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Korean J Gastroenterol  <  Volume 74(1); 2019 <  Articles

Korean J Gastroenterol 2019; 74(1): 57-62  https://doi.org/10.4166/kjg.2019.74.1.57
Synchronous Primary Leiomyosarcoma in the Thoracic Vertebra and the Liver
Young Kwan Kim*, Jung-A Kim1*, Soo Hyung Ryu , Jong Hyun Choi, Pei Chuan Tsung, Jong Hyeok Park, Jeong Seop Moon, Jae Chan Shim2, Hye Kyung Lee3 and James Matthew Loutzenhiser4
Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine; Department of Hemato-oncology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University1; Departments of Radiology2 and Pathology3, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea; Piedmont Transplant Institute of Atlanta4, Atlanta, GA, USA
Correspondence to: Soo Hyung Ryu, Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, 9 Mareunnae-ro, Jung-gu, Seoul 04551, Korea. Tel: +82-2-2270-0001, Fax: +82-2-2270-3012, E-mail: rshdrryu@hanmail.net, ORCID: https://orcid.org/0000-0002-1654-7057
Received: December 28, 2018; Revised: March 2, 2019; Accepted: April 1, 2019; Published online: July 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
This is a case report of simultaneous primary leiomyosarcomas in the spine and liver. A 64-year-old woman presented to the Seoul Paik Hospital with epigastric discomfort and constipation that she had experienced for two months. A physical examination revealed severe tenderness around the thoraco-lumbar junction. Esophagogastroduodenoscopy showed an ulceroinfiltrative lesion on the gastric angle. An abdominopelvic CT scan revealed two low attenuated lesions in the S4 and S8 regions of the liver, as well as a soft tissue mass at the T10 vertebra. Percutaneous ultrasonography-guided needle biopsy of the hepatic nodules revealed a leiomyosarcoma. The tumor at the T10 vertebra was removed to avoid spinal cord compression. The histology of this tumor was compatible with that of leiomyosarcoma. The potential primary sites for leiomyosarcoma, including the lung, thyroid, breast, kidney, genitourinary organs, and gastrointestinal tract, were subsequently investigated. No detectable abnormal findings that would suggest the origin of the tumor were found. Synchronous primary leiomyosarcomas in the spine and liver are quite rare and have a poor prognosis.
Keywords: Leiomyosarcoma; Bone and bones; Spine; Liver; Neoplasms, multiple primary


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