Metastatic leiomyosarcoma of the uterus with heterologous differentiation to malignant mesenchymoma.

Abstract

Heterologous differentiation in metastatic leiomyosarcomas of uterine origin is an extremely rare phenomenon. We report a remarkable case of a metastatic leiomyosarcoma from the uterus with an unusual pattern of tumor progression to malignant mesenchymoma after chemotherapy. The patient, an 80-yr-old woman with a history of metastatic leiomyosarcoma of the uterus to the lungs, presented with a large intra-abdominal mass. Histologic examination of the intraperitoneal mass demonstrated a high-grade sarcoma containing various heterologous malignant mesenchymal elements including osteosarcoma, chondrosarcoma, a liposarcoma-like area, and osteoclast-like multinucleated giant cells. Only the identification of small areas of smooth muscle differentiation revealed the true nature of the tumor as a metastatic leiomyosarcoma with aberrant sarcomatous differentiation. This unique presentation emphasizes the importance of clinicopathologic correlation in the diagnosis of tumors with unusual histology.

• Authors: Tien Anh Tran, Robert W Holloway
• Journal: International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists (Int J Gynecol Pathol) Vol. 31 Issue 5 Pg. 453-7 (Sep 2012) ISSN: 1538-7151 [Electronic] United States
• PMID: 22833086 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Aged, 80 and over
• Cell Differentiation
• Female
• Humans
• Leiomyosarcoma (pathology)
• Lung Neoplasms (secondary)
• Mesenchymoma (pathology)
• Uterine Neoplasms (pathology)