A case report of primary bladder leiomyosarcoma / 中华泌尿外科杂志

The patient, a 61-year-old female, was admitted to the hospital for 15 days of frequent urination, urgency, painful urination and hematuria. B-ultrasound showed irregular hypoechoic masses on the anterior wall of the bladder. CT showed that the right anterior wall of the bladder protruded into the cavity of the soft tissue mass, which was lobulated, and the edge of the mass showed arc-shaped calcification; enhancement shows that the mass continues to enhance. Cystoscopy showed a lobulated soft tissue mass protruding into the cavity on the right anterior wall of the bladder, and cystoscopy showed tumor-like lesions. The preoperative clinical and imaging diagnosis was a malignant tumor of the bladder. Open partial resection of the right anterior wall of the bladder under general anesthesia, and pathological diagnosis of bladder leiomyosarcoma after surgery. Adjuvant chemotherapy (gemcitabine 1.6 g + epirubicin 80 mg + cisplatin 30 mg) was started 2 months after the operation. The chemotherapy was discontinued after a year, and the patient had no obvious adverse reactions. There were no signs of recurrence and metastasis after a 2-year follow-up.

Primary leiomyosarcoma of bone: imaging findings / 中华放射学杂志

Objective To analyze the radiological imagines and SPECT imaging features of primary leiomyosarcoma of bone and to improve the diagnostic level. Methods The imaging data of 16 patients in our hospital from January 2009 to May 2018 were retrospectively analyzed by two senior musculoskeletal radiologists, and they were all proved by surgery and pathology. The location of the lesions, type of bone destruction, size, soft tissue mass, mineralization, pathological fracture and periosteal reaction were detected by radiography and CT. The types of bone destruction are osteolytic, cystic and mixed. Periosteal reaction was divided into codman triangle, layered periosteal reaction and spiculate periosteal reaction. The signal intensity of lesions, size, distruction of the bony cortex, soft tissue mass and peritumoral edema were detected by MRI.Signal intensity was divided into low signal,iso?signal and high signal by taking surrounding normal muscles as reference. Enhancement scan was used to detect the form of enhancement. SPECT bone scan: compared with normal bone, SPECT bone scan signals were higher than normal bone, which was called concentrated radioactivity. Results Among the 16 cases, located in tibia(5 cases), femur (4 cases), sacrum(1 case), pubis(1 case), ilium(1 case), thoracic vertebra (2 cases) and humerus(2 cases). Radiography showed osteolytic, cystic and mixed bone destruction, among which 8 cases were osteolytic, 2 cases were cystic, 4 cases were mixed, and 1 case was normal. On CT images, 9 cases were osteolytic, 6 cases with soft tissue masses, among which 3 cases with partial sclerosis rim (2 cases with pathological fractare and obviously enhanced), 1 case with mild bone expansion and soft tissue, 2 cases with partial sclerosis rim. Four cases were mixed, all with cortical bone destruction, penetration, 1 case with soft tissue mass and periosteal reaction, 1 case which in the long bone of the extremity was central in location with periosteal reaction. Two cases were obviously and heterogeneously enhanced atter the enhanced CT scanning (1 case with bone expansion). Two cases were cystic,all with cortical destruction and penetration,1 case with soft tissue mass,1 case with partial sclerotic rim;after the enhanced CT scanning,2 case were obviously and heterogeneously enhanced. The most of the MR imagines showed the iso?intensity signal(10cases) and/or lightly lower signal(3cases), lightly higher sign(2cases) on T1WI, inhomogeneous hyperintensity on T2WI (15cases),after injected contrast medium,the tumor was inhomogeneous enhancement(14cases)with the cysts, necrosis and hemorrhage in it,11 cases with soft tissue masses,12 cases accompanied by peritumoral edema. On SPECT bone scan,10 Cases showed significant concentrated radioactivity(1 case was circumferential) and 1 case was mild concentrated radioactivity. Conclusion PLB usually occurs in the lower extremities,more frequently at the distal end of the femur, the proximal end of the tibia. The mainly appearance are central situated and osteolytic destruction with mass of the soft tissue. Although PLB has some imaging features, it is difficult to differentiate it from malignant bone tumors. Multi?imaging modalities such as radiography, CT, MRI and SPECT may suggest the diagnosis.

Surgical Treatment for an Invasive Leiomyosarcoma of the Inferior Vena Cava

A 49-year-old woman presented with right lumbar pain and edema in both legs. Computed tomography showed a large low attenuated mass around and in the S7 segment of the liver involving the right kidney and multiple enlarged mesenteric lymph nodes. There were multiple variably sized discrete nodules in both lungs. Cavography showed subtotal occlusion of the inferior vena cava (IVC). She was successfully treated by wide resection and IVC reconstruction with partial cardiopulmonary bypass and metastasectomy.

Leiomyosarcoma of the Maxillary Sinus: A Case Report

Leiomyosarcoma(LMS) is a malignant neoplasm of smooth muscle origin, which accounts for 7 % of all soft tissue sarcomas. The most common sites are the gastrointestinal tract and female genital tract. In contrast, primary LMS of the oral and maxillofacial area is rare due to the paucity of smooth muscle in this region. Especially, LMS of the paranasal sinuses is very rare and has an aggressive clinical behavior. Only 28 cases have been described in the english literature, and of these, only 3 patients treated with surgery had a disease-free survival. A 46-year-old woman came to our department for the evaluation of pain on right midface. After a diagnostic work-up, the lesion was diagnosed as LMS of the right maxillary sinus. The radical surgery was done and chemotherapy combined radiotherapy was followed from post operation 1 month. The patient was disease free at post-operation 1 year. We will report this case with literature review.