Metachronous Sarcoma: A Case of Pleomorphic Leiomyosarcoma in a Patient with a History of Fibrosarcoma

Seung Ki Ahn; Hwan Jun Choi; Hyun Ju Lee

doi:10.12790/ahm.2017.22.4.299

Journal List > Arch Hand Microsurg > v.22(4) > 1106609

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Ahn, Choi, and Lee: Metachronous Sarcoma: A Case of Pleomorphic Leiomyosarcoma in a Patient with a History of Fibrosarcoma

Case Report

Arch Hand Microsurg 2017;22(4):299-304.

Published online: 5 January 2017

DOI: https://doi.org/10.12790/ahm.2017.22.4.299

Metachronous Sarcoma: A Case of Pleomorphic Leiomyosarcoma in a Patient with a History of Fibrosarcoma

Seung Ki Ahn¹, Hwan Jun Choi¹, Hyun Ju Lee²

¹Department of Plastic and Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea

²Department of Pathology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea

Corresponding author: Hwan Jun Choi Department of Plastic and Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, 31 Sooncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Korea TEL: +82-41-570-2195, FAX: +82-41-574-6133, E-mail: medi619@hanmail.net

This work was supported by the Soonchunhyang University Research Fund.

Received 9 June 2017 Accepted 21 June 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Metachronous cancers were defined as those that were detected after an interval of more than 6 months. The instance of two histologically distinct sarcomas in one patient is very unusual. A 42-year-old woman presented for evaluation of a painless mass in her right axilla area. She gave a history of operation 8 years ago for treating a fibrosarcoma on her right upper arm at local clinic. Eight years ago, the lesion was widely excised. Magnetic resonance imaging revealed a new generated tumor at her right axilla. After a wide surgical resection, we performed anterolateral thigh free flap for cover the defect. Second neoplasm is leiomyosarcoma. These two neoplasms are 2 histologically distinct tumors. There is no report of a case of metachronous soft tissue sarcoma both pleomorphic leiomyosarcoma and fibrosarcoma in upper extremity within one person. We emphasize the importance of considering the possibility of metachronous sarcoma.

Keywords: Pleomorphic leiomyosarcoma, Metachronous sarcoma, Soft tissue sarcoma, Fibrosarcoma, Anterolateral thigh free flap

REFERENCES

1.Daigeler A., Lehnhardt M., Sebastian A, et al. Metachronous bilateral soft tissue sarcoma of the extremities. Lan-genbecks Arch Surg. 2008. 393:207–12.

2.Tukiainen E., Böhling T., Huuhtanen R. Soft tissue sarcoma of the trunk and extremities. Scand J Surg. 2003. 92:257–63.

3.Pitcher ME., Fish S., Thomas JM. Management of soft tissue sarcoma. Br J Surg. 1994. 81:1136–9.

4.Dei Tos AP. Classification of pleomorphic sarcomas: where are we now? Histopathology. 2006. 48:51–62.

5.Folpe AL. Fibrosarcoma: a review and update. Histopathology. 2014. 64:12–25.

6.Warren S., Gates O. Multiple primary malignant tumors. A survey of the literature and statistical study. Am J Cancer. 1932. 16:1358–414.

7.Grobmyer SR., Luther N., Antonescu CR., Singer S., Bren-nan MF. Multiple primary soft tissue sarcomas. Cancer. 2004. 101:2633–5.

8.Picardo NE., Mann B., Whittingham-Jones P., Shaerf D., Skinner JA., Saifuddin A. Bilateral symmetrical metachronous myxofibrosarcoma: a case report and review of the literature. Skeletal Radiol. 2011. 40:1085–8.

9.Grimer R., Judson I., Peake D., Seddon B. Guidelines for the management of soft tissue sarcomas. Sarcoma. 2010. 2010:506182.

Fig.1.

Microscopic examinations of the fibrosarcoma. The mass is composed of short spindle cell fascicles arranged haphazardly with some eosinophilic collagen fiber (H&E, ×200).

Fig.2.

A magnetic resonance imaging revealed a new generated tumor at her right axilla.

Fig.3.

Gross examination of the pleomorphic leiomyosarcoma. The mass is a well-demarcated nodular, and located between subcutaneous fat tissue and skeletal muscular tissue. The cut surface reveals homogeneous grey whitish solid nature.

Fig.4.

Microscopic examinations of the pleomorphic leiomyosarcoma. The mass is composed of marked pleomorphic short spindle cells arranged haphazardly (H&E, ×400).

Fig.5.

Excision site with free flap coverage was healed well and there was only little scar. There was no evidence of re-currence and metastasis.

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