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self index.cfm
site_filepath /www/sites/mfapp/templates/main/
 
Alan Trachtenberg, Md  
     
     


histology and general description

(More Micrographs)

General Search on Combo Chemo & Leiomyosarcoma:
Remission due to CYVADIC chemotherapy of primary leiomyosarcoma derived from mesentelium of the sigmoid colon: a case report] [Article in Japanese] Takano M, Kita T, Kiuchi Y, Nagata I.

Uterine myxoid leiomyosarcoma and YVADIC-etoposide therapy. Fukunishi H, Yukimura N, Takeuchi S, Kitazawa S.


(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Display&dopt=pubmed_pubmed&from_uid=7806003)

Anticancer Drugs 1996 Nov;7(8):885-9
Remission of advanced uterine leiomyosarcoma with pulmonary metastases with carboplatin and paclitaxel.

Kudelka AP, Termrungruanglert W, Vadhan-Raj S, Edwards CL, Varma DG, Tornos C, Verschraegen CF, Kavanagh JJ.
University of Texas MD Anderson Cancer Center, Houston 77030, USA.
A patient who had a high-grade uterine leiomyosarcoma (LMS) with extensive intra-abdominal and pulmonary metastases at the time of diagnosis underwent supracervical hysterectomy, bilateral salpingo-oophorectomy and tumor reductive surgery. She then received induction chemotherapy with paclitaxel 135 mg/m2 over 24 h and carboplatin (target AUC = 7.5 mg.ml/min) monthly for seven courses, achieving remission with a small amount of residual disease. The treatment was well tolerated except for peripheral neuropathy. Accordingly, the combination of carboplatin and paclitaxel may be considered in patients with advanced high-grade LMS of the uterus, and this regimen warrants further study in this disease.



Gemcitabine (Gemzar) Drug for Cancer: Use, Side Effects, Interactions

Gemcitabine (Gemzar) Drug for Cancer: Use, Side Effects, Interactions

Eli Lilly and Company Gemzar Page

GEMZAR®
(GEMCITABINE HCl) FOR INJECTION (Package Insert) - Eli Lilly


Specific Chemotherapy Drugs

Flavoperidol

the NCI site that describes the gemcitabine plus flavopiridol trial

NCI Links to Other Web Sites/Resources

Uterine Cancer Treatment Tool from PDR.net

Investigational role of gemcitabine in Advanced breast cancer

Understanding the Approval Process for New Cancer Drugs

Google search on Gemcitabine & Leiomyosarcoma

Gemzar: The CancerBACUP Factsheet


Lilly Gemzar Resources

Google search on Gemcitabine & Sarcoma treatment

Searching for trials at NCI

Am Soc for Clinical Oncology Search Page

Specific Uterine Sarcoma trials at the James

Leiomyosarcoma: General Information for the public

Interesting Thalidomide trial at University of Massachusetts Memorial Medical Center, Worcester, Massachusetts, 01655, United States; Recruiting
Harrison George Ball, III 508-334-1160


Support for Sarcoma Patients

(Under Construction)

(Under Construction)

(Under Construction)

(Under Construction)

(Under Construction)

(Under Construction)

(Under Construction)

General Search on Combo Chemo & Leiomyosarcoma:
Remission due to CYVADIC chemotherapy of primary leiomyosarcoma derived from mesentelium of the sigmoid colon: a case report] [Article in Japanese] Takano M, Kita T, Kiuchi Y, Nagata I.

Uterine myxoid leiomyosarcoma and YVADIC-etoposide therapy. Fukunishi H, Yukimura N, Takeuchi S, Kitazawa S.


(http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Display&dopt=pubmed_pubmed&from_uid=7806003)

Anticancer Drugs 1996 Nov;7(8):885-9
Remission of advanced uterine leiomyosarcoma with pulmonary metastases with carboplatin and paclitaxel.

Kudelka AP, Termrungruanglert W, Vadhan-Raj S, Edwards CL, Varma DG, Tornos C, Verschraegen CF, Kavanagh JJ.
University of Texas MD Anderson Cancer Center, Houston 77030, USA.
A patient who had a high-grade uterine leiomyosarcoma (LMS) with extensive intra-abdominal and pulmonary metastases at the time of diagnosis underwent supracervical hysterectomy, bilateral salpingo-oophorectomy and tumor reductive surgery. She then received induction chemotherapy with paclitaxel 135 mg/m2 over 24 h and carboplatin (target AUC = 7.5 mg.ml/min) monthly for seven courses, achieving remission with a small amount of residual disease. The treatment was well tolerated except for peripheral neuropathy. Accordingly, the combination of carboplatin and paclitaxel may be considered in patients with advanced high-grade LMS of the uterus, and this regimen warrants further study in this disease.



Gemcitabine (Gemzar) Drug for Cancer: Use, Side Effects, Interactions

Gemcitabine (Gemzar) Drug for Cancer: Use, Side Effects, Interactions

Eli Lilly and Company Gemzar Page


Specific Chemotherapy Drugs

Flavoperidol

the NCI site that describes the gemcitabine plus flavopiridol trial

NCI Links to Other Web Sites/Resources

Uterine Cancer Treatment Tool from PDR.net

Investigational role of gemcitabine in Advanced breast cancer

Understanding the Approval Process for New Cancer Drugs

Google search on Gemcitabine & Leiomyosarcoma

Gemzar: The CancerBACUP Factsheet


Lilly Gemzar Resources

Google search on Gemcitabine & Sarcoma treatment

Searching for trials at NCI

Am Soc for Clinical Oncology Search Page

Specific Uterine Sarcoma trials at the James

Leiomyosarcoma: General Information for the public

Interesting Thalidomide trial at
Tufts University School of Medicine, Boston, Massachusetts, 02111, United States; Recruiting:
Evelyn Nunez 617-636-6058


Support for Sarcoma Patients

GEMZAR®
(GEMCITABINE HCl) FOR INJECTION (Package Insert) - Eli Lilly


Cancer Medicine. 5th ed.
Bast, Robert C.; Kufe, Donald W.; Pollock, Raphael E.; Weichselbaum, Ralph R.; Holland, James F.; Frei, Emil, editors.Canada: BC Decker Inc; c2000.


Request # 14637898 was sent to MDUZCA for:
Abramson S; Gilkeson RC; Goldstein JD; Woodard PK; Eisenberg R; Abramson N
Benign metastasizing leiomyoma: clinical, imaging, 2001 Jun;176(6):1409-13.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11373202

AJR Am J Roentgenol. 2001 Jun;176(6):1409-13. Related Articles, Links

Benign metastasizing leiomyoma: clinical, imaging, and pathologic correlation.

Abramson S, Gilkeson RC, Goldstein JD, Woodard PK, Eisenberg R, Abramson N.

Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106, USA.

OBJECTIVE: We describe the clinical presentation and the radiographic and CT findings of benign metastasizing leiomyoma. CONCLUSION: Benign metastasizing leiomyoma is an asymptomatic disease characterized by well-defined, numerous, pulmonary lesions without a preponderant distribution.

PMID: 11373202 [PubMed - indexed for MEDLINE]
__

http://www.vh.org/adult/provider/radiology/ITTR/BenignMetaLeiomyoma/BngMetaLeiomyoma.html

__


AJR Am J Roentgenol. 1983 Aug;141(2):269-72. Related Articles, Links
Leiomyomatous lung lesions: a proposed classification.
Martin E.
A case of multiple pulmonary leiomyomas is presented. In a review of the literature, a confusing array of rare diseases all pertaining to multiple leiomyomas was found. These were reduced to three entities: leiomyomatosis in women, metastatic leiomyoma in men and children, and multiple pulmonary fibroleiomyomatous hamartoma occurring in anyone. The leiomyomatous diseases in women are related to uterine leiomyomas and they are hormone-sensitive. This is of great prognostic importance. The classification, definitions, and discussion should prove helpful in understanding these rare multiple diseases.

Publication Types:
Case Reports
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6603116



Women at risk if benign metastasizing leiomyoma develops from uterine leiomyoma
Leiomyoma
July 13, 2004
2004 JUL 13 - (NewsRx.com & NewsRx.net) -- If benign metastasizing leiomyoma develops from metastasizing uterine leiomyoma, speculate researchers, many women may be at risk for the disease.
"Benign metastasizing leiomyoma (BML) is a rare disease, with 100 cases reported in the literature through 2003. Initially described by Steiner in 1939, it was believed to be a primary lung neoplasm and was referred to as fibroleiomyomatous hamartoma. This name was challenged and changed some 40 years later in 1977, when a series of specimens were interpreted as metastatic implantation from benign uterine myomas," wrote S. Pitts and colleagues, University of Miami.
"The term 'BML' describes the presence of benign smooth muscle tumors in an organ distant from the uterus, most commonly the lung, usually associated with a current or prior history of uterine leiomyomata. The disease is usually present in premenopausal women, several years after a myomectomy or hysterectomy for uterine fibroids," explained the researchers.
"The prevalence of BML is unknown, as most women are diagnosed after an incidental abnormal chest radiograph. However, uterine leiomyomas are the most common neoplasm in the female genital tract, present in 20% to 30% of women over the age of 30, more than 40% of women over the age of 40, and are more common in black women.
"Uterine leiomyomas develop during the reproductive period when hormonal effects are at a maximum level, enlarge during pregnancy, and regress after menopause," Pitts and coauthors continued.
"Therefore," they suggested, "if BML develops from metastasizing uterine leiomyoma, this could place a large population of women at risk for the disease."
Pitts and coauthors published their study in Clinics in Chest Medicine (Benign metastasizing leiomyoma and lymphangioleiomyomatosis: sex-specific diseases? Clin Chest Med, 2004;25(2):343).
For additional information, contact M.K. Glassberg, University of Miami, School of Medicine, Vascular Biology Institute, Department Med, Division Pulmonology & Critical Care, 1600 NW 10th Avenue, Miami, FL 3316 USA.
The publisher of the journal Clinics in Chest Medicine can be contacted at: W B Saunders Co., Independence Square West Curtis Center, Ste. 300, Philadelphia, PA 19106-3399 USA.
The information in this article comes under the major subject areas of Oncology and Women's Health. This article was prepared by Cancer Weekly editors from staff and other reports. Copyright 2004, Cancer Weekly via NewsRx.com & NewsRx.net.
©Copyright 2004, Women's Health Weekly via NewsRx.com & NewsRx.net
return to OBGYN.net Headline News ... (2001 archives)
____

Clin Chest Med. 2004 Jun;25(2):343-60. Related Articles, Links
FPRIVATE "TYPE=PICT;ALT=Click here to read"
Benign metastasizing leiomyoma and lymphangioleiomyomatosis: sex-specific diseases?

Pitts S, Oberstein EM, Glassberg MK.

Department of Internal Medicine, University of Rochester School of Medicine, Strong Memorial Hospital, 6704 Setters Run, Rochester, NY 14564, USA.

The striking similarity between benign metastasizing leiomyoma and lymphangioleiomyomatosis is that they both affect young women. This observation underscores the importance of gender-dependent variables in disease and our lack of understanding of gender differences. Many researchers are currently investigating the link between disease and hormone levels in the body. The beneficial role of estrogens remains in question in pulmonary medicine, and further ongoing research should help to define the role of hormones in the lung.

Publication Types:
Review
Review, Tutorial


http://rad.usuhs.mil/medpix/medpix.html?mode=tf_case&pt_id=7168¬hing=

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15099894


_______________________
Re: Lung Nodule is Benign Metastasizing Leioyoma
Date: Tue, 15 Jul 2003 08:28:12 -0600
Newsgroups: sci.med.diseases.cancer
Size: 11,858 bytes
"Steph" wrote in message
news:fELQa.436876$email-address-deleted...
>
> That's very encouraging, but I find it difficult to believe that the
> cytologist could ditinguish between metastatic leiomyosarcoma and a
"benign
> metastasising leiomyoma" on the basis of a needle biopsy.
>
> I have to admit, though, I've never even heard of the latter disease.
>
>
Yes, "benign metastasizing leiomyoma" is an unusual tumor---sounds a bit
like an oxymoron to have something metastatic that is benign, but
fortunately that's how it seems to behave. It's something you might want to
keep in the back of your mind in case you ever run across it, since a
misdiagnosis can lead to disastrous overtreatment not to mention the
psychological distress of thinking one has incurable sarcomatous metastasis
when that isn't the case at all!
There are about 70 pstgs in Medline, and it seems to be possible to tell
from a needle biopsy that that is a likely diagnosis---apparently the
absence of mitotic figures (at least in most cases) and the presence of
female sex hormone receptors and certain other immunohistochemical markers
are key features.
Dtsch Med Wochenschr. 2001 May 11;126(19):551-5.
[Benign metastasizing leiomyoma of the lung--a rare differential diagnosis
of pulmonary space-occupying lesions]
[Article in German]
Pawlik C, Wildberger JE, Tietze L, Matern S, Busch N.
Klinik fur Innere Medizin, Bundesknappschafts-Krankenhaus Bardenberg.
HISTORY AND ADMISSION FINDINGS: A 45-year-old woman was refferred for
diagnosis of an accidentally found symptomless space-occupying lesions in
the central part of the right lung. She had undergone a hysterectomy 4 years
before and reported smoking 15 cigarettes daily since the age of 17 years.
Physical examination was normal. INVESTIGATIONS: As primary bronchial
carcinoma or metastasis to the lung was suspected she underwent a series of
diagnostic tests: sonography, computed tomography (CT), gastroscopy,
coloscopy, bronchoscopy, skeletal scintigraphy, gynaecological examination
and various laboratory tests, none of which indicated a primary
extrapulmonary tumour. CT-guided fine-needle biopsy then suggested benign
metastasizing pulmonary leiomyoma (BMPL). TREATMENT AND COURSE: The largest
of the tumours were surgically removed, confirming BMPL. Hormone receptors
(for oestrogen, progesterone) having been demonstrated, progesterone
treatment was initiated as prophylaxis against recurrences. CT 6 months
later revealed new intrapulmonary foci. Administration of luteinizing
hormone-releasing hormone analog to stop completely any oestrogen effect,
and CT of the thorax 6 months later showed that both tumour numbers and
their size had been reduced. The patient remained asymptomatic and the
findings had not changed in the subsequent 12 months. CONCLUSION: BMPL is a
rare cause of a space-occupying pulmonary lesion, predominantly affecting
middle-aged women after hysterectomy for uterine myoma. The pathogenesis
remains unclear, hormone-dependent tumour growth being discussed as a
possible mechanism. Anti-oestrogen administration is the treatment of choice
to achieve remission and effective prevention of recurrences.
PMID: 11402911
-----------------------------
Acta Cytol. 1994 May-Jun;38(3):398-402.
Fine needle aspiration diagnosis of benign metastasizing leiomyoma of the
lung. A case report.
Hafiz MA, Wang KP, Berkman A.
Department of Pathology, University of Maryland School of Medicine,
Baltimore.
Percutaneous fine needle aspiration biopsy was performed on a woman with
multiple bilateral lung nodules. The cytology and histology showed a benign
spindle cell tumor compatible with benign metastasizing leiomyoma. The
patient had a history of hysterectomy 14 years earlier for a cellular
leiomyoma with atypia. No significant mitosis was present in either the
uterine tumor or lung metastasis.
PMID: 8191830
--------------------------------
Virchows Arch. 2000 Sep;437(3):284-92.
Benign metastasizing leiomyoma of the uterus: documentation of clinical,
immunohistochemical and lectin-histochemical data of ten cases.
Kayser K, Zink S, Schneider T, Dienemann H, Andre S, Kaltner H, Schuring MP,
Zick Y, Gabius HJ.
Department of Pathology, Thoraxklinik, Heidelberg, Germany. email-address-deleted
The clinical histories of 10 women suffering from benign metastasizing
leiomyoma (BML) after hysterectomy and information on lung lesions detected
in these women are presented, together with corresponding data for 2 women
with metastasizing leiomyosarcoma of the uterus for comparison: gross
appearance, survival, and light microscopical, immunohistochemical and
lectin-histochemical findings are reported. All patients with BML had
undergone hysterectomy for uterus leiomyomatosus without any detection of
sarcomatous lesions in the uterus wall. After a median period of 14.9 years
intrapulmonary masses were detected by imaging techniques. On average, six
nodules with a mean diameter of 1.8 cm were seen. Resection of the lesions
was performed in all cases. The immunohistochemical and lectin-histochemical
examination of the tumors included analysis of the proliferation-associated
protein Ki-67, the p53 protein, estrogen and progesterone receptor,
sarcolectin as an indicator of the presence of lymphokine macrophage
migration inhibitory factor, antibodies and the labeled protein to assess
galectin (galactoside-binding animal lectin)-dependent parameters, analysis
of tumor vascularization (CD-34), and expression of bcl-2, vimentin, smooth
muscle actin, desmin, and keratin. The lesions were characterized by low
proliferation activity of 2.9% (measured with Ki-67), frequent hormone
receptor expression (8 of the 10 cases presented hormone-specific
receptors), low to moderate vascularization compared with metastases from
the two uterine sarcomas, remarkable p53 overexpression and frequent
expression of the lymphokine, the galectins and accessible binding sites.
{Abstract truncated}
PMID: 11037349
-------------------------
*****There are a lot of articles debating if these things are truly
metastatic from the uterine leiomyoma or if they represent a tendency to
form lots of little benign leiomyomas in various places including the lung,
but at least in this study, they seem to be clonal metastases from the
primary tumor.
Hum Pathol. 2000 Jan;31(1):126-8.
Benign metastasizing leiomyoma: a cytogenetically balanced but clonal
disease.
Tietze L, Gunther K, Horbe A, Pawlik C, Klosterhalfen B, Handt S,
Merkelbach-Bruse S.
Institute of Pathology and Department of Internal Medicine, Aachen
University of Technology, Germany.
Benign metastasizing leiomyoma (BML) is a rare condition, characterized by
the occurrence of multiple smooth-muscle nodules, most often located in the
lung after previous hysterectomy because of histologically benign appearing
leiomyoma. Although the condition resembles a metastatic process, case
studies provided evidence that it may be the result of an intravenous
leiomyomatosis or an independent and multifocal smooth-muscle proliferation.
Comparative genomic hybridization and X-chromosome inactivation analysis
were used in a case of BML to determine whether pulmonary and uterine tumors
are related one to another. A balanced karyotype, previously reported in
leiomyomas and an identical X-chromosome inactivation pattern found in all
tumorlets, is most consistent with a monoclonal origin of both uterine and
pulmonary tumors and the interpretation that pulmonary lesions are
metastatic.
PMID: 10665925
--------------------------------
***Apparently some of these tumors tend to shrink by themselves after
menopause:
Arai T, Yasuda Y, Takaya T, Shibayama M.Natural decrease of benign
metastasizing leiomyoma.
Chest. 2000 Mar;117(3):921-2. No abstract available.
PMID: 10713035 [PubMed - indexed for MEDLINE
Free full-text article available online
--------------------------------------
The lung isn't the only site of these metastases:
Nihon Kokyuki Gakkai Zasshi. 1999 Feb;37(2):146-50.
[So-called benign metastasizing leiomyoma of the lung presenting with bone
metastases]
[Article in Japanese]
Nakanishi S, Nakano K, Hiramoto T, Shimizu M, Nakamura K, Yamane N.
Department of Internal Medicine, Kure National Hospital, Hiroshima, Japan.
The patient, a 42-year-old woman, was admitted to our hospital because of
abnormal shadows on chest X-ray films obtained during a routine medical
check-up. Her medical history included a uterine myomectomy at the age of
21, and thereafter, periodic lumbago and back pain for which she had not
sought any medical treatment. Chest computed tomography detected a number of
pulmonary nodules in both whole lung fields, and magnetic resonance imaging
revealed many spherical metastatic lesions in the thoracic and lumbar
vertebrae. Although we initially suspected lung cancer, no primary lesion
was found. A thoracoscopic lung biopsy revealed leiomyomatous tumors that
were histologically similar to the uterine myoma removed 21 years
previously. The final diagnosis was so-called benign metastasizing leiomyoma
(BML). Because the removed tumor contained a high concentration of
progesterone receptors (240 fmol/mg), a gonadotropin-releasing hormone
analogue was administered, and proved effective in relieving the patient's
periodic lumbago and back pain. The findings in this case suggested that the
so-called BML was in fact a metastasis of a low-grade uterine
leiomyosarcoma.
PMID: 10214045
-------------------------
Am J Surg Pathol. 1998 Jul;22(7):897-901. Related Articles, Links
Multiple smooth muscle tumors arising in deep soft tissue of lower limbs
with uterine leiomyomas.
Horiuchi K, Yabe H, Mukai M, Morioka H, Udagawa Y, Nozawa S, Yabe Y.
Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo,
Japan.
A 40-year-old woman had multiple smooth muscle tumors in the left inguinal
region, the bilateral thighs, the omentum, the peritoneum, and the right
infundibulum pelvic ligament associated with uterine leiomyomas. She had a
history of uterine leiomyomas, which were resected 13 years ago.
Histopathologic evaluation revealed tumor masses composed of smooth muscle
cells with relatively low cellularity, which were consistent with a
diagnosis of leiomyoma. Tumor necrosis and nuclear atypia were absent.
Mitotic figures were very scarce (less than 1 mitotic figure per 10
high-power fields). Immunohistochemical evaluation revealed a positive
reaction of the tumor cells to muscle markers, estrogen receptors, and
progesterone receptors. No pulmonary lesion was found. Similar instances of
uterine leiomyomas with histologically benign extrauterine smooth muscle
tumors have been reported. This curious condition has been referred to as
"benign metastasizing leiomyoma," in which most of the reported cases
involve the lungs. The distribution of extrauterine tumors in our case is
very unusual and may be the first case with multiple leiomyomas in deep soft
tissue of the limbs. Consideration was given to the concept that these may
be of multifocal origin, rather than metastases.
Publication Types:
Review
Review of Reported Cases
PMID: 9669352
----------------------------------
I suspect that some cases of "cured" metastatic leiomyosarcomas may have
been misdiagnosed benign metastasizing leiomyomas. One friend of mine (who
had had a hysterectomy several years before) was found to have multiple
pulmonary "leiomyosarcomas" supposedly metastatic from a lesion on her leg
similar to the ones in the above article, and despite being told that
long-term survival was unlikely with widespread lung mets, she has done fine
for about 10 years after a round of chemo, and she seems to have no further
problem, which I doubt would have been the case had it been truly a
soft-tissue sarcoma with lung mets.
]
http://www.ultrasound-technician.com/school_of_ultrasound/diagnostic_medical_sonography_school/diagnostic_medical_sonography_school_msg29639/diagnostic_medical_sonography_school_msg29639.shtml

http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijtcvs/vol6n1/myoma.xml


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