SS  Vol.4 No.8 , August 2013
High-Grade Extremity Myxofibrosarcoma with Synchronous Mesenteric Leiomyosarcoma: Double Primary Sarcomas

Here, we report the case of a 47-year-old male who presented with a painless palpable mass in the right shoulder. This extremity tumor was diagnosed as a high-grade myxofibrosarcoma after a wide excision. Simultaneously, a synchronous mesenteric mass was discovered, which proved to be a leiomyosarcoma.

Cite this paper
M. Shin and S. Kim, "High-Grade Extremity Myxofibrosarcoma with Synchronous Mesenteric Leiomyosarcoma: Double Primary Sarcomas," Surgical Science, Vol. 4 No. 8, 2013, pp. 345-349. doi: 10.4236/ss.2013.48068.

[1]   E. G. Demicco and A. J. Lazar, “Clinicopathologic Considerations: How Can We Fine Tune Our Approach to Sarcoma?” Seminars in Oncology, Vol. 38, Suppl. 3, 2011, pp. S3-18. doi:10.1053/j.seminoncol.2011.09.001

[2]   D. G. Hope and J. J. Mulvihill, “Malignancy in Neurofibromatosis,” Advances in Neurology, Vol. 29, 1981, pp. 33-56.

[3]   D. H. Abramson, M. R. Melson, I. J. Dunkel and C. M. Frank, “Third (Fourth and Fifth) Nonocular Tumors in Survivors of Retinoblastoma,” Ophthalmology, Vol. 108, No. 10, 2001, pp. 1868-1876. doi:10.1016/S0161-6420(01)00713-8

[4]   P. Aurello, C. Cicchini, R. De Angelis, et al., “Synchronous and Metachronous Retroperitoneal Sarcomas: Two Case Reports,” Anticancer Research, Vol. 22, No. 4, 2002, pp. 2409-2412.

[5]   F. P. Li, J. F. Fraumeni, J. J. Mulvihill, et al., “A Cancer Family Syndrome in Twenty-Four Kindreds,” Cancer Research, Vol. 48, No. 18, 1988, pp. 5358-5362.

[6]   S. Sleijfer, C. Seynaeve and J. Verweij, “Using Single-Agent Therapy in Adult Patients with Advanced Soft Tissue Sarcoma Can Still Be Considered Standard Care,” Oncologist, Vol. 10, No. 10, 2005, pp. 833-841.

[7]   M. Tascilar, W. J. Loos, C. Seynaeve, J. Verweij and S. Sleijfer, “The Pharmacologic Basis of Ifosfamide Use in Adult Patients with Advanced Soft Tissue Sarcomas,” Oncologist, Vol. 12, No. 11, 2007, pp. 1351-1360.

[8]   R. W. Mutter, S. Singer, Z. Zhang, M. F. Brennan and K. M. Alektiar, “The Enigma of Myxofibrosarcoma of the Extremity,” Cancer, Vol. 118, No. 2, 2012, pp. 518-527. doi:10.1002/cncr.26296

[9]   T. Mentzel, E. Calonje, C. Wadden, et al., “Myxofibrosarcoma. Clinicopathologic Analysis of 75 Cases with Emphasis on the Low-Grade Variant,” The American Journal of Surgical Pathology, Vol. 20, No. 4, 1996, pp. 391-405. doi:10.1097/00000478-199604000-00001

[10]   S. W. Weiss and F. M. Enzinger, “Myxoid Variant of Malignant Fibrous Histiocytoma,” Cancer, Vol. 39, No. 4, 1977, pp. 1672-1685. doi:10.1002/1097-0142(197704)39:4<1672::AID-CNCR282039044 2>3.0.CO;2-C

[11]   L. Angervall, L. G. Kindblom and C. Merck, “Myxofibrosarcoma. A Study of 30 Cases,” Acta Pathologica Microbiologica Scandinavica Section A Pathology, Vol. 85A, No. 2, 1977, pp. 127-140. doi:10.1111/j.1699-0463.1977.tb00410.x

[12]   A. Gronchi, S. Lo Vullo, C. Colombo, et al., “Extremity Soft Tissue Sarcoma in a Series of Patients TREATED at a Single Institution: Local Control Directly Impacts Survival,” Annals of Surgery, Vol. 251, No. 3, 2010, pp. 506-511. doi:10.1097/SLA.0b013e3181cf87fa

[13]   P. Gustafson, H. Willen, B. Baldetorp, et al., “Soft Tissue Leiomyosarcoma. A Population-Based Epidemiologic and Prognostic Study of 48 Patients, Including Cellular DNA Content,” Cancer, Vol. 70, No. 1, 1992, pp. 114-119. doi:10.1002/1097-0142(19920701)70:1<114::AID-CNCR282070011 9>3.0.CO;2-U

[14]   D. Massi, G. Beltrami, M. M. Mela, et al., “Prognostic Factors in Soft Tissue Leiomyosarcoma of the Extremities: A Retrospective Analysis of 42 Cases,” European Journal of Surgical Oncology, Vol. 30, No. 5, 2004, pp. 565-572. doi:10.1016/j.ejso.2004.03.002

[15]   G. D. Demetri, S. Antonia, R. S. Benjamin, et al., “Soft Tissue Sarcoma,” Journal of the National Comprehensive Cancer Network, Vol. 8, No. 6, 2010, pp. 630-674.

[16]   K. Miyajima, Y. Oda, Y. Oshiro, et al., “Clinicopathological Prognostic Factors in Soft Tissue Leiomyosarcoma: A Multivariate Analysis,” Histopathology, Vol. 40, No. 4, 2002, pp. 353-359. doi:10.1046/j.1365-2559.2002.01361.x

[17]   A. Tsang, J. R. Nash, M. V. Fordham, M. N. Hartley and G. J. Poston, “The Management of Retroperitoneal Liposarcoma with Synchronous Intra-Duodenal Sarcoma,” European Journal of Surgical Oncology, Vol. 29, No. 6, 2003, pp. 515-518. doi:10.1016/S0748-7983(03)00050-7

[18]   A. Hadidy, A. Alsharif, R. Sheikh-Ali, et al., “Odontogenic Myxofibroma Synchronous with Primary Angiosarcoma of the Spleen,” British Journal of Radiology, Vol. 83, No. 985, 2010, pp. e10-13. doi:10.1259/bjr/14078580

[19]   K. Tsutsumi, Y. Aida, T. Ohno and M. Ookura, “Primary cardiac Rhabdomyosarcoma Following a Uterine Leiomyosarcoma: Double Primary Sarcomas,” Japanese Journal of Thoracic and Cardiovascular Surgery, Vol. 53, No. 8, 2005, pp. 458-462. doi:10.1007/s11748-005-0086-7

[20]   S. R. Grobmyer, N. Luther, C. R. Antonescu, S. Singer and M. F. Brennan, “Multiple Primary Soft Tissue Sarcomas,” Cancer, Vol. 101, No. 11, 2004, pp. 2633-2635. doi:10.1002/cncr.20679

[21]   L. Congyang, W. Xinggui, L. Hao and H. Weihua, “Synchronous Histiocytic Sarcoma and Diffuse Large B Cell Lymphoma Involving the Stomach: A Case Report and Review of the Literature,” International Journal of Hematology, Vol. 93, No. 2, 2011, pp. 247-252. doi:10.1007/s12185-011-0773-3

[22]   A. Cossu, A. Deiana, A. Lissia, et al., “Synchronous Interdigitating Dendritic Cell Sarcoma and B-Cell Small Lymphocytic Lymphoma in a Lymph Node,” Archives of Pathology & Laboratory Medicine, Vol. 130, No. 4, 2006, pp. 544-547.

[23]   M. Rettenmaier, H. D. Epstein, L. N. Abaid, K. A. Bechtol and B. H. Goldstein, “Leiomyosarcoma with Synchronous Clear Cell Ovarian Carcinoma,” Onkologie, Vol. 33, No. 12, 2010, pp. 695-697. doi:10.1159/000322216

[24]   Y. Takemoto, M. Kawahara, S. Yamamoto, et al., “Synchronous Primary Adenocarcinoma of the Lung and Leiomyosarcoma of the Small Intestine,” Internal Medicine, Vol. 39, No. 8, 2000, pp. 655-658. doi:10.2169/internalmedicine.39.655

[25]   O. Merimsky, Y. Kollender, J. Issakov, et al., “Multiple Primary Malignancies in Association with Soft Tissue Sarcomas,” Cancer, Vol. 91, No. 7, 2001, pp. 1363-1371. doi:10.1002/1097-0142(20010401)91:7<1363::AID-CNCR1140>3.0.CO;2-F

[26]   R. Geva, I. Jiveliouk, M. Inbar, et al., “The Co-Occurrence of Breast Cancer and Soft Tissue Sarcoma in a Single Cohort Series,” American Journal of Clinical Oncology, Vol. 32, No. 1, 2009, pp. 34-37. doi:10.1097/COC.0b013e31817b6087

[27]   A. Fon, L. Mileshkin, J. Slavin, et al., “Synchronous Diagnosis of Hodgkin Lymphoma and Osteosarcoma,” Internal Medicine Journal, Vol. 37, No. 10, 2007, pp. 731-732. doi:10.1111/j.1445-5994.2007.01465.x

[28]   C. V. Wa, S. DeVries, Y. Y. Chen, F. M. Waldman and E. S. Hwang, “Clinical Application of Array-Based Comparative Genomic Hybridization to Define the Relationship between Multiple Synchronous Tumors,” Modern Pathology, Vol. 18, No. 4, 2005, pp. 591-597. doi:10.1038/modpathol.3800332

[29]   E. Hernando, E. Charytonowicz, M. E. Dudas, et al., “The AKT-mTOR Pathway Plays a Critical Role in the Development of Leiomyosarcomas,” Nature Medicine, Vol. 13, No. 6, 2007, pp. 748-753. doi:10.1038/nm1560

[30]   V. de Giorgi, R. Santi, M. Grazzini, et al., “Synchronous Angiosarcoma, Melanoma and Morphea of the Breast Skin 14 Years after Radiotherapy for Mammary Carcinoma,” Acta Dermato-Venereologica, Vol. 90, No. 3, 2010, pp. 283-286.

[31]   N. Ally, D. Kumar and F. M. Wodajo, “Synchronous Fibrosarcoma and Medullary Thyroid Cancer in a Man with AIDS,” American Journal of Clinical Oncology, Vol. 29, No. 5, 2006, pp. 532-533. doi:10.1097/

[32]   J. H. Park, C. H. Kang, C. H. Kim and I. J. Chae, “Highly Malignant Soft Tissue Sarcoma of the Extremity with a Delayed Diagnosis,” World Journal of Surgical Oncology, Vol. 8, 2010, p. 84. doi:10.1186/1477-7819-8-84