Metastatic Retroperitoneal Leiomyosarcoma: Case Report
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n1.4592Keywords:
Epithelial-Mesenchymal Transition, Leiomyosarcoma/diagnosis, Delayed DiagnosisAbstract
Introduction: Leiomyosarcomas (LMS) are rare malignant neoplasms originating in smooth muscle, more common in women in their fifth and sixth decades of life. Inherent characteristics of the retroperitoneum allow LMS in this location to reach substantial proportions and present symptoms only in more advanced stages. Case report: A 37-year-old woman sought medical attention in July 2020 due to the growth of a painful, fixed mass in the left hemiabdomen that appeared six months earlier. The patient denied urinary or gastrointestinal alterations but reported an 8 kg weight loss in the last month. Computed tomography identified a lobulated, heterogeneous formation in the left flank measuring 8.5 cm, along with hepatic and pulmonary nodules. Subsequently, surgical resection of the lesion, nephroureterectomy, and hepatic biopsy were performed, confirming the diagnosis of LMS through anatomopathological and immunohistochemical analysis. After unsuccessful adjuvant chemotherapy, she progressed to multiple metastases and is currently undergoing palliative treatment. Conclusion: Detecting and diagnosing retroperitoneal LMS are challenging. Awareness of their aggressiveness, especially in young patients, is crucial to ensure personalized and early interventions, thereby improving the prognosis.
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McAddy NC, Hallin M, Strauss D, et al. CT imaging improves histopathological grading of retroperitoneal leiomyosarcomas. Eur J Surg Oncol. 2020;46(2):288-92. doi: https://doi.org/10.1016/j.ejso.2019.10.007 DOI: https://doi.org/10.1016/j.ejso.2019.10.007
Marko J, Wolfman DJ. Retroperitoneal leiomyosarcoma from the radiologic pathology archives. Radiographics. 2018;38(5):1403-20. doi: https://doi.org/10.1148/rg.2018180006 DOI: https://doi.org/10.1148/rg.2018180006
Balti M, Ayari J, Ben Azaiez M, et al. Retroperitoneal leiomyosarcoma in adults. Presse Med. 2019;48:77-9. doi: https://doi.org/10.1016/j.lpm.2018.11.003 DOI: https://doi.org/10.1016/j.lpm.2018.11.003
Oliveira DH, Lima FM, Ramos AR, et al. Sarcoma retroperitoneal: relato de caso. Rev Saber Dig. 2021;14(1):32. doi: https://doi.org/10.24859/SaberDigital.2021v14n1.935 DOI: https://doi.org/10.24859/SaberDigital.2021v14n1.935
Mack T, Purgina B. Updates in pathology for retroperitoneal soft tissue sarcoma. Current Oncology. 2022;29(9):6400-18. doi: https://doi.org/10.3390/curroncol29090504 DOI: https://doi.org/10.3390/curroncol29090504
Sacoto Urgilez D. Vascular Retroperitoneal and Pelvic Leiomyosarcoma a Rare Disease Requiring Complex Surgery. J Cancer Res Therap Oncol. 2020;8:1-5
World Health Organization. WHO Classification of Tumours editorial board. soft tissue and bone tumours. 5. ed. Lyon: IARC; 2020. v. 3.
Bright CJ, Hawkins MM, Winter DL, et al. Risk of soft-tissue sarcoma among 69,460 five-year survivors of childhood cancer in Europe. J Natl Cancer Inst. 2018;110(6):649-60. doi: https://doi.org/10.1093/jnci/djx235 DOI: https://doi.org/10.1093/jnci/djx235
Ducimetière F, Lurkin A, Ranchère-Vince D, et al. Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. PLoS One. 2011;6(8):e20294. doi: https://doi.org/10.1371/journal.pone.0020294 DOI: https://doi.org/10.1371/journal.pone.0020294
Kirane A, Crago AM. The importance of surgical margins in retroperitoneal sarcoma. J Surg Oncol. 2016;113(3):270-6. doi: https://doi.org/10.1002/jso.24135 DOI: https://doi.org/10.1002/jso.24135
Sassa N. Retroperitoneal tumors: review of diagnosis and management. Int J Urol. 2020;27(12):1058-70. doi: https://doi.org/10.1111/iju.14361 DOI: https://doi.org/10.1111/iju.14361
Dominguez DA, Sampath S, Agulnik M, et al. Surgical Management of Retroperitoneal Sarcoma. Curr Oncol. 2023;30(5):4618-31. doi: https://doi.org/10.3390/curroncol30050349 DOI: https://doi.org/10.3390/curroncol30050349
Constantinidou A, Jones RL. Systemic therapy in retroperitoneal sarcoma management. J Surg Oncol. 2018;117(1):87-92. doi: https://doi.org/10.1002/jso.2493310.1002 DOI: https://doi.org/10.1002/jso.24933
Gopikrishna V. A report on case reports. J Conserv Dent. 2010;13(4):265-71. doi: https://doi.org/10.4103/0972-0707.73375 DOI: https://doi.org/10.4103/0972-0707.73375
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