Leiomyosarcoma of the larynx as a local relapse of squamous cell carcinoma--report of an unusual case.
BACKGROUND
The authors report on leiomyosarcoma after previously treated squamous cell carcinoma (SCC) at the glottis.


METHODS
Primary tumor and relapses were investigated morphologically, immunohistochemically, and with molecular methods.


RESULTS
The SCC was typical, but few cells showed a spindle-shaped pattern. The relapse tumor was a spindle-shaped and epitheloid tumor with the morphological and immunohistochemical appearance of leiomyosarcoma (sm-actin+, desmin+, caldesmon+, vimentin+, keratin-).The comparative genomic hybridization (CGH) revealed some gains and losses in the leiomyosarcoma. Because of altered material, the investigation failed in the primary. A fluorescence in situ hybridization (5p) focally detected 3 chromosmomal copies, corresponding to gains on 5p in CGH of leiomyosarcoma.


CONCLUSIONS
Leiomyosarcoma after SCC is very uncommon. A connection between both seems likely in this case. Transdifferentiation, also seen in other tumors or carcinosarcomas, could be based on aberrant differentiation of a pluripotent stem cell.
Institute of Pathology, University Würzburg, Germany. ullrich.voelker@mail.uni-wuerzburg.de
Hans-Ullrich
HU
Völker
Andreas
A
Zettl
Eugenia
E
Haralambieva
Bernd
B
Blume
Rudolf
R
Hagen
Hans-Konrad
HK
Müller-Hermelink
Matthias
M
Scheich
D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D007890:Leiomyosarcoma / Q000473:pathology*; D008297:Male; D016609:Neoplasms, Second Primary / Q000473:pathology*