Vol 73, No 4 (2023)
Pictures in Oncology
Published online: 2023-07-04

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Uterine leiomyosarcoma metastatic to the pancreas

Anna Rygula1, Michał Kowalski1, Marcin Ziętek23
Nowotwory. Journal of Oncology 2023;73(4):255.

Abstract

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Pictures in oncology

NOWOTWORY Journal of Oncology

2023, volume 73, number 4, 255

DOI: 10.5603/NJO.a2023.0029

© Polskie Towarzystwo Onkologiczne

ISSN 0029540X, e-ISSN: 2300-2115

www.nowotwory.edu.pl

Uterine leiomyosarcoma metastatic to the pancreas

Anna Rygula1Michał Kowalski1Marcin Ziętek23
1Student Research Group of Oncology, Department of Oncology, Wroclaw Medical University, Wroclaw, Poland
2Department of Oncology, Wroclaw Medical University, Wroclaw, Poland
32nd Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Haematology Centre, Wroclaw, Poland

How to cite:

Rygula A, Kowalski M, Ziętek M. Uterine leiomyosarcoma metastatic to the pancreas. NOWOTWORY J Oncol 2023; 73: 255.

In July 2021, a 57-year-old woman with a medical history of uterine leiomyosarcoma, diagnosed and excised in 2016, was referred to the Lower Silesian Oncology Center. PET-CT results revealed a nodular lesion of 6.7x5.8x7 cm in the pelvis and a focal lesion in the tail of the pancreas. In August 2021, the patient underwent a laparotomy to remove a retroperitoneal tumor and the vaginal stump. The pancreatic tail tumor was not excised due to the repeated laparotomy and the local advancement of the pelvic tumor. The histopathological examination revealed leiomyosarcoma G2 and infiltration of leiomyosarcoma in the sigmoid colon. Subsequently, a median relaparotomy was performed to excise the tail tumor, and an examination of the postoperative material revealed metastatic leiomyosarcoma (fig. 1). The patient was offered adjuvant doxorubicin chemotherapy but refused treatment. Radical surgery is recommended to treat retroperitoneal sarcomas, and complete cross resection is associated with improved survival [1, 2]. Adjuvant therapy typically involves doxorubicin or ifosfamide chemotherapy [2]. Incomplete mass removal should not be performed if the tumor is unresectable, as it worsens the patient’s prognosis.

Figure 1. Computed tomography images of the metastatic pancreatic tumor before excision. A – image of a 5 cm tumor in the tail of the pancreas – transverse view; B – image of a 5 cm tumor in the tail of the pancreas – coronal view

References

  1. Dominguez DA, Sampath S, Agulnik M, et al. Surgical Management of Retroperitoneal Sarcoma. Curr Oncol. 2023; 30(5): 4618–4631, doi: 10.3390/curroncol30050349, indexed in Pubmed: 37232807.
  2. Mehren Mv, Kane J, Agulnik M, et al. Soft Tissue Sarcoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network. 2022; 20(7): 815–833, doi: 10.6004/jnccn.2022.0035.



Nowotwory. Journal of Oncology