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Robbins basic pathology, vol. 8. Philadelphia: Elsevier; 2007. Google Scholar Evans HL, Chawla SP, Simpson C, Finn KP. Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases, with emphasis on diagnostic criteria and prognostic factors. Cancer. 1988;62:2239–47.Article CAS PubMed Google Scholar Agaimy A, Wunsch PH. True smooth muscle neoplasms of the gastrointestinal tract: morphological spectrum and classification in a series of 85 cases from a single institute. Langenbecks Arch Surg. 2007;392:75–81.Article PubMed Google Scholar Greenson JK. Gastrointestinal stromal tumors and other mesenchymal lesions of the gut. Mod Pathol Off J U S Can Acad Pathol Inc. 2003;16:366–75. Google Scholar Yamaguchi U, Hasegawa T, Masuda T, et al. Differential diagnosis of gastrointestinal stromal tumor and other spindle cell tumors in the gastrointestinal tract based on immunohistochemical analysis. Virchows Arch. 2004;445:142–50.Article CAS PubMed Google Scholar Miettinen M, Sarlomo-Rikala M, Sobin LH, Lasota J. Esophageal stromal tumors: a clinicopathologic, immunohistochemical, and molecular genetic study of 17 cases and comparison with esophageal leiomyomas and leiomyosarcomas. Am J Surg Pathol. 2000;24:211–22.Article CAS PubMed Google Scholar Miettinen M, Kopczynski J, Makhlouf HR, et al. Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the duodenum. Am J Surg Pathol. 2003;27:625–41.Article PubMed Google Scholar Miettinen M, Sarlomo-Rikala M, Sobin LH, Lasota J. Gastrointestinal stromal tumors and leiomyosarcomas in the colon: a clinicopathologic, immunohistochemical, and molecular genetic study of 44 cases. Am J Surg Pathol. 2000;24:1339–52.Article CAS PubMed Google Scholar Kubota T. Gastrointestinal stromal tumor (GIST) and imatinib. Int J Clin Oncol. 2006;11:184–9.Article CAS PubMed Google Scholar Lux ML, Rubin BP, Biase TL, et al. 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Basile Cancer Institute, American University of Beirut Medical Center, Beirut, LebanonDeborah Mukherji, Sally Temraz & Ali ShamseddineHematology - Oncology Division, Tumor Registry, P.O.Box: 11-0236, Riad El Solh, Beirut, 110 72020, LebanonAli ShamseddineAuthorsLara HilalView author publicationsYou can also search for this author in PubMed Google ScholarKassem BaradaView author publicationsYou can also search for this author in PubMed Google ScholarDeborah MukherjiView author publicationsYou can also search for this author in PubMed Google ScholarSally TemrazView author publicationsYou can also search for this author in PubMed Google ScholarAli ShamseddineView author publicationsYou can also search for this author in PubMed Google ScholarCorresponding authorCorrespondence to Ali Shamseddine.Ethics declarations Conflict of interest None. Rights and permissionsReprints and PermissionsAbout this articleCite this articleHilal, L., Barada, K., Mukherji, D. et al. Gastrointestinal (GI) leiomyosarcoma (LMS) case series and review on diagnosis, management, and prognosis. Med Oncol 33, 20 (2016). https://doi.org/10.1007/s12032-016-0730-3Download citationReceived: 31 December 2015Accepted: 07 January 2016Published: 20 January 2016DOI: https://doi.org/10.1007/s12032-016-0730-3">
Author(s): Hilal L, Barada K, Mukherji D, Temraz S, Shamseddine A
This review of 76 gastrointestinal (GI) leiomyosarcoma (LMS) cases that include 11 cases from the American University of Beirut Medical Centerrepresents, to our knowledge, the largest number of combined GI LMS cases reported. The age range of GI LMS is variable, and the presentation is non-specific, making pathological diagnosis essential. LMSs usually lack CD117 and CD 34 mutations and are usually positive for smooth muscle cell markers. The review highlights surgery as the mainstay of treatment with negative margins attained most of the times. Adjuvant chemotherapy is used in around 7–27 % of the cases mainly for small intestinal and colorectal LMS. The relatively small number of patients is a limitation on outcome analysis. However, LMS has a risk of recurrence reaching 39–80 % and secondary metastasis reaching 55–71 % in small intestinal and colorectal cases. In light of the high frequency of recurrence and metastasis, enrolling patients in clinical randomized trials to investigate the role of chemotherapy, radiation therapy, and targeted therapy is required for better control of this rare aggressive GI tumor.
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Evans HL, Chawla SP, Simpson C, Finn KP. Smooth muscle neoplasms of the uterus other than ordinary leiomyoma. A study of 46 cases, with emphasis on diagnostic criteria and prognostic factors. Cancer. 1988;62:2239–47.
Agaimy A, Wunsch PH. True smooth muscle neoplasms of the gastrointestinal tract: morphological spectrum and classification in a series of 85 cases from a single institute. Langenbecks Arch Surg. 2007;392:75–81.
Greenson JK. Gastrointestinal stromal tumors and other mesenchymal lesions of the gut. Mod Pathol Off J U S Can Acad Pathol Inc. 2003;16:366–75.
Yamaguchi U, Hasegawa T, Masuda T, et al. Differential diagnosis of gastrointestinal stromal tumor and other spindle cell tumors in the gastrointestinal tract based on immunohistochemical analysis. Virchows Arch. 2004;445:142–50.
Miettinen M, Sarlomo-Rikala M, Sobin LH, Lasota J. Esophageal stromal tumors: a clinicopathologic, immunohistochemical, and molecular genetic study of 17 cases and comparison with esophageal leiomyomas and leiomyosarcomas. Am J Surg Pathol. 2000;24:211–22.
Miettinen M, Kopczynski J, Makhlouf HR, et al. Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the duodenum. Am J Surg Pathol. 2003;27:625–41.
Miettinen M, Sarlomo-Rikala M, Sobin LH, Lasota J. Gastrointestinal stromal tumors and leiomyosarcomas in the colon: a clinicopathologic, immunohistochemical, and molecular genetic study of 44 cases. Am J Surg Pathol. 2000;24:1339–52.
Kubota T. Gastrointestinal stromal tumor (GIST) and imatinib. Int J Clin Oncol. 2006;11:184–9.
Lux ML, Rubin BP, Biase TL, et al. KIT extracellular and kinase domain mutations in gastrointestinal stromal tumors. Am J Pathol. 2000;156:791–5.
Heinrich MC, Corless CL, Duensing A, et al. PDGFRA activating mutations in gastrointestinal stromal tumors. Science. 2003;299:708–10.
Emile J, Théou N, Tabone S, et al. Clinicopathologic, phenotypic, and genotypic characteristics of gastrointestinal mesenchymal tumors. Clin Gastroenterol Hepatol. 2004;2:597–605.
Pantaleo MA, Astolfi A, Indio V, et al.: SDHA Loss-of-Function Mutations in KIT–PDGFRA Wild-Type Gastrointestinal Stromal Tumors Identified by Massively Parallel Sequencing. J Natl Cancer Inst. 2011.
Katz SC, DeMatteo RP. Gastrointestinal stromal tumors and leiomyosarcomas. J Surg Oncol. 2008;97:350–9.
Yamamoto H, Handa M, Tobo T, et al. Clinicopathological features of primary leiomyosarcoma of the gastrointestinal tract following recognition of gastrointestinal stromal tumours. Histopathology. 2013;63:194–207.
Stelow EB, Jones DR, Shami VM. Esophageal leiomyosarcoma diagnosed by endoscopic ultrasound-guided fine-needle aspiration. Diagn Cytopathol. 2007;35:167–70.
Lindenmann J, Matzi V, Maier A, Smolle-Juettner FM. Transthoracic esophagectomy and lobectomy performed in a patient with synchronous lung cancer and combined esophageal cancer and esophageal leiomyosarcoma. Eur J Cardio Thorac Surg. 2007;31:322–4.
Zhu X, Zhang XQ, Li BM, Xu P, Zhang KH, Chen J. Esophageal mesenchymal tumors: endoscopy, pathology and immunohistochemistry. World J Gastroenterol. 2007;13:768–73.
Pramesh CS, Pantvaidya GH, Moonim MT, Jambhekar NA, Sharma S, Deshpande RK. Leiomyosarcoma of the esophagus. Dis Esophagus. 2003;16:142–4.
Insabato L, Di Vizio D, Ciancia G, Pettinato G, Tornillo L, Terracciano L. Malignant gastrointestinal leiomyosarcoma and gastrointestinal stromal tumor with prominent osteoclast-like giant cells. Arch Pathol Lab Med. 2004;128:440–3.
Soufi M, Errougani A, Chekkof RM. Primary gastric leiomyosarcoma in young revealed by a massive hematemesis. J Gastrointest Cancer. 2009;40:69–72.
Pauser U, Grimm H. Intramucosal leiomyosarcoma of the stomach following hereditary retinoblastoma in childhood—a case report and review of the literature. World J Surg Oncol. 2008;6:131.
Masuzawa N, Kishimoto M, Nishimura A, et al. Gastric leiomyosarcoma manifesting peculiar findings: radiological–pathological correlation. Pathol Int. 2009;59:306–11.
Insabato L, Masone S, Campione S, et al. Coexistence of primary gastric giant cell-rich leiomyosarcoma and gastrointestinal stromal tumor: report of a very rare combination and review of the literature. Int J Surg Pathol. 2012;20:74–8.
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Author informationAuthors and Affiliations AuthorsLara HilalView author publications Kassem BaradaView author publications Deborah MukherjiView author publications Sally TemrazView author publications Ali ShamseddineView author publications Corresponding author Ethics declarations Conflict of interestNone.
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About this articleCite this articleHilal, L., Barada, K., Mukherji, D. et al. Gastrointestinal (GI) leiomyosarcoma (LMS) case series and review on diagnosis, management, and prognosis. Med Oncol 33, 20 (2016). https://doi.org/10.1007/s12032-016-0730-3
Received: 31 December 2015
Accepted: 07 January 2016
Published: 20 January 2016
DOI: https://doi.org/10.1007/s12032-016-0730-3
Referred From: http://link.springer.com/10.1007/s12032-016-0730-3
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