title: Primary hepatic leiomyosarcoma in a woman after renal transplantation: report of a case.
abstract: In contrast to malignant lymphomas or skin cancer, smooth muscle tumors including leiomyosarcoma are rarely associated with transplant recipients. We herein present a 33-year-old woman with end-stage renal disease who received a transplant at 27 years of age. Four years after the transplantation, at age 31, she underwent a mastectomy because of primary right breast cancer, which was found to be a 5-mm-sized mucinous carcinoma with no regional lymph node metastasis. Six years after the transplantation, a liver tumor was unexpectedly discovered. An explorative laparotomy revealed a well-encapsulated tumor occupying the posterior portion of the right lobe of the liver. The patient underwent a posterior segmentectomy. Histologically, the tumor possessed intermingling fascicles of spindle cells with eosinophilic cytoplasm and elongated nuclei. Based on an immunohistochemical examination, the tumor cells were positive for the muscle-associated antibody. In addition, RNA probes for Epstein-Barr virus were negative based on in situ hybridization. The histologic, immunohistochemical findings were considered to be diagnostic for leiomyosarcoma, which is a low-grade malignancy. Two years after surgery, the patient is doing well with no recurrence of liver tumors or breast cancer.
authors.affiliation: Department of Surgery, National Kanazawa Hospital, Ishikawa, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Fujita
authors.forename: Masato
authors.initials: M
authors.lastname: Kiriyama
authors.forename: Taiichi
authors.initials: T
authors.lastname: Kawamura
authors.forename: Toru
authors.initials: T
authors.lastname: Ii
authors.forename: Shigeru
authors.initials: S
authors.lastname: Takegawa
authors.forename: Shotaro
authors.initials: S
authors.lastname: Dohba
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kojima
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Ozaki
authors.forename: Kishichiro
authors.initials: K
authors.lastname: Watanabe
mesh_terms: D000199:Actins / Q000032:analysis; D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis; D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis; D003893:Desmin / Q000032:analysis; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016030:Kidney Transplantation; D007890:Leiomyosarcoma / Q000737:chemistry / Q000276:immunology / Q000473:pathology; D008113:Liver Neoplasms / Q000737:chemistry / Q000276:immunology / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000175:diagnosis
chemical_list: D000199:Actins; D003893:Desmin