J Korean Surg Soc.  2013 Jan;84(1):66-69.

Metastatic leiomyosarcoma of the intrapancreatic bile duct

• Perysinakis I
• Katopodi A
• Avlonitis
• Georgiadou D
• Choreftaki T
• Christopoulos G
• Margaris I

Abstract

We report the case of a patient with a history of surgically treated pulmonary leiomyosarcoma, presenting with recurrent acute cholangitis and metastatic leiomyosarcoma of the common bile duct. Preoperative examinations had revealed a high grade malignant neoplasm and bilateral lung metastases. The patient underwent pylorus-preserving pancreaticoduodenectomy and survived for 5.5 years after the first diagnosis.

Keyword

Leiomyosarcoma; Neoplasm metastasis; Common bile duct

MeSH Terms

Bile
Bile Ducts
Cholangitis
Common Bile Duct
Humans
Leiomyosarcoma
Lung
Neoplasm Metastasis
Pancreaticoduodenectomy

Figure

• 

  Fig. 1 Leiomyosarcoma arising from the intrapancreatic common bile duct. The tumor infiltrates the full thickness of the common bile duct, extends into its lumen and invades the pancreas. Tumor cell necrosis, high cellularity, many mitotic counts, pleomorphism, and nuclear atypia are present in the neoplasm (H&E, ×10).

• 

  Fig. 2 Leiomyosarcoma arising from the intrapancreatic common bile duct (Desmin, ×10).

• 

  Fig. 3 Leiomyosarcoma arising from the intrapancreatic common bile duct (smooth muscle actin, ×20).

Reference

1. Riddle ND, Quigley BC, Browarsky I, Bui MM. Leiomyosarcoma arising in the pancreatic duct: a case report and review of the current literature. Case Report Med. 2010. 2010:252364.

2. Naik MJ, Lim CH, Agasthian T. Primary pulmonary leiomyosarcoma: a rare presentation. Asian Cardiovasc Thorac Ann. 2000. 8:67–69.

3. Arnold LM 3rd, Burman SD, O-Yurvati AH. Diagnosis and management of primary pulmonary leiomyosarcoma. J Am Osteopath Assoc. 2010. 110:244–246.

4. Hayashi T, Tagawa T, Ashizawa K, Abe K, Kinoshita N, Tsutsui S, et al. Contrast-enhanced dynamic magnetic resonance imaging of primary pulmonary leiomyosarcoma. Tohoku J Exp Med. 2006. 210:263–267.

5. Dubose JJ, Sutherland MJ. Primary pulmonary spindle cell neoplasm. Curr Surg. 2005. 62:341–343.

6. Hur YH, Kim HH, Park EK, Seoung JS, Kim JW, Jeong YY, et al. Primary leiomyosarcoma of the pancreas. J Korean Surg Soc. 2011. 81:Suppl 1. S69–S73.

7. Ip PP, Tse KY, Tam KF. Uterine smooth muscle tumors other than the ordinary leiomyomas and leiomyosarcomas: a review of selected variants with emphasis on recent advances and unusual morphology that may cause concern for malignancy. Adv Anat Pathol. 2010. 17:91–112.