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| Treat Uterine Leiomyosarcoma Metastatic to Lung |   histology and general description (More Micrographs) General Search on Combo Chemo & Leiomyosarcoma: Remission due to CYVADIC chemotherapy of primary leiomyosarcoma derived from mesentelium of the sigmoid colon: a case report] [Article in Japanese] Takano M, Kita T, Kiuchi Y, Nagata I. Uterine myxoid leiomyosarcoma and YVADIC-etoposide therapy. Fukunishi H, Yukimura N, Takeuchi S, Kitazawa S. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Display&dopt=pubmed_pubmed&from_uid=7806003) Anticancer Drugs 1996 Nov;7(8):885-9 Remission of advanced uterine leiomyosarcoma with pulmonary metastases with carboplatin and paclitaxel. Kudelka AP, Termrungruanglert W, Vadhan-Raj S, Edwards CL, Varma DG, Tornos C, Verschraegen CF, Kavanagh JJ. University of Texas MD Anderson Cancer Center, Houston 77030, USA. A patient who had a high-grade uterine leiomyosarcoma (LMS) with extensive intra-abdominal and pulmonary metastases at the time of diagnosis underwent supracervical hysterectomy, bilateral salpingo-oophorectomy and tumor reductive surgery. She then received induction chemotherapy with paclitaxel 135 mg/m2 over 24 h and carboplatin (target AUC = 7.5 mg.ml/min) monthly for seven courses, achieving remission with a small amount of residual disease. The treatment was well tolerated except for peripheral neuropathy. Accordingly, the combination of carboplatin and paclitaxel may be considered in patients with advanced high-grade LMS of the uterus, and this regimen warrants further study in this disease. Gemcitabine (Gemzar) Drug for Cancer: Use, Side Effects, Interactions Gemcitabine (Gemzar) Drug for Cancer: Use, Side Effects, Interactions Eli Lilly and Company Gemzar Page GEMZAR® (GEMCITABINE HCl) FOR INJECTION (Package Insert) - Eli Lilly Specific Chemotherapy Drugs Flavoperidol the NCI site that describes the gemcitabine plus flavopiridol trial NCI Links to Other Web Sites/Resources Uterine Cancer Treatment Tool from PDR.net Investigational role of gemcitabine in Advanced breast cancer Understanding the Approval Process for New Cancer Drugs Google search on Gemcitabine & Leiomyosarcoma Gemzar: The CancerBACUP Factsheet Lilly Gemzar Resources Google search on Gemcitabine & Sarcoma treatment Searching for trials at NCI Am Soc for Clinical Oncology Search Page Specific Uterine Sarcoma trials at the James Leiomyosarcoma: General Information for the public Interesting Thalidomide trial at University of Massachusetts Memorial Medical Center, Worcester, Massachusetts, 01655, United States; Recruiting Harrison George Ball, III 508-334-1160 Support for Sarcoma Patients (Under Construction) (Under Construction) (Under Construction) (Under Construction) (Under Construction) (Under Construction) (Under Construction) General Search on Combo Chemo & Leiomyosarcoma: Remission due to CYVADIC chemotherapy of primary leiomyosarcoma derived from mesentelium of the sigmoid colon: a case report] [Article in Japanese] Takano M, Kita T, Kiuchi Y, Nagata I. Uterine myxoid leiomyosarcoma and YVADIC-etoposide therapy. Fukunishi H, Yukimura N, Takeuchi S, Kitazawa S. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Display&dopt=pubmed_pubmed&from_uid=7806003) Anticancer Drugs 1996 Nov;7(8):885-9 Remission of advanced uterine leiomyosarcoma with pulmonary metastases with carboplatin and paclitaxel. Kudelka AP, Termrungruanglert W, Vadhan-Raj S, Edwards CL, Varma DG, Tornos C, Verschraegen CF, Kavanagh JJ. University of Texas MD Anderson Cancer Center, Houston 77030, USA. A patient who had a high-grade uterine leiomyosarcoma (LMS) with extensive intra-abdominal and pulmonary metastases at the time of diagnosis underwent supracervical hysterectomy, bilateral salpingo-oophorectomy and tumor reductive surgery. She then received induction chemotherapy with paclitaxel 135 mg/m2 over 24 h and carboplatin (target AUC = 7.5 mg.ml/min) monthly for seven courses, achieving remission with a small amount of residual disease. The treatment was well tolerated except for peripheral neuropathy. Accordingly, the combination of carboplatin and paclitaxel may be considered in patients with advanced high-grade LMS of the uterus, and this regimen warrants further study in this disease. Gemcitabine (Gemzar) Drug for Cancer: Use, Side Effects, Interactions Gemcitabine (Gemzar) Drug for Cancer: Use, Side Effects, Interactions Eli Lilly and Company Gemzar Page Specific Chemotherapy Drugs Flavoperidol the NCI site that describes the gemcitabine plus flavopiridol trial NCI Links to Other Web Sites/Resources Uterine Cancer Treatment Tool from PDR.net Investigational role of gemcitabine in Advanced breast cancer Understanding the Approval Process for New Cancer Drugs Google search on Gemcitabine & Leiomyosarcoma Gemzar: The CancerBACUP Factsheet Lilly Gemzar Resources Google search on Gemcitabine & Sarcoma treatment Searching for trials at NCI Am Soc for Clinical Oncology Search Page Specific Uterine Sarcoma trials at the James Leiomyosarcoma: General Information for the public Interesting Thalidomide trial at Tufts University School of Medicine, Boston, Massachusetts, 02111, United States; Recruiting: Evelyn Nunez 617-636-6058 Support for Sarcoma Patients GEMZAR® (GEMCITABINE HCl) FOR INJECTION (Package Insert) - Eli Lilly Cancer Medicine. 5th ed. Bast, Robert C.; Kufe, Donald W.; Pollock, Raphael E.; Weichselbaum, Ralph R.; Holland, James F.; Frei, Emil, editors.Canada: BC Decker Inc; c2000. Request # 14637898 was sent to MDUZCA for: Abramson S; Gilkeson RC; Goldstein JD; Woodard PK; Eisenberg R; Abramson N Benign metastasizing leiomyoma: clinical, imaging, 2001 Jun;176(6):1409-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11373202 AJR Am J Roentgenol. 2001 Jun;176(6):1409-13. Related Articles, Links Benign metastasizing leiomyoma: clinical, imaging, and pathologic correlation. Abramson S, Gilkeson RC, Goldstein JD, Woodard PK, Eisenberg R, Abramson N. Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106, USA. OBJECTIVE: We describe the clinical presentation and the radiographic and CT findings of benign metastasizing leiomyoma. CONCLUSION: Benign metastasizing leiomyoma is an asymptomatic disease characterized by well-defined, numerous, pulmonary lesions without a preponderant distribution. PMID: 11373202 [PubMed - indexed for MEDLINE] __ http://www.vh.org/adult/provider/radiology/ITTR/BenignMetaLeiomyoma/BngMetaLeiomyoma.html __ AJR Am J Roentgenol. 1983 Aug;141(2):269-72. Related Articles, Links Leiomyomatous lung lesions: a proposed classification. Martin E. A case of multiple pulmonary leiomyomas is presented. In a review of the literature, a confusing array of rare diseases all pertaining to multiple leiomyomas was found. These were reduced to three entities: leiomyomatosis in women, metastatic leiomyoma in men and children, and multiple pulmonary fibroleiomyomatous hamartoma occurring in anyone. The leiomyomatous diseases in women are related to uterine leiomyomas and they are hormone-sensitive. This is of great prognostic importance. The classification, definitions, and discussion should prove helpful in understanding these rare multiple diseases. Publication Types: Case Reports http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6603116 Women at risk if benign metastasizing leiomyoma develops from uterine leiomyoma Leiomyoma July 13, 2004 2004 JUL 13 - (NewsRx.com & NewsRx.net) -- If benign metastasizing leiomyoma develops from metastasizing uterine leiomyoma, speculate researchers, many women may be at risk for the disease. "Benign metastasizing leiomyoma (BML) is a rare disease, with 100 cases reported in the literature through 2003. Initially described by Steiner in 1939, it was believed to be a primary lung neoplasm and was referred to as fibroleiomyomatous hamartoma. This name was challenged and changed some 40 years later in 1977, when a series of specimens were interpreted as metastatic implantation from benign uterine myomas," wrote S. Pitts and colleagues, University of Miami. "The term 'BML' describes the presence of benign smooth muscle tumors in an organ distant from the uterus, most commonly the lung, usually associated with a current or prior history of uterine leiomyomata. The disease is usually present in premenopausal women, several years after a myomectomy or hysterectomy for uterine fibroids," explained the researchers. "The prevalence of BML is unknown, as most women are diagnosed after an incidental abnormal chest radiograph. However, uterine leiomyomas are the most common neoplasm in the female genital tract, present in 20% to 30% of women over the age of 30, more than 40% of women over the age of 40, and are more common in black women. "Uterine leiomyomas develop during the reproductive period when hormonal effects are at a maximum level, enlarge during pregnancy, and regress after menopause," Pitts and coauthors continued. "Therefore," they suggested, "if BML develops from metastasizing uterine leiomyoma, this could place a large population of women at risk for the disease." Pitts and coauthors published their study in Clinics in Chest Medicine (Benign metastasizing leiomyoma and lymphangioleiomyomatosis: sex-specific diseases? Clin Chest Med, 2004;25(2):343). For additional information, contact M.K. Glassberg, University of Miami, School of Medicine, Vascular Biology Institute, Department Med, Division Pulmonology & Critical Care, 1600 NW 10th Avenue, Miami, FL 3316 USA. The publisher of the journal Clinics in Chest Medicine can be contacted at: W B Saunders Co., Independence Square West Curtis Center, Ste. 300, Philadelphia, PA 19106-3399 USA. The information in this article comes under the major subject areas of Oncology and Women's Health. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2004, Cancer Weekly via NewsRx.com & NewsRx.net. ©Copyright 2004, Women's Health Weekly via NewsRx.com & NewsRx.net return to OBGYN.net Headline News ... (2001 archives) ____ Clin Chest Med. 2004 Jun;25(2):343-60. Related Articles, Links FPRIVATE "TYPE=PICT;ALT=Click here to read" Benign metastasizing leiomyoma and lymphangioleiomyomatosis: sex-specific diseases? Pitts S, Oberstein EM, Glassberg MK. Department of Internal Medicine, University of Rochester School of Medicine, Strong Memorial Hospital, 6704 Setters Run, Rochester, NY 14564, USA. The striking similarity between benign metastasizing leiomyoma and lymphangioleiomyomatosis is that they both affect young women. This observation underscores the importance of gender-dependent variables in disease and our lack of understanding of gender differences. Many researchers are currently investigating the link between disease and hormone levels in the body. The beneficial role of estrogens remains in question in pulmonary medicine, and further ongoing research should help to define the role of hormones in the lung. Publication Types: Review Review, Tutorial http://rad.usuhs.mil/medpix/medpix.html?mode=tf_case&pt_id=7168¬hing= http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15099894 _______________________ Re: Lung Nodule is Benign Metastasizing Leioyoma Date: Tue, 15 Jul 2003 08:28:12 -0600 Newsgroups: sci.med.diseases.cancer Size: 11,858 bytes "Steph" news:fELQa.436876$email-address-deleted... > > That's very encouraging, but I find it difficult to believe that the > cytologist could ditinguish between metastatic leiomyosarcoma and a "benign > metastasising leiomyoma" on the basis of a needle biopsy. > > I have to admit, though, I've never even heard of the latter disease. > > Yes, "benign metastasizing leiomyoma" is an unusual tumor---sounds a bit like an oxymoron to have something metastatic that is benign, but fortunately that's how it seems to behave. It's something you might want to keep in the back of your mind in case you ever run across it, since a misdiagnosis can lead to disastrous overtreatment not to mention the psychological distress of thinking one has incurable sarcomatous metastasis when that isn't the case at all! There are about 70 pstgs in Medline, and it seems to be possible to tell from a needle biopsy that that is a likely diagnosis---apparently the absence of mitotic figures (at least in most cases) and the presence of female sex hormone receptors and certain other immunohistochemical markers are key features. Dtsch Med Wochenschr. 2001 May 11;126(19):551-5. [Benign metastasizing leiomyoma of the lung--a rare differential diagnosis of pulmonary space-occupying lesions] [Article in German] Pawlik C, Wildberger JE, Tietze L, Matern S, Busch N. Klinik fur Innere Medizin, Bundesknappschafts-Krankenhaus Bardenberg. HISTORY AND ADMISSION FINDINGS: A 45-year-old woman was refferred for diagnosis of an accidentally found symptomless space-occupying lesions in the central part of the right lung. She had undergone a hysterectomy 4 years before and reported smoking 15 cigarettes daily since the age of 17 years. Physical examination was normal. INVESTIGATIONS: As primary bronchial carcinoma or metastasis to the lung was suspected she underwent a series of diagnostic tests: sonography, computed tomography (CT), gastroscopy, coloscopy, bronchoscopy, skeletal scintigraphy, gynaecological examination and various laboratory tests, none of which indicated a primary extrapulmonary tumour. CT-guided fine-needle biopsy then suggested benign metastasizing pulmonary leiomyoma (BMPL). TREATMENT AND COURSE: The largest of the tumours were surgically removed, confirming BMPL. Hormone receptors (for oestrogen, progesterone) having been demonstrated, progesterone treatment was initiated as prophylaxis against recurrences. CT 6 months later revealed new intrapulmonary foci. Administration of luteinizing hormone-releasing hormone analog to stop completely any oestrogen effect, and CT of the thorax 6 months later showed that both tumour numbers and their size had been reduced. The patient remained asymptomatic and the findings had not changed in the subsequent 12 months. CONCLUSION: BMPL is a rare cause of a space-occupying pulmonary lesion, predominantly affecting middle-aged women after hysterectomy for uterine myoma. The pathogenesis remains unclear, hormone-dependent tumour growth being discussed as a possible mechanism. Anti-oestrogen administration is the treatment of choice to achieve remission and effective prevention of recurrences. PMID: 11402911 ----------------------------- Acta Cytol. 1994 May-Jun;38(3):398-402. Fine needle aspiration diagnosis of benign metastasizing leiomyoma of the lung. A case report. Hafiz MA, Wang KP, Berkman A. Department of Pathology, University of Maryland School of Medicine, Baltimore. Percutaneous fine needle aspiration biopsy was performed on a woman with multiple bilateral lung nodules. The cytology and histology showed a benign spindle cell tumor compatible with benign metastasizing leiomyoma. The patient had a history of hysterectomy 14 years earlier for a cellular leiomyoma with atypia. No significant mitosis was present in either the uterine tumor or lung metastasis. PMID: 8191830 -------------------------------- Virchows Arch. 2000 Sep;437(3):284-92. Benign metastasizing leiomyoma of the uterus: documentation of clinical, immunohistochemical and lectin-histochemical data of ten cases. Kayser K, Zink S, Schneider T, Dienemann H, Andre S, Kaltner H, Schuring MP, Zick Y, Gabius HJ. Department of Pathology, Thoraxklinik, Heidelberg, Germany. email-address-deleted The clinical histories of 10 women suffering from benign metastasizing leiomyoma (BML) after hysterectomy and information on lung lesions detected in these women are presented, together with corresponding data for 2 women with metastasizing leiomyosarcoma of the uterus for comparison: gross appearance, survival, and light microscopical, immunohistochemical and lectin-histochemical findings are reported. All patients with BML had undergone hysterectomy for uterus leiomyomatosus without any detection of sarcomatous lesions in the uterus wall. After a median period of 14.9 years intrapulmonary masses were detected by imaging techniques. On average, six nodules with a mean diameter of 1.8 cm were seen. Resection of the lesions was performed in all cases. The immunohistochemical and lectin-histochemical examination of the tumors included analysis of the proliferation-associated protein Ki-67, the p53 protein, estrogen and progesterone receptor, sarcolectin as an indicator of the presence of lymphokine macrophage migration inhibitory factor, antibodies and the labeled protein to assess galectin (galactoside-binding animal lectin)-dependent parameters, analysis of tumor vascularization (CD-34), and expression of bcl-2, vimentin, smooth muscle actin, desmin, and keratin. The lesions were characterized by low proliferation activity of 2.9% (measured with Ki-67), frequent hormone receptor expression (8 of the 10 cases presented hormone-specific receptors), low to moderate vascularization compared with metastases from the two uterine sarcomas, remarkable p53 overexpression and frequent expression of the lymphokine, the galectins and accessible binding sites. {Abstract truncated} PMID: 11037349 ------------------------- *****There are a lot of articles debating if these things are truly metastatic from the uterine leiomyoma or if they represent a tendency to form lots of little benign leiomyomas in various places including the lung, but at least in this study, they seem to be clonal metastases from the primary tumor. Hum Pathol. 2000 Jan;31(1):126-8. Benign metastasizing leiomyoma: a cytogenetically balanced but clonal disease. Tietze L, Gunther K, Horbe A, Pawlik C, Klosterhalfen B, Handt S, Merkelbach-Bruse S. Institute of Pathology and Department of Internal Medicine, Aachen University of Technology, Germany. Benign metastasizing leiomyoma (BML) is a rare condition, characterized by the occurrence of multiple smooth-muscle nodules, most often located in the lung after previous hysterectomy because of histologically benign appearing leiomyoma. Although the condition resembles a metastatic process, case studies provided evidence that it may be the result of an intravenous leiomyomatosis or an independent and multifocal smooth-muscle proliferation. Comparative genomic hybridization and X-chromosome inactivation analysis were used in a case of BML to determine whether pulmonary and uterine tumors are related one to another. A balanced karyotype, previously reported in leiomyomas and an identical X-chromosome inactivation pattern found in all tumorlets, is most consistent with a monoclonal origin of both uterine and pulmonary tumors and the interpretation that pulmonary lesions are metastatic. PMID: 10665925 -------------------------------- ***Apparently some of these tumors tend to shrink by themselves after menopause: Arai T, Yasuda Y, Takaya T, Shibayama M.Natural decrease of benign metastasizing leiomyoma. Chest. 2000 Mar;117(3):921-2. No abstract available. PMID: 10713035 [PubMed - indexed for MEDLINE Free full-text article available online -------------------------------------- The lung isn't the only site of these metastases: Nihon Kokyuki Gakkai Zasshi. 1999 Feb;37(2):146-50. [So-called benign metastasizing leiomyoma of the lung presenting with bone metastases] [Article in Japanese] Nakanishi S, Nakano K, Hiramoto T, Shimizu M, Nakamura K, Yamane N. Department of Internal Medicine, Kure National Hospital, Hiroshima, Japan. The patient, a 42-year-old woman, was admitted to our hospital because of abnormal shadows on chest X-ray films obtained during a routine medical check-up. Her medical history included a uterine myomectomy at the age of 21, and thereafter, periodic lumbago and back pain for which she had not sought any medical treatment. Chest computed tomography detected a number of pulmonary nodules in both whole lung fields, and magnetic resonance imaging revealed many spherical metastatic lesions in the thoracic and lumbar vertebrae. Although we initially suspected lung cancer, no primary lesion was found. A thoracoscopic lung biopsy revealed leiomyomatous tumors that were histologically similar to the uterine myoma removed 21 years previously. The final diagnosis was so-called benign metastasizing leiomyoma (BML). Because the removed tumor contained a high concentration of progesterone receptors (240 fmol/mg), a gonadotropin-releasing hormone analogue was administered, and proved effective in relieving the patient's periodic lumbago and back pain. The findings in this case suggested that the so-called BML was in fact a metastasis of a low-grade uterine leiomyosarcoma. PMID: 10214045 ------------------------- Am J Surg Pathol. 1998 Jul;22(7):897-901. Related Articles, Links Multiple smooth muscle tumors arising in deep soft tissue of lower limbs with uterine leiomyomas. Horiuchi K, Yabe H, Mukai M, Morioka H, Udagawa Y, Nozawa S, Yabe Y. Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan. A 40-year-old woman had multiple smooth muscle tumors in the left inguinal region, the bilateral thighs, the omentum, the peritoneum, and the right infundibulum pelvic ligament associated with uterine leiomyomas. She had a history of uterine leiomyomas, which were resected 13 years ago. Histopathologic evaluation revealed tumor masses composed of smooth muscle cells with relatively low cellularity, which were consistent with a diagnosis of leiomyoma. Tumor necrosis and nuclear atypia were absent. Mitotic figures were very scarce (less than 1 mitotic figure per 10 high-power fields). Immunohistochemical evaluation revealed a positive reaction of the tumor cells to muscle markers, estrogen receptors, and progesterone receptors. No pulmonary lesion was found. Similar instances of uterine leiomyomas with histologically benign extrauterine smooth muscle tumors have been reported. This curious condition has been referred to as "benign metastasizing leiomyoma," in which most of the reported cases involve the lungs. The distribution of extrauterine tumors in our case is very unusual and may be the first case with multiple leiomyomas in deep soft tissue of the limbs. Consideration was given to the concept that these may be of multifocal origin, rather than metastases. Publication Types: Review Review of Reported Cases PMID: 9669352 ---------------------------------- I suspect that some cases of "cured" metastatic leiomyosarcomas may have been misdiagnosed benign metastasizing leiomyomas. One friend of mine (who had had a hysterectomy several years before) was found to have multiple pulmonary "leiomyosarcomas" supposedly metastatic from a lesion on her leg similar to the ones in the above article, and despite being told that long-term survival was unlikely with widespread lung mets, she has done fine for about 10 years after a round of chemo, and she seems to have no further problem, which I doubt would have been the case had it been truly a soft-tissue sarcoma with lung mets. ] http://www.ultrasound-technician.com/school_of_ultrasound/diagnostic_medical_sonography_school/diagnostic_medical_sonography_school_msg29639/diagnostic_medical_sonography_school_msg29639.shtml http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijtcvs/vol6n1/myoma.xml http://www.greenjournal.org/cgi/content/abstract/89/5/850 |
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