Leiomyosarcoma - Revision history

Michael: /* General */

2014-10-16T06:15:30Z

General

← Older revision		Revision as of 06:15, 16 October 2014
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	==General==		==General==
	*Poor prognosis.		*Poor prognosis - usually.
	**In locally advanced/metastatic disease (arising from the uterus) the median survival is 12-14 months.<ref>{{Cite journal \| last1 = Hadoux \| first1 = J. \| last2 = Morice \| first2 = P. \| last3 = Lhommé \| first3 = C. \| last4 = Duvillard \| first4 = P. \| last5 = Balleyguier \| first5 = C. \| last6 = Haie-Meder \| first6 = C. \| last7 = Gouy \| first7 = S. \| last8 = Uzan \| first8 = C. \| last9 = Mazeron \| first9 = R. \| title = [Uterine leiomyosarcoma: epidemiology, pathology, biology, diagnosis, prognosis and treatment]. \| journal = Bull Cancer \| volume = 100 \| issue = 9 \| pages = 903-15 \| month = Sep \| year = 2013 \| doi = 10.1684/bdc.2013.1801 \| PMID = 24004576 }}</ref>		**In locally advanced/metastatic disease (arising from the uterus) the median survival is 12-14 months.<ref>{{Cite journal \| last1 = Hadoux \| first1 = J. \| last2 = Morice \| first2 = P. \| last3 = Lhommé \| first3 = C. \| last4 = Duvillard \| first4 = P. \| last5 = Balleyguier \| first5 = C. \| last6 = Haie-Meder \| first6 = C. \| last7 = Gouy \| first7 = S. \| last8 = Uzan \| first8 = C. \| last9 = Mazeron \| first9 = R. \| title = [Uterine leiomyosarcoma: epidemiology, pathology, biology, diagnosis, prognosis and treatment]. \| journal = Bull Cancer \| volume = 100 \| issue = 9 \| pages = 903-15 \| month = Sep \| year = 2013 \| doi = 10.1684/bdc.2013.1801 \| PMID = 24004576 }}</ref>
	**Skin leiomyosarcoma do so well it has been proposed to no longer refer to them as ''sarcomas''.<ref name=pmid21358302/>
	*Do not (generally) arise from leiomyomas.		*Do not (generally) arise from leiomyomas.
	*Often singular, i.e. one tumour; unlike [[leiomyoma]]s (which are often multiple).		*Often singular, i.e. one tumour; unlike [[leiomyoma]]s (which are often multiple).
	*May be a part of [[hereditary leiomyomatosis and renal cell cancer]].		*May be a part of [[hereditary leiomyomatosis and renal cell cancer]].

			Note:
			*''Skin leiomyosarcoma'' do so well it has been proposed to no longer refer to them as ''sarcomas''.<ref name=pmid21358302/>

	==Gross==		==Gross==

Michael: /* General */

2014-10-16T06:14:24Z

General

← Older revision		Revision as of 06:14, 16 October 2014
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	==General==		==General==
	*Poor prognosis.		*Poor prognosis.
			**In locally advanced/metastatic disease (arising from the uterus) the median survival is 12-14 months.<ref>{{Cite journal \| last1 = Hadoux \| first1 = J. \| last2 = Morice \| first2 = P. \| last3 = Lhommé \| first3 = C. \| last4 = Duvillard \| first4 = P. \| last5 = Balleyguier \| first5 = C. \| last6 = Haie-Meder \| first6 = C. \| last7 = Gouy \| first7 = S. \| last8 = Uzan \| first8 = C. \| last9 = Mazeron \| first9 = R. \| title = [Uterine leiomyosarcoma: epidemiology, pathology, biology, diagnosis, prognosis and treatment]. \| journal = Bull Cancer \| volume = 100 \| issue = 9 \| pages = 903-15 \| month = Sep \| year = 2013 \| doi = 10.1684/bdc.2013.1801 \| PMID = 24004576 }}</ref>
			**Skin leiomyosarcoma do so well it has been proposed to no longer refer to them as ''sarcomas''.<ref name=pmid21358302/>
	*Do not (generally) arise from leiomyomas.		*Do not (generally) arise from leiomyomas.
	*Often singular, i.e. one tumour; unlike [[leiomyoma]]s (which are often multiple).		*Often singular, i.e. one tumour; unlike [[leiomyoma]]s (which are often multiple).
	*May be a part of [[hereditary leiomyomatosis and renal cell cancer]].		*May be a part of [[hereditary leiomyomatosis and renal cell cancer]].

	==Gross==		==Gross==
	Features:		Features:

Michael: /* Microscopic */ fix mitotic counts

2014-10-16T06:04:07Z

Microscopic: fix mitotic counts

← Older revision		Revision as of 06:04, 16 October 2014
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	#*Zonal necrosis is suggestive of vascular cause.		#*Zonal necrosis is suggestive of vascular cause.
	*#Mitoses - '''key feature''' - definitions suffer from [[HPFitis]]:		*#Mitoses - '''key feature''' - definitions suffer from [[HPFitis]]:
	#>=10 mitoses/HPF - if spindled.<ref name=Ref_GP281>{{Ref GP\|281}}</ref>		#>=10 mitoses/10 HPF - if spindled.<ref name=Ref_GP281>{{Ref GP\|281}}</ref>
	#>=5 mitoses/HPF - if epithelioid.<ref name=Ref_GP281>{{Ref GP\|281}}</ref>		#>=5 mitoses/10 HPF - if epithelioid.<ref name=Ref_GP281>{{Ref GP\|281}}</ref>
	#>=2 mitoses/HPF - if [[myxoid]].<ref name=Ref_GP281>{{Ref GP\|281}}</ref>		#>=2 mitoses/10 HPF - if [[myxoid]].<ref name=Ref_GP281>{{Ref GP\|281}}</ref>
	#>=1 mitosis/HPF - if cutaneous.<ref name=pmid21358302>{{cite journal \|author=Kraft S, Fletcher CD \|title=Atypical intradermal smooth muscle neoplasms: clinicopathologic analysis of 84 cases and a reappraisal of cutaneous "leiomyosarcoma" \|journal=Am. J. Surg. Pathol. \|volume=35 \|issue=4 \|pages=599–607 \|year=2011 \|month=April \|pmid=21358302 \|doi=10.1097/PAS.0b013e31820e6093 \|url=}}</ref>		#>=1 mitosis/10 HPF - if cutaneous.<ref name=pmid21358302>{{cite journal \|author=Kraft S, Fletcher CD \|title=Atypical intradermal smooth muscle neoplasms: clinicopathologic analysis of 84 cases and a reappraisal of cutaneous "leiomyosarcoma" \|journal=Am. J. Surg. Pathol. \|volume=35 \|issue=4 \|pages=599–607 \|year=2011 \|month=April \|pmid=21358302 \|doi=10.1097/PAS.0b013e31820e6093 \|url=}}</ref>
	*+/-Heterologous elements, e.g. malignant cartilage or bone.<ref name=pmid22833086>{{Cite journal \| last1 = Anh Tran \| first1 = T. \| last2 = Holloway \| first2 = RW. \| title = Metastatic leiomyosarcoma of the uterus with heterologous differentiation to malignant mesenchymoma. \| journal = Int J Gynecol Pathol \| volume = 31 \| issue = 5 \| pages = 453-7 \| month = Sep \| year = 2012 \| doi = 10.1097/PGP.0b013e318246977d \| PMID = 22833086 }}</ref>		*+/-Heterologous elements, e.g. malignant cartilage or bone.<ref name=pmid22833086>{{Cite journal \| last1 = Anh Tran \| first1 = T. \| last2 = Holloway \| first2 = RW. \| title = Metastatic leiomyosarcoma of the uterus with heterologous differentiation to malignant mesenchymoma. \| journal = Int J Gynecol Pathol \| volume = 31 \| issue = 5 \| pages = 453-7 \| month = Sep \| year = 2012 \| doi = 10.1097/PGP.0b013e318246977d \| PMID = 22833086 }}</ref>

Michael at 06:35, 25 July 2014

2014-07-25T06:35:34Z

← Older revision		Revision as of 06:35, 25 July 2014
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	\| Site = [[uterus]], [[skin]], others		\| Site = [[uterus]], [[skin]], others
	\| Assdx =		\| Assdx =
	\| Syndromes =		\| Syndromes = [[hereditary leiomyomatosis and renal cell cancer]]
	\| Clinicalhx =		\| Clinicalhx =
	\| Signs =		\| Signs =
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	*Do not (generally) arise from leiomyomas.		*Do not (generally) arise from leiomyomas.
	*Often singular, i.e. one tumour; unlike [[leiomyoma]]s (which are often multiple).		*Often singular, i.e. one tumour; unlike [[leiomyoma]]s (which are often multiple).
			*May be a part of [[hereditary leiomyomatosis and renal cell cancer]].

	==Gross==		==Gross==
	Features:		Features:

Michael: /* IHC */

2013-10-09T15:23:35Z

IHC

← Older revision		Revision as of 15:23, 9 October 2013
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	*MIB1 high.		*MIB1 high.
	*Kertins usu. -ve -- more often +ve in epithelioid variant.		*Kertins usu. -ve -- more often +ve in epithelioid variant.

			==Sign out==
			<pre>
			SKIN LESION, LEFT SHOULDER (SUTURE AT 12 O'CLOCK), WIDE EXCISION:
			- LEIOMYOSARCOMA, MARGINALLY EXCISED.
			-- PLEASE SEE TUMOUR SUMMARY.
			- DERMAL SCAR.
			</pre>

	==See also==		==See also==

Michael: /* Microscopic */

2013-09-29T04:07:55Z

Microscopic

← Older revision		Revision as of 04:07, 29 September 2013
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	*[[Smooth muscle tumour of uncertain malignant potential]] (STUMP).		*[[Smooth muscle tumour of uncertain malignant potential]] (STUMP).
	*[[Endometrial stromal sarcoma]].		*[[Endometrial stromal sarcoma]].
			*[[Atypical leiomyoma]].

	===Images===		===Images===

Michael: more

2013-09-29T04:06:22Z

← Older revision		Revision as of 04:06, 29 September 2013
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	{{ Infobox diagnosis		{{ Infobox diagnosis
	\| Name = {{PAGENAME}}		\| Name = {{PAGENAME}}
	\| Image = Cutaneous_leiomyosarcoma_-~~_a_-_intermed_mag~~.jpg		\| Image = Cutaneous_leiomyosarcoma_-_high_mag.jpg
	\| Width =		\| Width =
	\| Caption = Leiomyosarcoma. [[H&E stain]].		\| Caption = Leiomyosarcoma. [[H&E stain]].

Michael: /* Images */

2013-09-29T04:05:55Z

Images

← Older revision		Revision as of 04:05, 29 September 2013
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	Image:Cutaneous_leiomyosarcoma_-_a_-_intermed_mag.jpg \| Cutaneous leiomyosarcoma - intermed. mag. (WC)		Image:Cutaneous_leiomyosarcoma_-_a_-_intermed_mag.jpg \| Cutaneous leiomyosarcoma - intermed. mag. (WC)
	Image:Cutaneous_leiomyosarcoma_-_high_mag.jpg \| Cutaneous leiomyosarcoma - high mag. (WC)		Image:Cutaneous_leiomyosarcoma_-_high_mag.jpg \| Cutaneous leiomyosarcoma - high mag. (WC)
			Image:Cutaneous_leiomyosarcoma_-_very_high_mag.jpg \| Cutaneous leiomyosarcoma - very high mag. (WC)
	</gallery>		</gallery>
	www:		www:
	*[http://path.upmc.edu/cases/case107/micro.html Cutaneous leiomyosarcoma (upmc.edu)].		*[http://path.upmc.edu/cases/case107/micro.html Cutaneous leiomyosarcoma (upmc.edu)].

	===Subtypes===		===Subtypes===
	Major variants:<ref name=Ref_GP284>{{Ref GP\|284}}</ref>		Major variants:<ref name=Ref_GP284>{{Ref GP\|284}}</ref>

Michael: more

2013-09-29T04:03:43Z

← Older revision		Revision as of 04:03, 29 September 2013
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	\| Width =		\| Width =
	\| Caption = Leiomyosarcoma. [[H&E stain]].		\| Caption = Leiomyosarcoma. [[H&E stain]].
	\| Micro =		\| Micro = fasciclar arrangement (characteristic of smooth muscle), features of malignancy (usually need 2 of 3): † (1) nuclear atypia, (2) tumour cell necrosis, (3) mitoses - variable & definitions suffer from [[HPFitis]]
	\| Subtypes =		\| Subtypes = major: spindled leiomyosarcoma (leiomyosarcoma NOS), epithelioid leiomyosarcoma, myxoid leiomyosarcoma; minor: leiomyosarcoma with prominent intravascular growth, leiomyosarcoma with osteoclast-type cells, leiomyosarcoma with clear cells, leiomyosarcoma with xanthoma-type cells
	\| LMDDx =		\| LMDDx = [[pleomorphic undifferentiated sarcoma]], [[atypical fibroxanthoma]] (skin only), [[EBV-associated smooth muscle tumour]], [[carcinosarcoma]], [[smooth muscle tumour of uncertain malignant potential]] (STUMP), [[endometrial stromal sarcoma]], [[atypical leiomyoma]] (symplastic leiomyoma)
	\| Stains =		\| Stains =
	\| IHC =		\| IHC =
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	\| Molecular =		\| Molecular =
	\| IF =		\| IF =
	\| Gross =		\| Gross = "fleshy" appearance, necrosis, large size
	\| Grossing =		\| Grossing =
	\| Site = [[uterus]], [[skin]]		\| Site = [[uterus]], [[skin]], others
	\| Assdx =		\| Assdx =
	\| Syndromes =		\| Syndromes =

Michael: +infobox

2013-09-29T03:57:35Z

+infobox

← Older revision		Revision as of 03:57, 29 September 2013
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			{{ Infobox diagnosis
			\| Name = {{PAGENAME}}
			\| Image = Cutaneous_leiomyosarcoma_-_a_-_intermed_mag.jpg
			\| Width =
			\| Caption = Leiomyosarcoma. [[H&E stain]].
			\| Micro =
			\| Subtypes =
			\| LMDDx =
			\| Stains =
			\| IHC =
			\| EM =
			\| Molecular =
			\| IF =
			\| Gross =
			\| Grossing =
			\| Site = [[uterus]], [[skin]]
			\| Assdx =
			\| Syndromes =
			\| Clinicalhx =
			\| Signs =
			\| Symptoms =
			\| Prevalence = uncommon
			\| Bloodwork =
			\| Rads =
			\| Endoscopy =
			\| Prognosis = poor
			\| Other =
			\| ClinDDx =
			}}
	'''Leiomyosarcoma''' is a malignant tumour of smooth muscle. It is seen in various places including the [[uterus]] and [[skin]].		'''Leiomyosarcoma''' is a malignant tumour of smooth muscle. It is seen in various places including the [[uterus]] and [[skin]].

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	*[[Endometrial stromal sarcoma]].		*[[Endometrial stromal sarcoma]].

	Images:		===Images===
	*Uterine:		Uterine:
	**[http://commons.wikimedia.org/wiki/File:Uterine_leiomyosarcoma_%281%29.jpg Uterine leiomyosarcoma 1 (WC)].		<gallery>
	**[http://commons.wikimedia.org/wiki/File:Uterine_leiomyosarcoma_%282%29.jpg Uterine leiomyosarcoma 2 (WC)].		Image:Uterine_leiomyosarcoma_%281%29.jpg \| Uterine leiomyosarcoma 1 (WC)
	*Cutaneous:		Image:Uterine_leiomyosarcoma_%282%29.jpg \| Uterine leiomyosarcoma 2 (WC)
	**WC:		</gallery>
	***[http://commons.wikimedia.org/wiki/File:Cutaneous_leiomyosarcoma_-_intermed_mag.jpg Cutaneous leiomyosarcoma - intermed. mag. - shows fascicular pattern (WC)].		Cutaneous:
	***[http://commons.wikimedia.org/w/index.php?title=File:Cutaneous_leiomyosarcoma_-_a_-_intermed_mag.jpg Cutaneous leiomyosarcoma - intermed. mag. (WC)].		<gallery>
	***[http://commons.wikimedia.org/wiki/File:Cutaneous_leiomyosarcoma_-_high_mag.jpg Cutaneous leiomyosarcoma - high mag. (WC)].		Image:Cutaneous_leiomyosarcoma_-_intermed_mag.jpg \| Cutaneous leiomyosarcoma - intermed. mag. - shows fascicular pattern (WC)
	**www:		Image:Cutaneous_leiomyosarcoma_-_a_-_intermed_mag.jpg \| Cutaneous leiomyosarcoma - intermed. mag. (WC)
	***[http://path.upmc.edu/cases/case107/micro.html Cutaneous leiomyosarcoma (upmc.edu)].		Image:Cutaneous_leiomyosarcoma_-_high_mag.jpg \| Cutaneous leiomyosarcoma - high mag. (WC)
			</gallery>
			www:
			*[http://path.upmc.edu/cases/case107/micro.html Cutaneous leiomyosarcoma (upmc.edu)].
	===Subtypes===		===Subtypes===
	Major variants:<ref name=Ref_GP284>{{Ref GP\|284}}</ref>		Major variants:<ref name=Ref_GP284>{{Ref GP\|284}}</ref>

← Older revision		Revision as of 06:04, 16 October 2014
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	#*Zonal necrosis is suggestive of vascular cause.		#*Zonal necrosis is suggestive of vascular cause.
	*#Mitoses - '''key feature''' - definitions suffer from [[HPFitis]]:		*#Mitoses - '''key feature''' - definitions suffer from [[HPFitis]]:
	#>=10 mitoses/HPF - if spindled.<ref name=Ref_GP281>{{Ref GP\|281}}</ref>		#>=10 mitoses/10 HPF - if spindled.<ref name=Ref_GP281>{{Ref GP\|281}}</ref>
	#>=5 mitoses/HPF - if epithelioid.<ref name=Ref_GP281>{{Ref GP\|281}}</ref>		#>=5 mitoses/10 HPF - if epithelioid.<ref name=Ref_GP281>{{Ref GP\|281}}</ref>
	#>=2 mitoses/HPF - if [[myxoid]].<ref name=Ref_GP281>{{Ref GP\|281}}</ref>		#>=2 mitoses/10 HPF - if [[myxoid]].<ref name=Ref_GP281>{{Ref GP\|281}}</ref>
	#>=1 mitosis/HPF - if cutaneous.<ref name=pmid21358302>{{cite journal \|author=Kraft S, Fletcher CD \|title=Atypical intradermal smooth muscle neoplasms: clinicopathologic analysis of 84 cases and a reappraisal of cutaneous "leiomyosarcoma" \|journal=Am. J. Surg. Pathol. \|volume=35 \|issue=4 \|pages=599–607 \|year=2011 \|month=April \|pmid=21358302 \|doi=10.1097/PAS.0b013e31820e6093 \|url=}}</ref>		#>=1 mitosis/10 HPF - if cutaneous.<ref name=pmid21358302>{{cite journal \|author=Kraft S, Fletcher CD \|title=Atypical intradermal smooth muscle neoplasms: clinicopathologic analysis of 84 cases and a reappraisal of cutaneous "leiomyosarcoma" \|journal=Am. J. Surg. Pathol. \|volume=35 \|issue=4 \|pages=599–607 \|year=2011 \|month=April \|pmid=21358302 \|doi=10.1097/PAS.0b013e31820e6093 \|url=}}</ref>
	*+/-Heterologous elements, e.g. malignant cartilage or bone.<ref name=pmid22833086>{{Cite journal \| last1 = Anh Tran \| first1 = T. \| last2 = Holloway \| first2 = RW. \| title = Metastatic leiomyosarcoma of the uterus with heterologous differentiation to malignant mesenchymoma. \| journal = Int J Gynecol Pathol \| volume = 31 \| issue = 5 \| pages = 453-7 \| month = Sep \| year = 2012 \| doi = 10.1097/PGP.0b013e318246977d \| PMID = 22833086 }}</ref>		*+/-Heterologous elements, e.g. malignant cartilage or bone.<ref name=pmid22833086>{{Cite journal \| last1 = Anh Tran \| first1 = T. \| last2 = Holloway \| first2 = RW. \| title = Metastatic leiomyosarcoma of the uterus with heterologous differentiation to malignant mesenchymoma. \| journal = Int J Gynecol Pathol \| volume = 31 \| issue = 5 \| pages = 453-7 \| month = Sep \| year = 2012 \| doi = 10.1097/PGP.0b013e318246977d \| PMID = 22833086 }}</ref>