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Case Reports
. 2022 Feb 14;11(2):129-133.
doi: 10.1007/s13691-022-00535-0. eCollection 2022 Apr.

A case of pulmonary leiomyosarcoma achieving long-term survival after multiple metastasectomies

Yuki Azumi  1 , Tomoyuki Wakahara  1 , Kiyonori Kanemitsu  1 , Shinobu Tsuchida  1 , Mitsuru Sasako  1 , Kyoko Otani  2 , Takeshi Iwasaki  1
Affiliations
Case Reports

A case of pulmonary leiomyosarcoma achieving long-term survival after multiple metastasectomies

Yuki Azumi et al. Int Cancer Conf J. .

Abstract

A 58-year-old man who underwent lower lobectomy of the right lung for primary pulmonary leiomyosarcoma (PPL) 4 years ago presented with epigastric pain and was diagnosed with small bowel intussusception caused by an intestinal mass. Partial resection of the small intestine was performed, and pathological examination revealed metastatic leiomyosarcoma. Masses in the left adrenal gland, subcutaneous tissue of the left upper arm, right pleura, jejunum, right trapezius muscle, and right adrenal gland were subsequently detected in the following 4 years. Resection was performed for each tumor, which was histologically confirmed as metastatic leiomyosarcoma. However, 1 month after the last surgery, multiple systemic metastases were found, thus, he is currently undergoing chemotherapy. The patient has been alive for 8 years and 4 months after the first operation for PPL. PPL is an extremely rare disease with no established treatment strategy for recurrences. Aggressive metastasectomy may be beneficial in selected cases.

Keywords: Metastasectomy; Primary pulmonary leiomyosarcoma; Recurrence.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Contrast-enhanced CT showed a mass of the ilium causing small bowel intussusception (a). Coronal image (b)
Fig. 2
Fig. 2
Histological findings of the small intestine tumor. The tumor consisted of spindle cells with irregular-shaped nuclei (hematoxylin and eosin × 200) (a). Immunohistochemistry showed the tumor cells were partly positive for SMA (× 200) (b) and Desmin (× 200) (c)
Fig. 3
Fig. 3
Computed tomography revealed a mass in the left adrenal gland (a). PET/CT showed an increased uptake of FDG in the mass (b)
Fig. 4
Fig. 4
A subcutaneous mass appeared in the patient’s left upper arm
Fig. 5
Fig. 5
PET/CT showed an increased uptake of FDG in the pleural (a) and the jejunal mass (b)
Fig. 6
Fig. 6
CT showed the jejunal lesion causing small bowel obstruction
Fig. 7
Fig. 7
Metastatic sites and treatment. Square represents metastatic site treated by operation, and yellow square represents metastatic sites treated using anti-tumor agents. DXR doxorubicin; PPL primary pulmonary leiomyosarcoma
See this image and copyright information in PMC

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