Open AccessLeiomyosarcoma of the Sacral Bone in a Patient with a Past History of Resection of Uterine Leiomyoma
Author(s) -
Osamu Dohi,
Masahito Hatori,
Haruo Ohtani,
Mika Watanabe,
S. Kokubun
Publication year - 2003
Publication title -
upsala journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.808
H-Index - 41
eISSN - 2000-1967
pISSN - 0300-9734
DOI - 10.3109/2000-1967-115
Subject(s) - medicine , smooth muscle tumor , leiomyosarcoma , leiomyoma , atypia , pathology , malignancy , differential diagnosis , vimentin , uterus , nuclear atypia , uterine leiomyoma , giant cell , immunohistochemistry
We report here a case of leiomyosarcoma in the sacrum with a differential diagnosis of metastasizing leimyoma of uterus, since the patient had a past history of resection of uterine leimyoma 19 years ago. The sacral tumor was an osteolytic lesion, 8x6 cm in size on radiological examination. Microscopically, tumor cells consisted of spindle shaped cells with moderate cellular atypia. The tumor cells invaded into the surrounding muscle tissue. Immunohistochemistry revealed that the tumor cells were positive for alpha-SMA and vimentin, and they were enclosed by type IV collagen, suggesting the presence of the basement membrane. The labeling index of Ki-67 in the tumor cells was 25%. Re-examination of leiomyomas of uterus resected 19 years ago showed that they were typical leiomyomas, showing well-circumscribed tumors, composed of well-differentiated smooth muscle cells without nuclear atypia. The presence of radiological and pathological findings of malignancy of the sacral tumor excluded the possibility of metastasizing leiomyoma, suggesting that the sacral tumor was another primary tumor.