• Journal of Chest Surgery
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• v.35 no.10
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• pp.764-767
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• 2002

An unusual case of primary leiomyosarcoma at the left lower posterior chest wall with metastasis to the right lung parenchyme is presented. The patient was a 43-year-old man who was asymptomatic but a slow growing hard mass was noted at the left lower posterior chest wall. The chest computed tomography showed a tumor at the left lower posterior chest wall with multiple metastasis to the right lung. The left lower posterior chest wall mass was examined by percutaneous needle aspiration and it was revealed as rhabdomyosarcoma histologically. En bloc resection to the left lower posterior chest wall tumor and metastasectomy to the multiple nodules in the right lung were done and pathological examination finally revealed primary leiomyosarcoma at the left lower posterior chest wall with multiple metastasis to the right lung. Chemotherapy was scheduled as adjunctive measure.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.309-313
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• 2000

The metastasis of uterine leiornyosarcorna to the neck node has not been reported previously and the radiotherapy has been rarely used for the metastatic lesion of the other sites. We report a case of neck metastasis from a uterine leiornyosarcorna, which developed 10 months after surgery and postoperative pelvic radiotherapy. It also involved the parapharyngeal space, adjacent spine, and spinal canal. The metastatic neck mass was inoperable, and was treated by neck radiotherapy (6,000 cGy) and chemotherapy including taxol and carboplatin. The mass has regressed progressively to a nearly impalpable state. She has never developed spinal cord compression syndrome, and has maintained good swallowing for eight months since the neck radiotherapy and chemotherapy. Since the extensive metastatic neck mass showed good local response to high dose radiotherapy and chemotherapy, both treatments may be considered for an unresectable metastatic leiornyosarcorna.

• Journal of Yeungnam Medical Science
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• v.15 no.1
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• pp.114-124
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• 1998

We analyzed the mammographic (n=21) findings (location, margin, shape, cluster microcalcifications, size, multiplicity) and ultrasonographic (n=12) findings (shape, border, internal echo, boundary echo, posterior echo, lateral echo, width/depth ratio) to evaluate specific radiologic findings of histopathologically proved uncommon breast cancer. The mammographic findings (n=21) are as follow; 1) single; 16, multiple; 5 2) margin (smooth; 13, irregular; 4, spiculated; 4) 3) shape (round and ovoid; 9, lobulated; 8, irregular; 4) 4) cluster micro calcifications (abscent; 20, present; 1) 5) size (1-3cm; 18, 3-5cm; 2, 5cm> ; 1) 6) location (UOQ; 13, UIQ; 4, LIQ; 3, LOQ; 1). The ultrasonographic findings (n=12) are as follow; 1) shape (round to oval; 5, lobulated; 5, irregular; 2) 2) border (smooth even; 9, rough uneven; 3) 3) internal echo (fine homogeneous; 5, coarse heterogeneous; 7) 4) boundary echo (regular fine; 4, irregular thick; 8) 5) posterior echo (enhanced; 11, no change; 1) 6) lateral echo (marked; 7, nonexistent; 5) 7) width/depth ratio (1.5> ; 1, 1.0-1.5; 7, 1.0< ; 4). Uncommon breast cancer show benign nature on mammogram, but malignant nature on ultrasonogram (especially boundary echo, internal echo, width/depth ratio).

• The Korean Journal of Cytopathology
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• v.7 no.1
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• pp.107-110
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• 1996

Cytologic findings of 2 cases of metastatic leiomyosarcoma diagnosed by fine needle aspirtion cytology are reported. Case 1 is pleomorphic leiomyosarcoma which had metastsized to the liver from the stomach of a 54-year-old male patient. The cytologic features showed highly cellular aspirates with nuclear pleomorphism and interlacing pattern. Case 2 is low grade leiomyosarcoma that occurred in the uterus of a 43-year female patient and metastsized to both lungs. The aspirates were less cellular than that of case 1, and showed spindle cells with minimal pleomorphism, but ceil block revealed interlacing patterns of smooth muscle cells with occasional mitosis.

• Journal of Korean Traditional Oncology
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• v.24 no.1
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• pp.11-18
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• 2019

Objective: The purpose of this study is to report the effectiveness and possibility of Integrative Cancer Treatment (ICT) on an advanced metastatic leiomyosarcoma patient. Methods: The patient was diagnosed with recurred and advanced metastatic Leiomyosarcoma, suffering from dyspnea, abdominal discomfort, lower limb edema. The patient refused conventional treatment, such as chemotherapy, radiotherapy but was treated with ICT including acupuncture, pharmacopuncture, moxibustion, hypertherapy and herbal medicine for symptom management. The clinical outcomes were measured by NRS (Numeral rating scale). Results: After treatment, dyspnea, abdominal discomfort and lower limb edema was relieved from NRS 6 to 3, 7 to 3 and 7 to 6 respectively. Also, loss of body weight, decrease in abdominal, thigh and calf circumference were improved. During and after treatment, we found neither hepatotoxicity nor nephrotoxicity on laboratory findings. Conclusion: This case study suggests that ICT may improve symptom relief and life quality of leiomyosarcoma patient.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.44-51
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• 2009

Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.61-70
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• 2004

Purpose: We studied to decide the operative indication of the metastatic tumor in pelvis according to the oncologic results, the Eastern Cooperative Oncologic Group (ECOG) performance status and complication. Materials and methods: From May 1994 to May 2003, 9 patients who were performed on palliative treatment and 10 paitents on operative treatment due to metastatic tumor of pelvic bone were investigated. On palliative/operative group, the mean age of patients was 57.6/48.0 years old and the ratio of male to female was 5:4/7:3. Primary origins were 3 cases from kidney, 3 from cervix and 2 of lung, 2 of myeloma, 2 of Non-Hodgkin's Lymphoma, and 1 from breast, bladder, testis, prostate, stomach, liver and retroperitoneal leimyosarcoma respectively. The palliative treatment was performed in 5 cases with radiotherapy, 1 with chemotherapy, 2 with combined chemo-radiotherapy and 1 with percutaneous cementation. The operative methods were 1 case of bone cement insertion after curettage, 2 of Girdlestone with internal hemipelvectomy and 7 of reconstruction after wide excision. Reconstructions were done.: 1 case of bone cementation, 5 of autograft prosthesis composite with irradiation or pastuerization and 1 of saddle prosthesis. We have observed the oncologic results, the ECOG performance status and complication. Results: The oncologic results of palliative/operative groups are NED 0/1, AWD 2/6, DOC 1/2 and DOD 6/1. The ECOG performance status was changed from 1.5 into 4.3 in palliative group and from 2.6 into 2.2 in operative group. The complications were 3 cases of the prosthesis failure and 2 of infection. Conclusion: The indication of operation of metastatic pelvic tumor is decided in consideration of the patient's condition, the grade of malignancy in primary tumor and the life expectancy.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.1
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• pp.10-16
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• 2000

Object : The aim of the current study is to assess the results of segmental resection and replantation for primary malignant or aggressive tumors of the upper limb. Materials and Methods : From 1986 to 1994, ten patients who had primary malignant or aggressive tumors of the upper limb were managed with segmental resection and replantation method. The average duration of follow-up was 7 years and 7 months. Primary indication of this method is stage II B tumors which, because of their extend, could otherwise be adequately treated only by amputation. Three patients had chondrosarcoma, two had osteosarcoma, two had giant cell tumors with pathologic fracture, one had extensive chondroblastoma, one had Ewings sarcoma, and one had leiomyosarcoma. The location of the tumor was humerus in 6 patients, scapula in 3 patients, and soft tissue of forearm in 1 patient. Wide resection margins were achieved in 7 patients and marginal margin in three. Results : One patient died on 40 months after surgery due to systemic metastasis. Nine patients have remained disease free without local recurrence or metastasis. The average overall functional rating was 65% (43~90%) for ten patients on the last follow-up by the functional rating system of Enneking. The mean grasping power and pinching power of operative hand was 75%(28~95%) and 65%(43~90%) of the opposite hand, respectively. Complications associated with this surgical method included three wound dehiscences and one nerve injury that resolved with proper wound care and time. Conclusion : It was concluded that segmental resection and replantation might be used for partial limb salvage in selected cases for the treatment of primary malignant or aggressive tumors of the upper limb.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.154-163
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• 1995

With the development of anticancer chemotherapy and improved radiographic imaging studies, limb salvage operation became possible in the treatment of malignant and aggressive benign tumors. High grade sarcomas of the shoulder or the upper extremity can be surgically treated with a forequarter amputation, shoulder disarticulation or limb salvage surgery such as Tikhoff-Linberg procedure, segmental resection and replacement with endoprosthesis, segmental resection and replantation, or segmental resection and free vascularized bone graft. Among them the limb salvage surgery showed not only preservation of the remained upper extremity but also the excellent functional results. When comparing amputation and limb salvage operation while performing anticancer chemotherapy in both cases, 5 year survival rate, local recurrence, and distant metastasis did not show much difference. We studied 13 cases of limb salvage for the malignant and aggressive benign bone tumor of the upper extremity from March 1986 to December 1993 at Severance hospital. The summarized results were as follows. 1. There were 21 cases of malignant bone tumors and 5 cases of benign aggressive ones. 2. Of the 26 cases of malignant and benign aggressive bone tumors, limb salvage procedures such as Tikhoff-Linberg operation(8 cases), endoprosthetic replacement(2 cases), segmental resection and replantation(2 cases), and segmental resection and free vascularized fibular graft(l case) were done in 13 cases. 3. In 13 patient on whom the limb salvage procedure was performed, there were 3 osteosarcomas, 4 chondrosarcomas, 3 giant cell tumors, 1 Ewing's sarcoma, 1 leiomyosarcoma and 1 chondroblastoma. 4. In 13 patients, there was no local recurrence nor distant metastasis except one who had a segmental resection of the entire humerus part including glenoid and then postoperative anticancer chemotherapy for the treatment of the Ewing's sarcoma of the entire shaft of the humerus with pathological fracture. Local recurrence occurred 2 years and 6 months postoperatively in this Ewing's sarcoma patient, so forequarter amputation was performed and the irradiation and the anticancer chemontherapy were performed, but multiple bony metastasis developed and died of the disease 22 months after local recurrence. 5. The patients were followed-up for I year to 7 years and 5 months(average 4 years 5 months). 6. In 8 cases in which Tikhoff-Linberg procedure was performed, the function of the hand was almost normal. 7. Segmental resection and endoprosthetic replacement was performed in 2 cases, and the function of the remained upper extremity was good with no evidence of aseptic loosening or nerve palsy. 8. In 1 case of segmental resection and free vascularized fibular graft for the patient of the chon drosarcoma in the humerus, the function of the shoulder, elbow and hand was nearly normal. 9. In I case of leiomyosarcoma which involved both forearm muscles and bone near wrist joint, segmental resection and replantation was performed, and the patient has useful hand function.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.17-25
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• 1998

Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.