Nutrient content in vegetable species from the Argentine Chaco

A 43-year-old man with a primary leiomyosarcoma of the left sphenoid sinus is presented. To our knowledge, this is an unusual case of leiomyosarcoma, which has never been reported in the literature. Accurate and safe diagnosis was obtained by an endonasal endoscopic approach with minimal tissue invasion.     

A case of retroperitoneal leiomyosarcoma]

The Authors present a case of retroperitoneal leiomyosarcoma, diagnosed because of the early symptomatic hydronephrosis due to the compression of the tumour on the lumbar ureter. Some general clinical aspects of retroperitoneal sarcomas are discussed too. In the case presented adjuvant therapy was not advised, because of the small volume of the tumour and the possibility of its complete excision.     

Catheter ablation of ventricular tachycardia associated with remote myocardial infarction: utility of the atrial transseptal approach

BACKGROUND: To determine the magnetic resonance (MR) imaging features of hepatic metastases from leiomyosarcoma and determine the pathologic basis for the MR appearance of these neoplasms. METHODS: MR examinations of eight patients with a total of 16 hepatic metastases from leiomyosarcoma were retrospectively reviewed. Hepatic metastases originated from a primary gastrointestinal (n = 6), uterine (n = 1), or retroperitoneal (n = 1) leiomyosarcoma. Correlation between MR features and pathologic findings was performed in 11 metastases from which histologic material was obtained. RESULTS: Among the 10 metastases seen on T1-weighted MR images, nine were homogeneous and one was heterogeneous. The latter contained areas of necrosis and hemorrhage on pathologic examination. Among the 16 metastases seen on T2-weighted MR images, 12 were well delineated and completely homogeneous, with a marked hyperintense signal ("hemangiomalike" pattern). These neoplasms were composed of smooth fibrous tissue without macroscopically visible areas of necrosis on pathologic examination. The remaining four metastases were heterogeneous and contained varying degrees of necrosis and hemorrhage or gelatinous tissue. CONCLUSION: A hemangiomalike pattern is the most common feature on T2-weighted MR images. We found that homogeneous hyperintensity of hepatic metastases from leiomyosarcoma on T2-weighted MR image does not reflect cystic changes.     

Renal vein leiomyosarcoma

The third reported case of renal vein leiomyosarcoma is presented. Diagnosis was not made until exploratory celiotomy revealed a tumor originating from the left renal vein. The tumor was resected with margins of normal vein, and the patient was alive without recurrence 12 months after operation. Review of 65 cases of leiomyosarcoma originating in other retroperitoneal structures revealed a two-year survival rate of 20%. Therefore, we recommend consideration of postoperative adjunctive chemotherapy for renal vein leiomyosarcomas.     

Identification of alternative splicing form of Stat2

Three cases of pulmonary leiomyosarcoma were presented. The characteristic clinical features were described with review of literature. In comparison with bronchogenic carcinoma, the leiomyosarcoma has some characteristics: 1) On chest X-ray, it usually appears as a sharply demarcated, even density round mass, growing rapidly within the lung, it rarely accompanies with hilar or mediastinal lymph node metastasis. 2) The preoperative cytological or pathological diagnosis is difficult either by sputum smear or by bronchoscopic biopsy or by fine needle percutaneous aspiration biopsy. 3) Pathological differential diagnosis of leiomyosarcoma of lung from anaplastic lung cancer is difficult. In conclusion, the primary pulmonary leiomyosarcoma is a rare malignant tumor, detecting the present illness seriously, paying attention to the chest X-ray films characterize, early surgical resection is the only way to get diagnosis and effective treatment method.     

Hepatic leiomyosarcoma: ultrastructural study and review of the differential diagnosis

A primary leiomyosarcoma of the liver in a 12 year old female is reported. It is the eleventh such tumor to be recorded, the first to be documented in an adolescent and the first to be studied electron microscopically. By light microscopy the well differentiated portions of the tumor were characteristic of leiomyosarcoma. Ultrastructurally a minority of tumor cells contained myofilaments along with cytoplasmic dense bodies and marginal dense plaques, the most distinctive subcellular markers of smooth muscle cells. A brief review of the differential diagnosis is provided.     

Leiomyosarcoma of the stomach

A case of gastric leiomyosarcoma (primary maliganant mesenchymal neoplasia of non-lymphoblastic origin) personally observed, is presented. The pathological anatomy, aetiopathogensis, symptomatology and diagnosis of this disease are described as well as the surgical treatment of the case.     

Collaboration at the millennium: "we must all hang together, or assuredly we shall all hang separately"

A case is presented of a primary extragonadal retroperitoneal germ cell tumor (seminoma) in a 51-year-old male. The ultimate diagnosis was only achieved after curative surgical resection of the tumor. There was no demonstrable testicular neoplasm.     

Locus heterogeneity in autosomal dominant congenital external ophthalmoplegia (CFEOM)

An autopsy case of retroperitoneal leiomyosarcoma of a centenarial male is described. He complained of abdominal pain in his left side 1 month before his death. Ultrasonography and computed tomography revealed a large mass in the left abdominal cavity. At autopsy, a circumscribed mass, 15 cm in diameter, was found in the left-upper abdominal cavity, and seemed to be derived from the retroperitoneum in an exophytic manner. Histologically, spindle cells with slight eosinophilic cytoplasm and blunt-ended nuclei showed interwoven fascicular growth, and mitotic figures were easily encountered. Immunohistochemically, the tumor cells were labeled by alpha-smooth muscle actin and vimentin. To our knowledge, this case of leiomyosarcoma has presented in the oldest patient ever reported. The rarity of soft tissue sarcomas in the extremely elderly is also discussed.     

Antiretroviral treatment with nucleoside analogs does not decrease the viremia of the hepatitis C virus in patients with HIV-1 infection

Leiomyosarcoma is an uncommon malignant tumour of the pancreas. Many retroperitoneal leiomyosarcomas grow silently and are extremely large when diagnosed. We report a 45 year old lady who presented with abdominal lump and haemoptysis. Ultrasound guided biopsy of the mass revealed a pancreatic leiomyosarcoma. The patient had lung metastasis and received chemotherapy. She is alive with disease at last followup.     

Regulatory characteristics and promoter analysis of csiE, a stationary phase-inducible gene under the control of sigma S and the cAMP-CRP complex in Escherichia coli

The diagnosis of primary retroperitoneal masses is approached best by CT scan-guided transretroperitoneal core biopsy or by open biopsy. Excisional or wedge biopsy is the preferred method for undiagnosed lymphadenopathy. Resection without biopsy is indicated for large or enlarging nonfunctional primary adrenal masses.     

Extraorganic forms of abdominal localization of echinococcosis

The author has analysed 66 pateints (5.4% of all cases of the disease) with extraorganic abdominal echinococcosis. The forms of retroperitoneal (lumbar, pelvic, mesenteric and omental) and intraperitoneal echinococcosis (primary cystic and adhesive-disseminated) are differentiated. The problems of diagnosis, the differential diagnosis and selection of an appropriate therapy are discussed. The mortality in multiple and associated affections was within the range of 10 per cent.     

Yolk sac tumor of the bladder

A 1-year-old white boy presented with hematuria and was found to have a large polypoid bladder mass. Light and electron microscopic, and immunohistochemical diagnosis was a yolk sac (endodermal sinus) tumor. This is the first case of a primary yolk sac tumor of the bladder to be described in the English literature.     

Retroperitoneal germinoma marked by elevated serum lactic dehydrogenase

A case of primary retroperitoneal germinoma is presented in which markedly elevated serum lactic dehydrogenase levels were present before diagnosis, but declined to normal with abdominal irradiation. It is the first report of lactic dehydrogenase serving as a tumor marker in germinoma.     

Primary round-cell liposarcoma of the bladder

OBJECTIVE: To report a rare case of primary round cell liposarcoma of the urinary bladder. METHODS: A case of primary round cell liposarcoma of the urinary bladder in an 80-year-old female with hematuria is presented. The patient had a large, solid, non-circumscribed bladder tumor of 6.5 cms. The radiological, histological and immunohistochemical findings are discussed. RESULTS: The neoplasm was composed of isolated lipoblasts among numerous small round cells that were positive for S-100 and vimentin, and a high proliferation rate was demonstrated by Ki-67. The patient died 10 months after the histologic diagnosis. CONCLUSION: Primary liposarcoma of the urinary bladder is a very rare tumor with a poor prognosis that usually presents as a large tumor mass.     

Heat shock alters poly(A) tail length of Dictyostelium discoideum hsp32 RNA

BACKGROUND: Primary leiomyosarcoma of bone is a very rare malignant tumor with uncertain pathogenicity. METHODS: The authors studied five cases of surgically treated primary leiomyosarcoma of bone. Clinical histories and radiographic findings were recorded. Regular clinical and radiographic controls were obtained postoperatively. In all cases, immunohistochemical studies were used to confirm the diagnosis. Molecular biologic examinations, using the polymerase chain reaction technique with microsatellite DNA markers from regions of tumor-relevant genes, were performed to determine the stability of the genome or to detect some typical genomic changes. RESULTS: The study included three women and two men, with an average age of 42 years. The tumor was located in the pelvis in two patients, in the femur in two patients, and in the proximal tibia in one patient. All tumors were classified as high-grade tumors (four stage IIB, one stage IIA). Radiographically, all tumors appear as purely osteolytic lesions, with a geographic or moth-eaten appearance and without any sclerotic margin. Three patients underwent limb salvage surgery followed by endoprosthetic replacement. The other two patients required amputation. The mean follow-up was 19 months (range, 8-29 months). Three patients died of disease, with a mean postoperative survival period of 18 months (range, 6-27 months). Four patients developed diffuse pulmonary metastases after an average of 10.5 months. One of those patients responded well to chemotherapy. In all cases, immunohistochemistry showed strong reactivity of the tumor cells for (alpha-SMA and vimentin. Molecular biologic investigations revealed a high rate of genomic instabilities in all of the stage IIB tumors. CONCLUSION: Clinical follow-up suggests that primary osseous leiomyosarcoma has an aggressive biologic behavior. The immunohistochemical studies are useful tools and suggest that osseous leiomyosarcoma arise from the vascular smooth muscle cells within the bone. The molecular biologic findings of a high rate of genomic instability confirm the hypothesis that this rare entity is of an aggressive nature.     

Primary leiomyosarcoma. A rare tumor of the adrenal gland

OBJECTIVE: To report on a rare case of primary leiomyosarcoma of the adrenal. To our knowledge, this is the fourth case reported in the literature. METHODS: A patient with primary leiomyosarcoma of the adrenal gland is presented. The clinical features are described, and the diagnostic and therapeutic aspects of this rare primary mesenchymal tumor are discussed. RESULTS/CONCLUSIONS: The aggressive nature and the poor prognosis of this rare tumor type are emphasized.     

Epstein-Barr virus-associated leiomyosarcomas in liver transplantation recipients. Origin from either donor or recipient tissue

BACKGROUND: Leiomyosarcoma, a mesenchymal malignancy with smooth muscle differentiation, is extremely rare in children. Immunosuppression, due to either antirejection medication in organ transplantation recipients or human immunodeficiency virus infection (HIV), appears to constitute a predisposition. METHODS: Two cases of leiomyosarcoma in pediatric liver transplantation recipients were investigated and compared clinically with respect to site of origin and course of the disease and pathologically by routine histology and electron microscopy, by forensic DNA methodology for origin from donor or recipient tissue, and by EBER-1 in situ hybridization for evidence of latent Epstein-Barr virus (EBV) infection. RESULTS: A 9-year-old male developed a high grade, poorly differentiated leiomyosarcoma in his allografted liver 2 years after transplantation, and despite antineoplastic chemotherapy, he died of metastatic disease. The genotype of his tumor indicated an origin from allografted tissue. A 12-year-old female had a low grade retroperitoneal leiomyosarcoma involving the superior mesenteric vein. After resection, she remained disease free without chemotherapy. The genotype of her tumor indicated an origin from native tissue. In both tumors, latent EBV infection was documented. CONCLUSIONS: Neoplastic smooth muscle proliferation in immunosuppressed liver transplantation recipients is analogous to the more common posttransplantation lymphoproliferative disorder in involving transformation of either engrafted donor tissue or recipient tissue elsewhere in the body, in displaying a wide spectrum of histologic differentiation, grade and clinical behavior, and in exhibiting evidence of latent EBV infection.     

Smooth muscle neoplasms of the uterus--a 51 cases study

To discuss the diagnosis of uterine leiomyosarcoma and leiomyoma of cellular and bizarre type, we reviewed 51 cases and carried out P53 and desmin immunohistochemical staining on 43 cases. We found that in most cases leiomyosarcoma is accompanied by nuclear mitosis, cell atypia and margin infiltration. In a small number of cases, though mitotic figures are scarce, high cell atypia and marked margin infiltration were present. Leiomyoma variants may have high cellular density and bizarre nuclears but have no margin infiltration. Leiomyosarcoma has a high incidence of P53 expression, while no P53 expression was detected in leiomyoma variants. Desmin expression is closely correlated with the differentiation of smooth muscle neoplasms of the uterus. We conclude that nuclear mitotic activity is an important but not independent criteria in the diagnosis of uterine leiomyosarcoma. Cellular atypia and margin infiltration should be considered. P53 and desmin expression can be applied as accessary criteria.     

Retroperitoneal fibrosis: unusual localization

Six cases of retroperitoneal fibrosis, each with a different pathogenesis and unusual localization were observed from 1980 to 1996. Four patients had had previous surgery for a neoplasm, one patient had idiopathic retroperitoneal fibrosis, and the last patient was hardly classifiable due to the complexity of the clinical pattern. The mean survival in 3 patients with malignant retroperitoneal fibrosis was 7 months. Two patients treated with medical therapy are still alive and in good clinical condition. The aspecificity of the symptoms makes early diagnosis difficult. CT and NMR are essential procedures for differential diagnosis of abdominal masses. Histology differentiates benign from malignant retroperitoneal fibrosis. The choice between medical or surgical therapy depends on the general condition of each patient.