Published online Feb 26, 2019. doi: 10.12998/wjcc.v7.i4.473
Peer-review started: November 28, 2018
First decision: December 15, 2018
Revised: January 4, 2019
Accepted: January 26, 2019
Article in press: January 26, 2019
Published online: February 26, 2019
Processing time: 91 Days and 16 Hours
Leiomyosarcoma (LMS) of the thyroid gland is a rarely presented tumor that offers poor prognosis. To the best of the authors’ knowledge, there currently exist only 28 known cases described in the literature (limited to English).
Herein a case is reported of a 60-year-old female patient who had an LMS of the thyroid, which was accompanied by periodic dysphonia and breathing disorder as well as the feeling of pressure in the chest and neck. At the time the disease was diagnosed, no metastases were detected. Prior to the diagnosis, the patient experienced a uterine adenocarcinoma that had been treated by surgical procedure and radiotherapy. For the LMS, a total thyroidectomy was performed, followed by radiotherapy. Since metastases were also discovered in the lungs, sternum, and femur, chemotherapy was administered as well. Immunohistochemically, the tumor cells in the thyroid indicated positively for alpha smooth muscle actin, calponin, and H-caldesmon, but were negative for CD34, p63, estrogen receptor, progesterone receptor, and Epstein-Barr virus.
Although the etiology of the LMS is as of yet unknown, prior malignancy and radiation should be considered as risk factors.
Core tip: Leiomyosarcoma (LMS) of the thyroid gland is a rare tumor with only 28 cases described in the English literature. Etiology of leiomyosarcoma is still unknown. We present a case of LMS in which the patient had a prior malignancy and radiotherapy along with two similar cases previously described. Therefore, we hypothesize that prior malignancy and radiotherapy is a risk factor. Immunohistochemistry plays a crucial role in the diagnosis, and we provided substantial discussion about differential diagnosis of thyroid tumors, alongside with our microscopic findings that provide practical value for the daily practice of pathology.