Recently, we treated a patient with pulmonary vein sarcoma. The patient was a 41-year-old woman, had cough, short of breath and apsychia, with obvious jugular venous distention, rales in both lungs and a diastolic murmur at the apex. CT and Echo revealed a tumor in the left atrium. She received an emergency surgery to remove the mass in the heart. The pathological diagnosis demonstrated it as leiomyosarcoma. Though the patient accepted radiotherapy and chemotherapy, she still died of recurrence and metastasis of the sarcoma 10 months after operation.
Adult ; Fatal Outcome ; Female ; Humans ; Pulmonary Veins ; pathology ; surgery ; Sarcoma ; diagnosis ; drug therapy ; surgery ; Vascular Neoplasms ; diagnosis ; drug therapy ; surgery

Adult ; Diagnosis, Differential ; Female ; Humans ; Hysterectomy ; Leiomyomatosis ; pathology ; surgery ; Sarcoma, Endometrial Stromal ; pathology ; Uterine Neoplasms ; pathology ; surgery ; Uterus ; blood supply ; Vascular Neoplasms ; pathology ; surgery

Aggressive angiomyxoma is an uncommon mesenchymal myxoid tumor that is characterized by slow growth and frequent local recurrence. It is currently regarded as a nonmetastasizing tumor. We describe a case of recurrent aggressive angiomyxoma with invasion into the veins including the inferior vena cava and the right atrium and with pulmonary metastases. Our case, together with those unusual cases documented in previous reports, may lead to a reappraisal of the nature of aggressive angiomyxoma.
Adult ; Biopsy ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Lung Neoplasms/*secondary/surgery ; Myxoma/*diagnosis/pathology/surgery ; Radiography, Interventional ; Tomography, X-Ray Computed ; Vascular Neoplasms/*diagnosis/pathology/surgery ; Vena Cava, Inferior/pathology/surgery

Breast Neoplasms ; pathology ; radiotherapy ; surgery ; Diagnosis, Differential ; Female ; Hemangiosarcoma ; etiology ; pathology ; surgery ; Humans ; Iatrogenic Disease ; Neoplasm Recurrence, Local ; Neoplasms, Radiation-Induced ; etiology ; pathology ; surgery ; Vascular Diseases ; etiology ; pathology ; surgery

Adult ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Heart Neoplasms ; pathology ; Humans ; Myxoma ; pathology ; Ovarian Neoplasms ; secondary ; surgery ; Pulmonary Veins ; Sarcoma ; diagnostic imaging ; metabolism ; pathology ; secondary ; surgery ; Tomography, X-Ray Computed ; Vascular Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVETo study the treatment strategy and survival of patients with primary leiomyosarcoma of inferior vena cava (PIVCLMS).

METHODSClinical data of 12 cases with PIVCLMS admitted in Peking University People's Hospital from January 2006 to September 2014 were reviewed retrospectively. All cases were confirmed by pathology examination. Among them, there were 4 male and 8 female patients with a mean age of (54 ± 9) years old. Tumors arose from the inferior vena cava (IVC) upper segment in 5 patients, from the middle in other 7 patients. Cardiac extension was observed in 4 cases. Tumor resection was undertaken in 8 patients, the other 4 patients were inoperable. The series was analyzed to identify clinical outcome of surgical strategy and protective factors for patient survival.

RESULTSIn tumor resection group, 6 patients had radical resection and 2 underwent palliative resection. As for IVC reconstruction, caval wall resection with a direct suture was carried out in 6 patients or with prosthetic patch in 1 patient. The other 1 patient underwent a segment caval resection and prosthetic graft replacement in situ. In 4 cases of suprahepatic PIVCLMS cardiopulmonary bypass or perfusion by right atrial intubation was performed to assist bleeding control and maintain circulation stabilization, among them 1 patient survived for more than 101 months with no tumor recurrence or metastasis. Among the patients submitted to tumor resection 2 early postoperative deaths occurred, and another 2 patients had complications. All 4 patients submitted to non-resective operation (only neoplasm biopsy) died of PIVCLMS within 8 months. Except for 2 cases of early death, mean survival after tumor resection was (54 ± 40) months. Two patients presented local recurrence and hepatic metastasis at follow-up of 16 months and 68 months.

CONCLUSIONSTumor resection is the only therapy for PIVCLMS with an expectation for long-term survival. The applicant of cardiopulmonary bypass makes some inoperable indicated to tumor resection.

Adult ; Blood Vessel Prosthesis Implantation ; Cardiopulmonary Bypass ; Female ; Humans ; Leiomyosarcoma ; diagnosis ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Retrospective Studies ; Vascular Neoplasms ; diagnosis ; surgery ; Vena Cava, Inferior ; pathology

OBJECTIVETo investigate the clinicopathologic characteristics and differential diagnosis of myopericytoma.

METHODSSix cases of myopericytomas were analyzed by light microscopy and immunohistochemistry (LSAB detection method).

RESULTSTumors from 3 females and 3 males were found on the extremities and chest wall. The ages of these 6 patients ranged from 16 to 58 years. Histologically, all tumors were unencapsulated. The neoplastic cells were oval to spindle shaped with eosinophilic cytoplasm, had a myoid appearance and showd areas of concentric perivascular proliferation around lesional blood vessels which were present with focal myxoid stroma. Morphologically in some cases the tumor overlap myofibroma, hemangiopericytoma or glomus tumor. One tumor was located entirely within the lumen of a vein. In another case, the tumor displayed cellular pleomorphism, mitotic activity, necrosis should be diagnosed as malignant myopericytoma. The neoplastic cells were positive for SMA and negative for CD31, CD34, S-100, and CK.

CONCLUSIONSMyopericytoma is composed of oval to spindle shaped myoid cells with a striking tendeny for concentric perivascular growth. These cells differentiate towards perivascular myoid cells or myopericytes. Extremely rare malignant myopericytoma exist.

Actins ; metabolism ; Adolescent ; Adult ; Diagnosis, Differential ; Female ; Glomus Tumor ; metabolism ; pathology ; Hemangiopericytoma ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Myofibroma ; metabolism ; pathology ; Neoplasms, Vascular Tissue ; metabolism ; pathology ; Soft Tissue Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Actins ; metabolism ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms ; pathology ; Middle Aged ; Pulmonary Artery ; Pulmonary Embolism ; pathology ; Radiography ; Sarcoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vascular Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Actins ; metabolism ; Calcium-Binding Proteins ; metabolism ; Calmodulin-Binding Proteins ; metabolism ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Hysterectomy ; Leiomyoma, Epithelioid ; metabolism ; pathology ; Leiomyomatosis ; metabolism ; pathology ; surgery ; Leiomyosarcoma ; pathology ; Microfilament Proteins ; metabolism ; Middle Aged ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Rhabdoid Tumor ; metabolism ; pathology ; surgery ; Sarcoma, Endometrial Stromal ; metabolism ; pathology ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Vascular Neoplasms ; metabolism ; pathology ; surgery ; Veins ; pathology ; Vimentin ; metabolism

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) is commonly used for radical resection of gastric adenoma and mucosal cancer, but there is about 30% of discrepancy rate between the histology of the endoscopic biopsy and that of the resecwas to clarify the clinical significance of IL-6, VEGF, CRP before ESD. METHODS: We investigated the correlation between serum IL-6, VEGF, CRP level and discrepancy rate of gastric neoplastic lesions (10 low-grade dysplasias, 18 high-grade dysplasias, and 25 early gastic cancers). RESULTS: Serum levels of IL-6 in gastric adenoma and mucosal cancer patients were significantly higher than in healthy controls (p<0.05). Especially, serum IL-6 level of high-grade dysplasia patient was significantly higher than low-grade dysplasia and mucosal cancer patients, and the positive rate, sensitivity, and negative predictive value of serum IL-6 levels were higher in high-grade dysplasia patient compared to low-grade dysplasia patient and mucosal cancer patient. Serum levels of VEGF in patients with gastric adenoma and mucosal cancer were significantly higher than healthy controls (p<0.01). Serum levels of CRP in patients with mucosal cancer were significantly higher than in the controls (p<0.05), and the positive rate, sensitivity, and positive predictive value of serum CRP levels were higher in high-grade dysplasia and mucosal cancer patients compared to low-grade dysplasia patient. CONCLUSIONS: Serum levels of IL-6, VEGF, and CRP in patients with gastric neoplastic lesions were significantly higher than healthy controls, especially, serum IL-6 level of high grade dysplasia patient was significantly higher than low-grade dysplasia and mucosal cancer patients.
Adenoma/*diagnosis/pathology/surgery ; Adult ; Aged ; C-Reactive Protein/*analysis ; Carcinoma/*diagnosis/pathology/surgery ; Diagnosis, Differential ; Female ; Gastric Mucosa/*surgery ; Gastroscopy ; Humans ; Interleukin-6/*blood ; Male ; Middle Aged ; Predictive Value of Tests ; Stomach Neoplasms/*diagnosis/pathology/surgery ; Vascular Endothelial Growth Factors/*blood