography-computed tomography(PET-CT)scan showed uptake in the ascending and transverse colons.A colonoscopy revealed a 5.0 cm×3.5 cm×3.0 cm pedunculated polyp in the ascending colon.The polyp was removed using hot snare polypectomy technique and retrieved with Rothnet.Histopathologic examination of the polyp showed a metastatic pleomorphic leiomyosarcoma.CONCLUSION Uptake(s)on PET-CT in a patient with pleomorphic leiomyosarcoma should raise suspicion for metastasis.
基金Supported by National Natural Science Foundation of China,No81501530Scientific Research Projects of Hubei Health Commission,No. WJ2019M130Scientific Research Fund of Tongji Hospital,No. 2018B02
文摘BACKGROUND Leiomyosarcoma is a subtype of soft tissue sarcoma with adverse outcomes.Leiomyosarcoma accounts for nearly 70%of all uterine sarcomas and is responsible for a considerable proportion of deaths because of uterine cancer.Clinical characteristics and relevant diagnosis of pelvic leiomyosarcoma should be further explored.AIM To identify the outcome and relevant perioperative evaluation of patients with pelvic leiomyosarcoma.METHODS The Kaplan-Meier method was used to determine progression-free survival and overall survival rates.Factors predictive of outcomes were identified using univariate and multivariate Cox proportional hazards models.RESULTS Fifty-one patients with pelvic leiomyosarcoma were enrolled and divided into two groups including uterine leiomyosarcoma and non-uterine leiomyosarcoma.Overall,28.6%and 45.5%of uterine leiomyosarcoma and non-uterine leiomyosarcoma patients,respectively,had elevated carbohydrate antigen 125 levels,whereas 45.7%and 68.8%,respectively,underwent ultrasonography.Although 68.8%of uterine leiomyosarcoma patients were initially diagnosed with hysteromyoma,72.7%of non-uterine leiomyosarcoma patients had pelvic and abdominal masses.Moreover,93.3%of the recurrent lesions were detected using ultrasonography.Patients with International Federation of Gynaecology and Obstetrics(FIGO)stages III–IV disease had poorer progression-free survival values than those with FIGO stages I–II(P=0.027)disease.FIGO stage was significantly associated with poor progression-free survival in the univariate(hazard ratio=2.64,P=0.03)and multivariate(hazard ratio=2.49,P=0.048)analyses.CONCLUSION Serum tumour biomarkers cannot be used for pelvic leiomyosarcoma diagnosis.FIGO stage is critical to predict the outcome of uterine leiomyosarcoma.Ultrasonography is more reliable for postoperative follow-up than preoperative diagnosis.
文摘BACKGROUND Primary mediastinal leiomyosarcomas are extremely rare.We report a case of leiomyosarcoma around the thoracic and abdominal aorta,mimicking an aortic hematoma,and discuss the diagnostic value of ultrasound.CASE SUMMARY A 63-year-old female was hospitalized for abdominal pain.Initial computed tomography angiography revealed an enhanced mass around the lower thoracic and upper abdominal aorta.Aortic hematoma was strongly suspected,and stents were placed by interventional surgery.About 1 mo postoperatively,the patient was re-hospitalized because of progressive abdominal pain.Ultrasound showed that the mass had a heterogeneous echo.In contrast-enhanced ultrasound,the hyperechoic regions were filled with contrast medium after the aortic region was,indicating that the blood supply was abundant but had no direct connection with the aorta.There was no obvious contrast medium-filling in the hypoechoic area.These findings were similar to those of malignant tumors with liquefaction and necrosis.Positron emission tomography/computed tomography confirmed that the mass had a high metabolic signal similar to that of a malignant tumor.Leiomyosarcoma was confirmed by postoperative pathology.CONCLUSION Symptoms of mediastinal leiomyosarcoma surrounding the aorta may mimic aortic hematoma.Contrast-enhanced ultrasound can provide valuable and unique diagnostic clues.
文摘BACKGROUND Leiomyosarcoma(LMS)has a poor prognosis and rarely originates from the colon.If resection is possible,surgery is the first treatment most commonly considered.Unfortunately,no standard treatment exists for hepatic metastasis of LMS;although,several treatments,such as chemotherapy,radiotherapy,and surgery,have been used.Subsequently,the management of liver metastases remains controversial.CASE SUMMARY We present a rare case of metachronous liver metastasis in a patient with LMS originating from the descending colon.A 38-year-old man initially reported abdominal pain and diarrhea over the previous two months.Colonoscopy revealed a 4-cm diameter mass in the descending colon,40 cm from the anal verge.Computed tomography revealed intussusception of the descending colon due to the 4-cm mass.The patient underwent a left hemicolectomy.Immunohistochemical analysis of the tumor revealed that it was positive for smooth muscle actin and desmin,and negative for cluster of differentiation 34(CD34),CD117,and discovered on gastrointestinal stromal tumor(GIST)-1,which are characteristic of gastrointestinal LMS.A single liver metastasis developed 11 mo postoperatively;the patient subsequently underwent curative resection thereof.The patient remained disease-free after six cycles of adjuvant chemotherapy(doxorubicin and ifosfamide),and 40 and 52 mo after liver resection and primary surgery,respectively.Similar cases were obtained from a search of Embase,PubMed,MEDLINE,and Google Scholar.CONCLUSION Early diagnosis and surgical resection may be the only potential curative options for liver metastasis of gastrointestinal LMS.
文摘目的子宫肌瘤是女性生殖系统最常见的良性肿瘤,本研究通过文献计量分析,探究子宫肌瘤相关研究的发展趋势。方法使用术语“子宫肌瘤”和该术语的其他同义词,从Web of Science Core Collection(WOSCC)中搜索2000~2022年英文期刊发表的论文。使用Excel 2016和VOSviewer(版本1.6.18)分析相关数据,包括年发文量、国家、机构、关键词、作者和期刊。结果共检索到子宫肌瘤相关论文2,448篇,主要来自81个国家及52种期刊,文章数量逐年增加。美国学者对子宫肌瘤领域贡献最大(n=685),同时被引频次也最高(n=16,605)。发文量最多的机构是西北大学(n=68)。发文量最多的期刊是《Fertility and Sterility》,也是被引频次最多的期刊(n=3,678)。2022年最为高产,治疗新方法和预后相关研究是近年研究热点。结论本研究首次采用文献计量方式对子宫肌瘤领域进行文献计量学分析,揭示子宫肌瘤领域的研究现状,预测未来研究趋势,可为相关从业者提供参考。
