Arch Hand Microsurg.  2017 Dec;22(4):299-304. 10.12790/ahm.2017.22.4.299.

Metachronous Sarcoma: A Case of Pleomorphic Leiomyosarcoma in a Patient with a History of Fibrosarcoma

• Ahn SK
• Choi HJ
• Lee HJ

• KMID: 2406136
• DOI: http://doi.org/10.12790/ahm.2017.22.4.299

Abstract

Metachronous cancers were defined as those that were detected after an interval of more than 6 months. The instance of two histologically distinct sarcomas in one patient is very unusual. A 42-year-old woman presented for evaluation of a painless mass in her right axilla area. She gave a history of operation 8 years ago for treating a fibrosarcoma on her right upper arm at local clinic. Eight years ago, the lesion was widely excised. Magnetic resonance imaging revealed a new generated tumor at her right axilla. After a wide surgical resection, we performed anterolateral thigh free flap for cover the defect. Second neoplasm is leiomyosarcoma. These two neoplasms are 2 histologically distinct tumors. There is no report of a case of metachronous soft tissue sarcoma both pleomorphic leiomyosarcoma and fibrosarcoma in upper extremity within one person. We emphasize the importance of considering the possibility of metachronous sarcoma.

Keyword

Pleomorphic leiomyosarcoma; Metachronous sarcoma; Soft tissue sarcoma; Fibrosarcoma; Anterolateral thigh free flap

MeSH Terms

Adult
Arm
Axilla
Female
Fibrosarcoma*
Free Tissue Flaps
Humans
Leiomyosarcoma*
Magnetic Resonance Imaging
Neoplasms, Second Primary
Sarcoma*
Thigh
Upper Extremity

Figure

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  Fig.1. Microscopic examinations of the fibrosarcoma. The mass is composed of short spindle cell fascicles arranged haphazardly with some eosinophilic collagen fiber (H&E, ×200).

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  Fig.2. A magnetic resonance imaging revealed a new generated tumor at her right axilla.

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  Fig.3. Gross examination of the pleomorphic leiomyosarcoma. The mass is a well-demarcated nodular, and located between subcutaneous fat tissue and skeletal muscular tissue. The cut surface reveals homogeneous grey whitish solid nature.

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  Fig.4. Microscopic examinations of the pleomorphic leiomyosarcoma. The mass is composed of marked pleomorphic short spindle cells arranged haphazardly (H&E, ×400).

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  Fig.5. Excision site with free flap coverage was healed well and there was only little scar. There was no evidence of re-currence and metastasis.

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