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Dedifferentiated Leiomyosarcoma of the Uterus with Heterologous Elements: A Potential Diagnostic Pitfall

Dedifferentiation is a phenomenon that is well characterized in a variety of tumors and is defined by the occurrence of a high-grade or undifferentiated tumor, typically unrecognizable regarding its line of differentiation, from a low-grade/borderline neoplasm. This phenomenon has previously been de...

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Autores principales: Rawish, Kojo R., Fadare, Oluwole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3483660/
https://www.ncbi.nlm.nih.gov/pubmed/23119198
http://dx.doi.org/10.1155/2012/534634
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author Rawish, Kojo R.
Fadare, Oluwole
author_facet Rawish, Kojo R.
Fadare, Oluwole
author_sort Rawish, Kojo R.
collection PubMed
description Dedifferentiation is a phenomenon that is well characterized in a variety of tumors and is defined by the occurrence of a high-grade or undifferentiated tumor, typically unrecognizable regarding its line of differentiation, from a low-grade/borderline neoplasm. This phenomenon has previously been described in 2 uterine leiomyosarcomas, but both were devoid of heterologous elements. The authors describe herein a case of a dedifferentiated leiomyosarcoma of the uterus with osteoid heterologous elements, believed to be the first such reported case. The original tumor was a high-grade leiomyosarcoma with large low-grade and leiomyoma-like areas and whose constituent cells displayed intense nuclear immunoreactivity for both estrogen receptor (ER) and progesterone receptor (PR) in approximately 30% of cells. The tumor recurred six months after its resection as an undifferentiated sarcoma that was negative for smooth muscle markers, but which remained positive for ER and PR. Osteoid production was only identified in the recurrent tumor and was significant in extent therein. This case highlights the immunophenotypic changes that may occur in dedifferentiated leiomyosarcomas, and this possibility should be a consideration when an apparently undifferentiated sarcoma is identified in a patient with a history of uterine leiomyosarcoma. In our case, the expression of ER and PR provided significant supportive evidence of the uterine origin of the recurrent tumor.
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spelling pubmed-34836602012-11-01 Dedifferentiated Leiomyosarcoma of the Uterus with Heterologous Elements: A Potential Diagnostic Pitfall Rawish, Kojo R. Fadare, Oluwole Case Rep Obstet Gynecol Case Report Dedifferentiation is a phenomenon that is well characterized in a variety of tumors and is defined by the occurrence of a high-grade or undifferentiated tumor, typically unrecognizable regarding its line of differentiation, from a low-grade/borderline neoplasm. This phenomenon has previously been described in 2 uterine leiomyosarcomas, but both were devoid of heterologous elements. The authors describe herein a case of a dedifferentiated leiomyosarcoma of the uterus with osteoid heterologous elements, believed to be the first such reported case. The original tumor was a high-grade leiomyosarcoma with large low-grade and leiomyoma-like areas and whose constituent cells displayed intense nuclear immunoreactivity for both estrogen receptor (ER) and progesterone receptor (PR) in approximately 30% of cells. The tumor recurred six months after its resection as an undifferentiated sarcoma that was negative for smooth muscle markers, but which remained positive for ER and PR. Osteoid production was only identified in the recurrent tumor and was significant in extent therein. This case highlights the immunophenotypic changes that may occur in dedifferentiated leiomyosarcomas, and this possibility should be a consideration when an apparently undifferentiated sarcoma is identified in a patient with a history of uterine leiomyosarcoma. In our case, the expression of ER and PR provided significant supportive evidence of the uterine origin of the recurrent tumor. Hindawi Publishing Corporation 2012 2012-10-17 /pmc/articles/PMC3483660/ /pubmed/23119198 http://dx.doi.org/10.1155/2012/534634 Text en Copyright © 2012 K. R. Rawish and O. Fadare. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Rawish, Kojo R.
Fadare, Oluwole
Dedifferentiated Leiomyosarcoma of the Uterus with Heterologous Elements: A Potential Diagnostic Pitfall
title Dedifferentiated Leiomyosarcoma of the Uterus with Heterologous Elements: A Potential Diagnostic Pitfall
title_full Dedifferentiated Leiomyosarcoma of the Uterus with Heterologous Elements: A Potential Diagnostic Pitfall
title_fullStr Dedifferentiated Leiomyosarcoma of the Uterus with Heterologous Elements: A Potential Diagnostic Pitfall
title_full_unstemmed Dedifferentiated Leiomyosarcoma of the Uterus with Heterologous Elements: A Potential Diagnostic Pitfall
title_short Dedifferentiated Leiomyosarcoma of the Uterus with Heterologous Elements: A Potential Diagnostic Pitfall
title_sort dedifferentiated leiomyosarcoma of the uterus with heterologous elements: a potential diagnostic pitfall
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3483660/
https://www.ncbi.nlm.nih.gov/pubmed/23119198
http://dx.doi.org/10.1155/2012/534634
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