Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 27, 2018; 10(4): 402-408
Published online Apr 27, 2018. doi: 10.4254/wjh.v10.i4.402
Review of the literature laparoscopic surgery for metastatic hepatic leiomyosarcoma associated with smooth muscle tumor of uncertain malignant potential: Case report
Keisuke Fukui, Nobuhisa Takase, Taiichiro Miyake, Koji Hisano, Eri Maeda, Tohru Nishimura, Koichiro Abe, Akihito Kozuki, Tomohiro Tanaka, Naoki Harada, Manabu Takamatsu, Kunihiko Kaneda
Keisuke Fukui, Nobuhisa Takase, Taiichiro Miyake, Koji Hisano, Eri Maeda, Tohru Nishimura, Koichiro Abe, Akihito Kozuki, Tomohiro Tanaka, Naoki Harada, Manabu Takamatsu, Kunihiko Kaneda, Department of Surgery, Kakogawa Central City Hospital, Kakogawa 675-8611, Japan
Author contributions: Takase N and Takamatsu M operated on the patient and designed the report; Miyake T, Hisano K, Maeda E, Nishimura T, Abe K, Kozuki A, Tanaka T and Harada N drafted the paper; Kaneda K critically revised the paper with an important conceptual and editorial input.
Informed consent statement: The patients participating in the study provided informed written consent.
Conflict-of-interest statement: The authors declare no conflict of interest associated with this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nobuhisa Takase, MD, PhD, Doctor, Surgeon, Surgical Oncologist, Department of Surgery, Kakogawa Central City Hospital, 439, Honmachi, Kakogawa-cho, Kakogawa 675-8611, Japan. no-takase@kakohp.jp
Telephone: +81-79-4515500 Fax: +81-79-4515548
Received: January 19, 2018
Peer-review started: January 20, 2018
First decision: February 28, 2018
Revised: March 10, 2018
Accepted: April 2, 2018
Article in press: April 3, 2018
Published online: April 27, 2018
Processing time: 97 Days and 21.7 Hours
Abstract

Metastatic hepatic leiomyosarcoma is a rare malignant smooth muscle tumor. We report a case of metastatic hepatic leiomyosarcoma associated with smooth muscle tumor of uncertain malignant potential (STUMP). A 68-year-old female presented with a liver mass (60 mm × 40 mm, Segment 4). She underwent left salpingo-oophorectomy for an ovary tumor with STUMP in a broad ligament 6 years ago. Though FDG-PET showed obvious metabolically active foci, abnormal metabolically active foci other than the lesion were not detected. A malignant liver tumor was strongly suspected and laparoscopic partial liver resection was performed with vessel-sealing devices using the crush clamping method and Pringle maneuver. Immunohistochemical findings revealed metastatic liver leiomyosarcoma associated with STUMP in a broad ligament. This case is an extremely rare case of malignant transformation from primary STUMP to metastatic hepatic leiomyosarcoma. It provides important evidence regarding the treatment for metastatic hepatic leiomyosarcoma associated with STUMP.

Keywords: Leiomyosarcoma; Smooth muscle tumor; Hepatic neoplasm; Neoplasm metastasis; Laparoscopic surgery; Liver resection

Core tip: Metastatic hepatic leiomyosarcoma is a rare malignant smooth muscle tumor. This case report presents a case of smooth muscle tumor of uncertain malignant potential (STUMP) occurring in a broad ligament that developed into metastatic hepatic leiomyosarcoma over a period of 6 years, and an ultrasound-guided pure laparoscopic partial liver resection with vessel-sealing devices using the crush clamping method and Pringle maneuver was performed safely. This case is an extremely rare case of malignant transformation from primary STUMP to metastatic hepatic leiomyosarcoma. We share this case to provide important evidence regarding the treatment for metastatic hepatic leiomyosarcoma associated with STUMP.