Favorable control of rapidly progressive retroperitoneal pleomorphic leiomyosarcoma with multimodality therapy: a case report

BMC Research Notes

Eishi Baba¹  Koji Ikejiri³  Seiya Momosaki⁵  Hitoshi Kusaba²  Taisei Matsumura⁶  Keita Uchino⁴  Eiji Kusumoto³  Kotoe Takayoshi⁴  Kosuke Sagara² 

[1] Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan;Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan;Department of Gastrointestinal Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan;Department of Medical Oncology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyouhama, Chuo-ku, Fukuoka 810-8563, Japan;Department of Pathological Department, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan;Department of Radiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

关键词: Chemotherapy;    Multimodality therapy;    Local control;    Leiomyosarcoma;   

Others  :  1132451
DOI  :  10.1186/1756-0500-7-377

 received in 2013-09-10, accepted in 2014-06-06,  发布年份 2014

【 摘 要 】

Background

Retroperitoneal sarcomas (RPS), such as pleomorphic leiomyosarcoma, often invade or displace vital organs in the abdominal cavity and exhibit an aggressive clinical course. Complete surgical resection of the tumor and preoperative radiotherapy and chemotherapies can be used for non-metastatic RPS. However, in case of huge retroperitoneal sarcoma fully occupying the abdominal cavity, surgical resection tends to be insufficient, resulting in poor outcomes. This report describes a case of rapidly progressive retroperitoneal pleomorphic leiomyosarcoma that was favorably controlled by debulking surgery followed by combination chemotherapy and radiotherapy.

Case presentation

A 65-year-old Japanese woman developed abdominal discomfort due to a huge retroperitoneal tumor fully occupying the abdominal cavity. The immunohistochemical diagnosis was pleomorphic leiomyosarcoma with high-grade malignancy and aggressive proliferative features. Debulking surgery could be performed, but the small residual tumor had rapidly grown to an approximately 22 cm in length on the major axis within 38 days after the operation. The patient’s general condition progressively declined. Combination chemotherapy, consisting of doxorubicin and ifosfamide, was successfully administered for six cycles while maintaining dose intensity. The best objective response was a partial response, and the chemotherapy was well tolerated. Approximately 50 Gy of radiotherapy was delivered to the remaining tumor. This multimodal strategy resulted in progression-free survival for more than 17 months and achieved sustained symptomatic relief.

Conclusions

Multimodal therapy with debulking surgery, combination chemotherapy and radiotherapy controlled a rapidly progressive retroperitoneal pleomorphic leiomyosarcoma. Maintaining dose intensity of the chemotherapy and radiotherapy might contribute to overall tumor control.

【 授权许可】

   
2014 Sagara et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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