title: [Leiomyosarcoma with prominent osteoclast-like giant cells: a clinicopathologic analysis of 7 cases and review of literature].
abstract: OBJECTIVE
  To study the clinicopathologic features of leiomyosarcoma with prominent osteoclast-like giant cells.
  
  
  METHODS
  The clinical and pathologic features of 7 cases of leiomyosarcoma with prominent osteoclast-like giant cells were analyzed. Immunohistochemical and ultrastructural studies were performed. The literature was reviewed.
  
  
  RESULTS
  All cases occurred in adults, with a mean age of 63 years. There was no significant sex predilection (male-to-female ratio = 4:3). The tumor involved subcutaneous soft tissue of thigh (number = 2), left back (number = 1), retroperitoneum (number = 1), small intestine (number = 1), breast (number = 1) and uterus (number = 1). Histologic examination showed that the tumor was composed of relatively uniform spindly cells arranged in interlacing fascicles. The hallmark was the presence of prominent osteoclast-like giant cells, either intimately admixed with the spindly cells (number = 6) or forming giant cell tumor-like nodules (number = 1). Immunohistochemically, the spindly cells expressed smooth muscle actin, muscle-specific actin, desmin and h-caldesmon in various degrees, whereas the osteoclast-like giant cells expressed CD68. Ultrastructural study showed smooth muscle differentiation in the spindly cells and histiocytic differentiation in the osteoclast-like giant cells. Follow-up data were available in 6 cases. There were local recurrences and/or metastases in all the 6 patients. Three patients were alive with unresectable or recurrent/metastatic disease and two patients died of the disease.
  
  
  CONCLUSIONS
  Leiomyosarcoma with prominent osteoclast-like giant cells is a rare variant of leiomyosarcoma which should be distinguished from the so-called giant cell variant of malignant fibrous histiocytoma. The osteoclast-like giant cells are of histiocytic differentiation. Surgical resection remains the mainstay of management of this high-grade sarcoma.
authors.affiliation: Department of Pathology, Shanghai Miedical College, Fudan University, Shanghai 200032, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Xiao-li
authors.initials: XL
authors.lastname: Xu
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
mesh_terms: D000199:Actins / Q000378:metabolism; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D001415:Back; D001943:Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D002148:Calmodulin-Binding Proteins / Q000378:metabolism; D003893:Desmin / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D015726:Giant Cells / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007414:Intestinal Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D007890:Leiomyosarcoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010010:Osteoclasts / Q000378:metabolism / Q000473:pathology*; D012186:Retroperitoneal Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D013848:Thigh; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D014746:Vimentin / Q000378:metabolism; D000097382:CD68 Molecule
chemical_list: D000199:Actins; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D002148:Calmodulin-Binding Proteins; D003893:Desmin; D014746:Vimentin; C541116:ACTA2 protein, human; C067980:CD68 antigen, human; D000097382:CD68 Molecule