Takehara K, Aoki H, Takehara Y, Yamasaki R, Tanakaya K, Takeuchi H. Primary hepatic leiomyosarcoma with liver metastasis of rectal cancer. World J Gastroenterol 2012; 18(38): 5479-5484 [PMID: 23082067 DOI: 10.3748/wjg.v18.i38.5479]
Corresponding Author of This Article
Kiyoto Takehara, MD, Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. t_kiyotosan@cyberbb.com
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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Kiyoto Takehara, Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
Hideki Aoki, Yuko Takehara, Kohji Tanakaya, Hitoshi Takeuchi, Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Yamaguchi 740-8510, Japan
Rie Yamasaki, Department of Clinical Examination, National Hospital Organization Iwakuni Clinical Center, Yamaguchi 740-8510, Japan
Author contributions: Takehara K performed the surgery and was involved in writing the manuscript; Aoki H instructed during surgery and reviewed the manuscript; Takehara Y assisted with the surgery and patient care; Yamasaki R carried out the histopathological examination; Tanakaya K and Takeuchi H supervised the report.
Correspondence to: Kiyoto Takehara, MD, Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. t_kiyotosan@cyberbb.com
Telephone: +81-86-2237151 Fax: +81-86-2357636
Received: March 30, 2012 Revised: June 28, 2012 Accepted: July 9, 2012 Published online: October 14, 2012
Abstract
Primary hepatic leiomyosarcoma is a particularly rare tumor with a poor prognosis. Curative resection is currently the only effective treatment, and the efficacy of chemotherapy is unclear. This represents the first case report of a patient with primary hepatic leiomyosarcoma co-existing with metastatic liver carcinoma. We present a 59-year-old man who was diagnosed preoperatively with rectal cancer with multiple liver metastases. He underwent a curative hepatectomy after a series of chemotherapy regimens with modified FOLFOX6 consisting of 5-fluorouracil, leucovorin and oxaliplatin plus bevacizumab, FOLFIRI consisting of 5-fluorouracil, leucovorin and irinotecan plus bevacizumab, and irinotecan plus cetuximab. One of the liver tumors showed a different response to chemotherapy and was diagnosed as a leiomyosarcoma following histopathological examination. This case suggests that irinotecan has the potential to inhibit the growth of hepatic leiomyosarcomas. The possibility of comorbid different histological types of tumors should be suspected when considering the treatment of multiple liver tumors.
