A Case of Leiomyosarcoma of the Femoral Artery; Rare Location and Management at an Advanced Stage

Hamadoun Traoré *

Medical Oncology Department, Mohammed V Military Training Hospital, Morocco.

Andy J. Kouanga

Medical Oncology Department, Mohammed V Military Training Hospital, Morocco.

Mohammed Anouar Mokhlis

Medical Oncology Department, Mohammed V Military Training Hospital, Morocco.

Mendes Papys

Anatomy and Pathological Cytology Laboratory, Mohammed V Military Training Hospital, Morocco.

Choukri Elm’hadi

Medical Oncology Department, Mohammed V Military Training Hospital, Morocco.

Rachid Tanz

Medical Oncology Department, Mohammed V Military Training Hospital, Morocco.

Hassan Errihani

National Institute of Oncology, Morocco.

*Author to whom correspondence should be addressed.


Abstract

Vascular leiomyosarcomas are extremely rare tumours, accounting for less than 1% of all malignant tumours. Venous leiomyosarcomas occur five times more frequently than arterial leiomyosarcomas. These are most often found in the large vessels and less than 50% occur in the peripheral circulation. Median survival has not been quantified. It can be good if radical surgery is performed. Treatment, whatever the stage, requires multidisciplinary management. Surgery with en bloc resection remains the treatment of choice for localised disease; in patients with unresectable locally advanced or metastatic disease, systemic treatment with essentially palliative aims may be proposed. Anthracycline-based treatment is the standard first-line therapy.

We report a case report of a 50-year-old female patient with local, pulmonary and bone relapse of an operated left femoral artery leiomyosarcoma in whom we undertook palliative mono-chemotherapy.

Conclusion: Vascular leiomyosarcomas are extremely rare tumours, accounting for less than 1% of all malignant tumours. Median survival is dramatic for metastatic patients, with a median survival of 8 months, ranging from 5 to 20 months. Surgery remains the standard curative treatment for the localised stage; for stage 4, single chemotherapy is the treatment of choice.

Keywords: Leiomyosarcoma, femoral artery, surgery, localised disease, metastasis, chemotherapy, doxorubicin


How to Cite

Traoré, Hamadoun, Andy J. Kouanga, Mohammed Anouar Mokhlis, Mendes Papys, Choukri Elm’hadi, Rachid Tanz, and Hassan Errihani. 2024. “A Case of Leiomyosarcoma of the Femoral Artery; Rare Location and Management at an Advanced Stage”. Journal of Advances in Medicine and Medical Research 36 (7):252-58. https://doi.org/10.9734/jammr/2024/v36i75500.

Downloads

Download data is not yet available.

References

Gatta G, Capocaccia R, Botta L, et al. Burden and centralised treatment of rare tumours in Europe: Results from RARECARE net - a population-based study. Lancette Oncol. 2017;18:1022- 1039.

Sakpal SV, Mehta R, Babel N, et al. Peripheral artery leiomyosarcoma. J Vasc Surg. 2009;49:217-221.

Kieffer E, Alaoui M, Piette JC, et al. Leiomyosarcoma of the inferior vena cava, experience in 22 cases. Ann Surg. 2006;244:289-295.

Tresgallo-Parés, Ruben, et al. Primary leiomyosarcoma of the great saphenous vein: A case report. International Journal of Surgery Case Reports. 2021;88: 106565.

Rosenberg SA, Tepper J, Glatstein E, et al. Treatment of extremity soft tissue sarcomas: prospective randomized evaluations of (1) limb-sparing surgery plus radiotherapy versus amputation and (2) the role of adjuvant chemotherapy. Ann Surg. 1982;196:305-315.

Pisters PW, Harrison LB, Leung DH, et al. Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol. 1996; 14:859-868.

Beane JD, Yang JC, Blanc D, et al. Efficacy of adjuvant radiotherapy in the treatment of soft tissue sarcoma of the extremities: 20-year follow-up of a prospective randomised trial. Ann Surg Oncol. 2014;21:2484-2489.

Fiore M, Ford S, Callegaro D, et al. Adequate local control in high-risk limb soft tissue sarcomas treated with surgery alone at a referral centre: should radiotherapy still be standard? Ann Surg Oncol. 2018; 25:1536-1543.

Editorial Committee of the WHO Classification of Tumours. Soft tissue and bone tumours. 3. 5th ed. IARC, Lyon; 2020.Available:https://publications.iarc.fr/588

Accessed 1 May 2021.

Suffat LP, Mazza L, Farina EC, et al. Leiomyosarcoma of the inferior vena cava. Report of two cases and review of the literature. Ann Ital Chir. 2007;78: 303-306.

Penel N, Taieb S, Ceugnart L, et al. Report of eight recent cases of locally advanced primary pulmonary artery sarcomas: Failure of doxorubicin-based chemotherapy. J Thorac Oncol. 2008;3: 907-911.

Naouli H, Lathelize H, Bouarhroum A. Leiomyosarcoma of the great saphenous vein: A case report and review of the literature Anne. Vasc. Surg. April 2019;56: 353 e1-353 e6.

Fremed DI, Faries PL, Schanzer HR, Marin ML, Ting W. Primary saphenous vein leiomyosarcoma presenting as deep vein thrombosis Vascular. December 2014; 22(6):450-453.

Blackmon SH, Shah N, Roth JA, et al. Resection of pulmonary and extra pulmonary sarcomatous metastases is associated with long-term survival. Ann Thora Surgery. 2009;88(Discussion 884-875):877-884.

Antman K, Crowley J, Balcerzak SP, et al. A phase III randomized intergroup trial of doxorubicin and dacarbazine with or without ifosfamide and mesna in advanced soft tissue and bone sarcoma. J Clin Oncol. 1993;11:1276-1285.

Judson I, Verweij J, Gelderblom H, et al. Doxorubicin alone versus intensified doxorubicin plus ifosfamide for first-line treatment of advanced or metastatic soft tissue sarcoma: A phase 3 randomised controlled trial. Lancette Oncol. 2014;15: 415-423.

D'Ambrosio L, Touati N, Blay JY, et al. Doxorubicin plus dacarbazine, doxorubicin plus ifosfamide or doxorubicin alone as first-line treatment for advanced leiomyosarcoma: A European Organisation for Research and Treatment of Cancer soft tissue group and bone sarcoma propensity score matching analysis. Cancer. 2020; 126:2637-2647.

Stacchiotti S, Tortoreto M, Bozzi F, et al. Dacarbazine in solitary fibrous tumor: A case series analysis and preclinical evidence regarding temozolomide and anti-angiogenic agents. Clin Cancer Res. 2013;19:5192-5201.

Seddon B, Strauss SJ, Whelan J, et al. Gemcitabine and docetaxel versus doxorubicin as first-line treatment for advanced unresectable or metastatic soft tissue sarcoma (GeDDiS): A phase 3 randomised controlled trial. Lancette Oncol. 2017;18:1397-1410.

Frezza AM, Jones RL, Lo Vullo S, et al. Anthracycline, gemcitabine, and pazopanib in epithelioid sarcoma: A multi-institutional case series. JAMA Oncol. 2018;4: e180219.