Primary hepatic leiomyosarcoma in a woman after renal transplantation: report of a case.
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.
Fujita
Hideto
H
Department of Surgery, National Kanazawa Hospital, Ishikawa, Japan.
Kiriyama
Masato
M
Kawamura
Taiichi
T
Ii
Toru
T
Takegawa
Shigeru
S
Dohba
Shotaro
S
Kojima
Yasuhiko
Y
Yoshimura
Mitsuhiro
M
Kobayashi
Akihiko
A
Ozaki
Satoru
S
Watanabe
Kishichiro
K
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
D000199:Actins; D003893:Desmin