title: Leiomyosarcoma of the thyroid gland: A case report and literature review.
abstract: Primary smooth muscle tumors of the thyroid gland are extremely rare neoplasms. Due to their rarity, clinical case studies concerning management are lacking. According to a literature review, only 19 cases of primary thyroid leiomyosarcomas (TLs) have been reported. In the majority of patients, the prognosis is poor since adjuvant radiochemotherapy is ineffective on local recurrence and on long-term survival. In this study, we report the case of a 77-year-old male affected by a rapidly enlarging mass of the anterior neck, associated with bilateral lung metastases, and increasing dysphagia and dyspnea during the previous 6 months. A Tir4 neoplasm fine needle cytological diagnosis of the right thyroid lobe was reached and the patient underwent total thyroidectomy (TT). Definitive histological examination identified a TL. The patient succumbed 40 days later due to respiratory distress. A literature review was performed and TL differential diagnoses, management, including alternative treatment strategies, and adjuvant therapy were analyzed. TL is an aggressive rare mesenchymal malignant tumor. Although an improved multimodal approach is often necessary, TT and neck dissection represent the treatment of choice and are often the only possible therapy. Adjuvant radiochemotherapy appears to be ineffective and a high mortality rate is observed. TL remains a fatal tumor, and innovative and more effective therapeutic strategies to improve management and outcomes are required.
authors.affiliation: Department of Anaesthesiology, Surgical and Emergency Science VII Division of General Surgery, Second University of Naples, Naples I-80131, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.affiliation: Department of Anaesthesiology, Surgical and Emergency Science VII Division of General Surgery, Second University of Naples, Naples I-80131, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Candela
authors.affiliation: Department of Anaesthesiology, Surgical and Emergency Science VII Division of General Surgery, Second University of Naples, Naples I-80131, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Tartaglia
authors.affiliation: Department of Anaesthesiology, Surgical and Emergency Science VII Division of General Surgery, Second University of Naples, Naples I-80131, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Gambardella
authors.affiliation: Department of Anaesthesiology, Surgical and Emergency Science VII Division of General Surgery, Second University of Naples, Naples I-80131, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Mauriello
authors.affiliation: Thoracic Surgery Unit, Second University of Naples, Naples I-80138, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Pettinato
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Unit of Endocrinology and Diabetes Clinic, Second University of Naples, Naples I-80131, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellastella
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Unit of Endocrinology and Diabetes Clinic, Second University of Naples, Naples I-80131, Italy.
authors.forename: Kathrine
authors.initials: K
authors.lastname: Esposito
authors.affiliation: Department of Anaesthesiology, Surgical and Emergency Science VII Division of General Surgery, Second University of Naples, Naples I-80131, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Santini
keywords: fine-needle aspiration biopsy; smooth muscle tumor; thyroid leiomyosarcoma; total thyroidectomy