ABSTRACT
Uterine leiomyosarcoma (uLMS) is a rare but aggressive cancer with a high metastatic potential and an unfavorable prognosis. A 54-year-old woman with a history of uterine fibroids clinically presented with a painless, palpable left breast mass measuring 20 mm. A core biopsy of the breast mass demonstrated a cellular spindle cell neoplasm (a potentially malignant smooth muscle neoplasm; B4). A wide local breast-mass excision was performed, revealing grade-2 leiomyosarcoma. A re-review of the uterine fibroids revealed that the largest one (200 × 130 mm), initially diagnosed as symplastic leiomyoma, was morphologically identical to the breast lesion. Additional diagnostic work-up revealed multiple liver and pulmonary metastases with a suspected metastatic sclerotic lesion in the L3 projection. The patient was subsequently treated with chemotherapy protocol for metastatic uLMS. The latest follow-up in September 2023 confirmed stable disease. This case highlights the importance of considering unusual metastatic patterns when evaluating breast masses, particularly in patients with a history of non-specific uterine conditions. Comprehensive diagnostic work-up, including imaging and histopathologic examinations, is crucial for an accurate diagnosis of uLMS and appropriate treatment selection. Further studies are needed to better understand the underlying mechanisms and optimal management strategies for metastatic uLMS.
Subject(s)
Leiomyoma , Leiomyosarcoma , Lung Neoplasms , Female , Humans , Middle Aged , Leiomyosarcoma/diagnostic imaging , Antineoplastic Combined Chemotherapy Protocols , LiverABSTRACT
The HERe2Cure project, which involved a group of breast cancer experts, members of multidisciplinary tumor boards from healthcare institutions in Bosnia and Herzegovina, was initiated with the aim of defining an optimal approach to the diagnosis and treatment of HER2 positive breast cancer. After individual multidisciplinary consensus meetings were held in all oncology centers in Bosnia and Herzegovina, a final consensus meeting was held in order to reconcile the final conclusions discussed in individual meetings. Guidelines were adopted by consensus, based on the presentations and suggestions of experts, which were first discussed in a panel discussion and then agreed electronically between all the authors mentioned. The conclusions of the panel discussion represent the consensus of experts in the field of breast cancer diagnosis and treatment in Bosnia and Herzegovina. The objectives of the guidelines include the standardization, harmonization and optimization of the procedures for the diagnosis, treatment and monitoring of patients with HER2-positive breast cancer, all of which should lead to an improvement in the quality of health care of mentioned patients. The initial treatment plan for patients with HER2-positive breast cancer must be made by a multidisciplinary tumor board comprised of at least: a medical oncologist, a pathologist, a radiologist, a surgeon, and a radiation oncologist/radiotherapist.
Subject(s)
Breast Neoplasms/diagnosis , Breast Neoplasms/therapy , Receptor, ErbB-2/metabolism , Bosnia and Herzegovina , Combined Modality Therapy , Female , Humans , Mammography , MastectomyABSTRACT
UNLABELLED: The aim of this study is to access magnetic resonance as the imaging modality of choice in differentiation of cerebellopontine angle tumors. MATERIAL AND METHODS: In period of five years in 53 patients were diagnosed CPA tumors. 31 were women, 22 men, range age 14 to 72 years. All patients were examined on 1.0 Tesla magnetic resonance unit, using T1, PD, T2 WI sequences, and after paramagnetic contrast administration T1 W1 in three ortogonal planes. REZULTS: In 44 (83%) patients were diagnosed acoustic schwannoma (NVIII), and 8 patients of these had Neurifibromatosis Type 2. In 2 (4%) patients were diagnosed trigeminal schwannoma (NV), in 2 (4%) hypogossal schwannoma. By 5 (9%) patients were diagnosed meningiomas. All diagnoses were by histology confirm. CONCLUSION: Thanks to its multiplanar and multi-parameters capabilities Magnetic resonance allowed precise location and characterization of CPA tumors. MR is the imaging modality of choice for preoperative work-up of cerebellopontine angle tumors.
