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Ginekologia Polska 2023Leiomyomas are benign mesenchymal tumors that consist of smooth muscle cells and varying amounts of fibrous stroma. Uterine leiomyomas are the most common, affecting 20%... (Review)
Review
OBJECTIVES
Leiomyomas are benign mesenchymal tumors that consist of smooth muscle cells and varying amounts of fibrous stroma. Uterine leiomyomas are the most common, affecting 20% to 30% of reproductive-age women, but vaginal leiomyomas are rare. Treatments gradually diversify with increased awareness of vaginal leiomyoma, but transvaginal fibroid resection remains the commonly used scheme.
CASE REPORT
Herein, we present the case of a 50-year-old asymptomatic woman who had a mass in the left anterior wall of the vagina discovered by gynecological examination and ultrasound. We used oxytocin diluent injection during surgery to create a water pad in the tissue space and then performed a transvaginal myomectomy. There was little or negligible intraoperative bleeding and no peripheral tissue injury, early or late postoperative complications, incision dehiscence, and no surgical site infection.
CONCLUSIONS
Transvaginal ultrasonography is the preferred examination for vaginal leiomyomas, and transvaginal myomectomy is the classic treatment method. The formation of a water pad with oxytocin dilution can effectively reduce intraoperative bleeding and shorten surgery time.
Topics: Female; Humans; Middle Aged; Uterine Neoplasms; Oxytocin; Leiomyoma; Uterine Myomectomy; Vaginal Neoplasms; Water
PubMed: 36597753
DOI: 10.5603/GP.a2022.0145 -
Archives of Pathology & Laboratory... Dec 2006Malignant peripheral nerve sheath tumors arise from Schwann cells or within existing neurofibromas and have a strong association with type 1 neurofibromatosis. These... (Review)
Review
Malignant peripheral nerve sheath tumors arise from Schwann cells or within existing neurofibromas and have a strong association with type 1 neurofibromatosis. These tumors are histologically diverse and may contain malignant areas of divergent mesenchymal differentiation, the most common of which is skeletal muscle (rhabdomyosarcoma). Malignant peripheral nerve sheath tumor with rhabdomyosarcomatous differentiation is also known as malignant triton tumor. Malignant triton tumor has a worse prognosis than classic malignant peripheral nerve sheath tumor does, and the correct diagnosis requires attention to the clinical history and knowledge of the complexities regarding its differential diagnosis. In this review we discuss the clinical, histopathological, immunohistochemical, and prognostic features of this rare neoplasm.
Topics: Biomarkers, Tumor; CD57 Antigens; Humans; Immunohistochemistry; Myelin Basic Protein; Nerve Sheath Neoplasms; Rhabdomyosarcoma; S100 Proteins; Soft Tissue Neoplasms
PubMed: 17149968
DOI: 10.5858/2006-130-1878-MPNSTW -
Fertility and Sterility Jan 2011The purpose of the National Institutes of Health conference Fibroid Research Workshop in September 2007 was to bring Eunice Kennedy Shriver National Institute of Child...
The purpose of the National Institutes of Health conference Fibroid Research Workshop in September 2007 was to bring Eunice Kennedy Shriver National Institute of Child Health and Human Development-funded fibroid investigators together to discuss basic science and clinical research advances on uterine leiomyomata. General topics included advances in epidemiology, etiology, therapeutic approaches, and clinical trial challenges; suggestions for advancement of basic understanding, clinical intervention, clinical trials, and future directions were highlighted.
Topics: Clinical Trials as Topic; Education; Female; Humans; Leiomyoma
PubMed: 20883986
DOI: 10.1016/j.fertnstert.2010.08.049 -
Ultrasound in Obstetrics & Gynecology :... Aug 2022To correlate the ultrasound appearance of highly vascularized uterine myomas with their histopathological diagnosis. (Observational Study)
Observational Study
OBJECTIVE
To correlate the ultrasound appearance of highly vascularized uterine myomas with their histopathological diagnosis.
METHODS
This was a prospective observational study of patients with a preoperative ultrasound diagnosis of a highly vascularized uterine myoma (color score of 3 or 4, according to the Morphological Uterus Sonographic Assessment (MUSA) criteria), characterized by circumferential and intralesional vascular pattern, who underwent myomectomy or hysterectomy. For each patient, ultrasound characteristics were recorded at baseline, including the number of lesions, the size, echogenicity and border regularity of the lesion, presence of cystic areas and shadowing within the myoma, and visualization of the endometrium. Ultrasound features were correlated with the definitive histological diagnosis. Ultrasound features were then compared between malignant and benign lesions.
RESULTS
We included 70 patients with highly vascularized uterine myomas on power/color Doppler. Their mean age was 46.5 ± 11.4 years and 13 (18.6%) were postmenopausal. At histological examination, 65 (92.9%) uterine myomas were benign lesions, comprising 32 typical leiomyomas, 29 leiomyoma variants and four adenomyomas. The remaining five (7.1%) uterine myomas were malignant masses, comprising two uterine sarcomas, one leiomyosarcoma, one neuroendocrine tumor and one uterine smooth muscle tumor of uncertain malignant potential (STUMP). The mean age of patients with a malignant lesion was significantly higher than the age of those with a benign lesion (64.8 ± 16.0 vs 42.4 ± 5.1; P < 0.001). Four out of five patients with a malignant lesion were over 45 years old. Ultrasound demonstrated cystic areas within the lesion in 10/32 (31.3%) typical leiomyomas, 16/29 (55.2%) leiomyoma variants, all four adenomyomas and in the cases of STUMP and leiomyosarcoma. Lesion borders were regular in 64/65 (98.5%) benign lesions and 2/5 (40%) malignant lesions (P < 0.05). No significant differences were observed between benign and malignant lesions with respect to echogenicity, presence of shadowing and size. The endometrium was visible in 55/65 women with benign lesions and in 2/5 with malignant lesions (P = 0.03).
CONCLUSIONS
Our results showed that ultrasound features of uterine myomas, such as circumferential and intralesional vascularity, cystic areas and lesion borders, are important parameters for differential diagnosis, especially when combined with the patient's age. Such features could be useful to differentiate typical myomas from benign variants and malignant lesions in a preoperative setting and to select patients that may benefit from conservative management rather than surgery. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
Topics: Adenomyoma; Adult; Female; Humans; Leiomyoma; Leiomyosarcoma; Middle Aged; Myoma; Pregnancy; Smooth Muscle Tumor; Ultrasonography; Uterine Neoplasms; Uterus
PubMed: 35018681
DOI: 10.1002/uog.24855 -
BioMed Research International 2021Leiomyosarcoma is an uncommon soft tissue sarcoma that composed of malignant mesenchymal cells with distinct features of the smooth muscle lineage. Typically affects the...
Leiomyosarcoma is an uncommon soft tissue sarcoma that composed of malignant mesenchymal cells with distinct features of the smooth muscle lineage. Typically affects the uterus and gastrointestinal tract, it can rarely be seen in large blood vessels, lymphatic and glandular duts, the mesentery, the omentum, retroperitoneum, and limbs. Occurrence is particularly rare in the limb region. Retrospective study based on patient records and postoperative pathological histological features. Four patients with limb leiomyosarcoma that were operated between 2016 and 2020 were included, three of them arising in the subcutis of the thigh region and one in cubitus. Extend resection with satisfactory outcomes is reported. Pathological examination showed that masses were composed of a fascicular arrangement of hyperchromatic spindle-shaped cells, characterized by the proliferation of epithelioid cells with eosinophilic cytoplasm for epithelioid leiomyosarcoma. Leiomyosarcomas that arise in the soft tissue, although rare, should be differentiated from other lesions, such as neurilemoma, neurofibroma, liomyoma,lipomyoma, synoviosarcoma, rhabdomyosarcoma, malignant fibrous histiotoma, and malignant neurinoma.
Topics: Adult; Aged; Extremities; Female; Humans; Leiomyosarcoma; Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies; Soft Tissue Neoplasms; Treatment Outcome; Young Adult
PubMed: 34395610
DOI: 10.1155/2021/2106972 -
Genes, Chromosomes & Cancer Dec 2022The mammalian Vestigial-like (VGLL) transcriptional cofactor family of proteins VGLL1-4 has recently emerged as an important player in the tumorigenesis of diverse...
The mammalian Vestigial-like (VGLL) transcriptional cofactor family of proteins VGLL1-4 has recently emerged as an important player in the tumorigenesis of diverse neoplasms. The role of VGLL3 in soft tissue tumors is exemplified by its amplification in myxoinflammatory fibroblastic sarcoma and its rearrangement (fused to CHD7, CHD9, or MAMLD1) in hybrid schwannoma-perineurioma. This study characterizes a distinctive low-grade myogenic neoplasm with a striking predilection for the head and neck, characterized by VGLL3 fusions. The study includes five males and one female patient, aged 30-71 years (median, 56). Three tumors originated in the tongue, with one case each in the nasopharynx, oral cavity, and oropharynx. The VGLL3 fusion partners included TCF12 (n = 3), EP300 (n = 2), and PPARGC1A (n = 1). The tumor size range was 0.8-1.6 cm (all, but one, was <1 cm). Histologically, all tumors displayed bland spindle to ovoid cells arranged into vague fascicular and diffuse patterns. Mitotic activity ranged from 1 to 7 per 10 HPFs. Five tumors were muscle-centered and infiltrative, and one was centered beneath nasopharyngeal mucosa. Immunohistochemistry revealed consistent expression of desmin (diffuse in four and patchy in two cases) associated with patchy smooth muscle actin expression (4/6), and focal reactivity for myogenin (5/6) and myoD1 (1/3). All patients were managed surgically; one patient each received adjuvant radio- or chemotherapy. Three patients with follow-up were without disease at 8, 19, and 60 months and one was alive with unknown disease status at 24 months. All VGLL3 fusions were in-frame and involved exon 2, fused with either TCF12 exon 16, EP300 exon 31, or PPARGC1A exon 5, respectively. This series characterizes a distinctive subset of spindle cell rhabdomyosarcoma (RMS) with a predilection for the head and neck in adults, defined by VGLL3 fusions, likely indolent behavior and limited rhabdomyoblastic differentiation. Further delineation of this entity and differentiation from more aggressive molecular subtypes of spindle cell RMS is mandatory to define the most appropriate therapeutic strategy and avoid overtreatment.
Topics: Actins; Adult; Aged; Biomarkers, Tumor; DNA-Binding Proteins; Desmin; Female; Humans; Male; Middle Aged; Myogenin; Rhabdomyosarcoma; Soft Tissue Neoplasms; Transcription Factors
PubMed: 35766997
DOI: 10.1002/gcc.23083 -
Neurology India Sep 1999The light and electronmicroscopic changes are described in two cases of medullomyoblastoma, and compared with the changes seen in a case of foetal rhabdomyoma. The... (Comparative Study)
Comparative Study Review
The light and electronmicroscopic changes are described in two cases of medullomyoblastoma, and compared with the changes seen in a case of foetal rhabdomyoma. The medullomyoblastomas in two children aged 8 and 5 years, consisted predominantly of classical type of medulloblastoma cells, along with few to many 'strap cells' or 'myoid cells' which, on closer examination, showed clear cross striations, consistent with muscle fibres or myofibrils. The primitive myoid cells were similar to those encountered in larger numbers in a post-auricular rhabdomyoma, possibly of foetal origin in a 40 day old infant. The four pathogenetic mechanisms i.e. (i) an embryonal stage of myofibrillar differentiation; (ii) a malformative factor; (iii) a teratoid factor on account of the presence of mesenchyme derived striated muscle tissue in the obviously predominant ectodermal medulloblastoma; and (iv) metaplasia of the vascular smooth muscle cells in the medullomyoblastoma, are discussed.
Topics: Cerebellar Neoplasms; Fetus; Humans; Medulloblastoma; Rhabdomyoma
PubMed: 10514575
DOI: No ID Found -
Indian Pediatrics Apr 2016Malignant tumors in neonates are rare.
BACKGROUND
Malignant tumors in neonates are rare.
CASE CHARACTERISTICS
A tumor was detected in the left biceps of a 3-day old neonate. Tumor biopsy and molecular study confirmed the diagnosis of synovial sarcoma. The child received multi-modality treatment with surgery and chemotherapy.
OUTCOME
The child is disease-free on follow-up period of 12 months.
MESSAGE
Synovial sarcoma can rarely occur in a neonate.
Topics: Arm; Female; Humans; Infant, Newborn; Neoplasms, Muscle Tissue; Sarcoma, Synovial
PubMed: 27156552
DOI: 10.1007/s13312-016-0850-z -
Zhongguo Dang Dai Er Ke Za Zhi =...To study the clinical features of children with rhabdomyosarcoma (RMS) and the influencing factors for prognosis.
OBJECTIVES
To study the clinical features of children with rhabdomyosarcoma (RMS) and the influencing factors for prognosis.
METHODS
A retrospective analysis was performed on the clinical and follow-up data of 20 children with RMS who were admitted to the Department of Pediatric Hematology, Xiangya Hospital of Central South University, from June 2014 to September 2020.
RESULTS
The most common clinical symptoms of the 20 children with RMS at the first visit were painless mass (13/20, 65%), exophthalmos (4/20, 20%), and abdominal pain (3/20, 15%). According to the staging criteria of Intergroup Rhabdomyosarcoma Study Group (IRSG), there was 1 child (5%) with stage I RMS, 4 (20%) with stage II RMS, 9 (45%) with stage III RMS, and 6 (30%) with stage IV RMS. The median follow-up time was 19 months for the 20 children (range: 3-93 months), with a 2-year overall survival (OS) rate of 79.5% (95%: 20.1-24.3) and a 2-year event-free survival (EFS) rate of 72.0% (95%: 19.5-23.9). Pleomorphic RMS was associated with the reduced 2-year OS rate (<0.05), and distant metastasis, IRSG stage IV RMS, and high-risk RMS were associated with the reduced 2-year EFS rate (<0.05).
CONCLUSIONS
RMS has no specific clinical symptoms at the first visit, with painless mass as the most common symptom. Distant metastasis, IRSG stage, and risk degree may be associated with the prognosis of children with RMS.
Topics: Child; Humans; Prognosis; Retrospective Studies; Rhabdomyosarcoma; Rhabdomyosarcoma, Embryonal; Survival Rate
PubMed: 36111723
DOI: 10.7499/j.issn.1008-8830.2204033 -
European Journal of Nuclear Medicine... May 2016Twelve years ago a meta-analysis evaluated the diagnostic performance of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in assessing musculoskeletal... (Comparative Study)
Comparative Study Meta-Analysis Review
PURPOSE
Twelve years ago a meta-analysis evaluated the diagnostic performance of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in assessing musculoskeletal soft tissue lesions (MsSTL). Currently, PET/CT has substituted PET imaging; however, there has not been any published meta-analysis on the use of PET/CT or a comparison of PET/CT with PET in the diagnosis of MsSTL. Therefore, we conducted a meta-analysis to identify the current diagnostic performance of (18)F-FDG PET/CT and determine if there is added value when compared to PET.
METHODS
A systematic review of English articles was conducted, and MEDLINE PubMed, the Cochrane Library, and Embase were searched from 1996 to March 2015. Studies exploring the diagnostic accuracy of (18)F-FDG PET/CT (or dedicated PET) compared to histopathology in patients with MsSTL undergoing investigation for malignancy were included.
RESULTS
Our meta-analysis included 14 articles composed of 755 patients with 757 soft tissue lesions. There were 451 (60 %) malignant tumors and 306 benign lesions. The (18)F-FDG PET/CT (and dedicated PET) mean sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for diagnosing MsSTL were 0.96 (0.90, 1.00), 0.77 (0.67, 0.86), 0.88 (0.85, 0.91), 0.86 (0.78, 0.94), and 0.91 (0.83, 0.99), respectively. The posterior mean (95 % highest posterior density interval) for the AUC was 0.92 (0.88, 0.96). PET/CT had higher specificity, accuracy, and positive predictive value when compared to a dedicated PET (0.85, 0.89, and 0.91 vs 0.71, 0.85, and 0.82, respectively).
CONCLUSION
(18)F-FDG PET/CT and dedicated PET are both highly accurate in the diagnosis of MsSTL. PET/CT is more accurate and specific and has a higher positive predictive value than PET.
Topics: Bone Neoplasms; Fluorodeoxyglucose F18; Humans; Neoplasms, Muscle Tissue; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals
PubMed: 26631240
DOI: 10.1007/s00259-015-3242-z