Skip to main content
PMC home page
Sarcoma logoLink to Sarcoma
. 2002 Sep;6(3):105–110. doi: 10.1080/1357714021000065404

The Relation Between Histological, Tumor-Biological and Clinical Parameters in Deep and Superficial Leiomyosarcoma and Leiomyoma

Justin Pijpe 1,6,✉, Gerben H Torn Broers 1, Boudewijn ECh Plaat 1, M Hundeiker 2, F Otto 2, Mirjam F Mastik 1, Harald J Hoekstra 3, Winette T A van der Graaf 4, Eva van Den Berg 5, Willemina M Molenaar 1
PMCID: PMC2395483  PMID: 18521340

Abstract

Purpose: Leiomyosarcomas (LMS) of deep and superficial tissues were examined to identify prognostic markers explaining their different biological behaviour and to define differences between cutaneous and subcutaneous LMS. LMS and leiomyomas (LM) of the skin were compared to and consistent differences that could aid in the (sometimes difficult) diagnosis.

Patients: Material was obtained from 27 patients with a deep LMS, 14 with a superficial LMS, and 21 with a LM.

Methods: Proliferation markers (mitotic and Ki-67 indices), DNA ploidy, size, grade, and the amount of apoptosis were studied. Statistical analysis was performed and survival curves were constructed by the Kaplan-Meier method and compared by the log-rank test.

Results: Superficial LMS were smaller than deep LMS (p < 0.05), and the overall survival of patients with a superficial LMS was better than with a deep LMS (p < 0.05).Within the group of superficial LMS only entirely subcutaneous, and not cutaneous tumors metastasized.No differences were found in the other examined parameters. Proliferation and apoptotic indices were significantly higher in superficial LMS compared to superficial LM.

Discussion: The difference in clinical outcome between patients with a superficial and deep LMS, seems to be related to site and size.The metastatic potential of subcutaneous LMS, however, seems to be related to location alone and not to size.The amount of apoptosis and proliferation can be used as additional criteria in the differentiation between superficial LMS and LM.

Full Text

The Full Text of this article is available as a PDF (101.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Agarwal V., Greenebaum E., Wersto R., Koss L. G. DNA ploidy of spindle cell soft-tissue tumors and its relationship to histology and clinical outcome. Arch Pathol Lab Med. 1991 Jun;115(6):558–562. [PubMed] [Google Scholar]
  2. Alvegard T. A., Berg N. O., Baldetorp B., Fernö M., Killander D., Ranstam J., Rydholm A., Akerman M. Cellular DNA content and prognosis of high-grade soft tissue sarcoma: the Scandinavian Sarcoma Group experience. J Clin Oncol. 1990 Mar;8(3):538–547. doi: 10.1200/JCO.1990.8.3.538. [DOI] [PubMed] [Google Scholar]
  3. Coindre J. M., Trojani M., Contesso G., David M., Rouesse J., Bui N. B., Bodaert A., De Mascarel I., De Mascarel A., Goussot J. F. Reproducibility of a histopathologic grading system for adult soft tissue sarcoma. Cancer. 1986 Jul 15;58(2):306–309. doi: 10.1002/1097-0142(19860715)58:2<306::aid-cncr2820580216>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  4. Dahl I., Angervall L. Cutaneous and subcutaneous leiomyosarcoma. A clinicopathologic study of 47 patients. Pathol Eur. 1974;9(4):307–315. [PubMed] [Google Scholar]
  5. Emanuels A., Hollema H., Koudstaal J. Autoclave heating: an alternative method for microwaving? Eur J Morphol. 1994 Aug;32(2-4):337–340. [PubMed] [Google Scholar]
  6. Farshid Gelareh, Pradhan Malcolm, Goldblum John, Weiss Sharon W. Leiomyosarcoma of somatic soft tissues: a tumor of vascular origin with multivariate analysis of outcome in 42 cases. Am J Surg Pathol. 2002 Jan;26(1):14–24. doi: 10.1097/00000478-200201000-00002. [DOI] [PubMed] [Google Scholar]
  7. Fields J. P., Helwig E. B. Leiomyosarcoma of the skin and subcutaneous tissue. Cancer. 1981 Jan 1;47(1):156–169. doi: 10.1002/1097-0142(19810101)47:1<156::aid-cncr2820470127>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
  8. Gustafson P., Willén H., Baldetorp B., Fernö M., Akerman M., Rydholm A. Soft tissue leiomyosarcoma. A population-based epidemiologic and prognostic study of 48 patients, including cellular DNA content. Cancer. 1992 Jul 1;70(1):114–119. doi: 10.1002/1097-0142(19920701)70:1<114::aid-cncr2820700119>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  9. Hashimoto H., Daimaru Y., Tsuneyoshi M., Enjoji M. Leiomyosarcoma of the external soft tissues. A clinicopathologic, immunohistochemical, and electron microscopic study. Cancer. 1986 May 15;57(10):2077–2088. doi: 10.1002/1097-0142(19860515)57:10<2077::aid-cncr2820571033>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  10. Jensen M. L., Jensen O. M., Michalski W., Nielsen O. S., Keller J. Intradermal and subcutaneous leiomyosarcoma: a clinicopathological and immunohistochemical study of 41 cases. J Cutan Pathol. 1996 Oct;23(5):458–463. doi: 10.1111/j.1600-0560.1996.tb01435.x. [DOI] [PubMed] [Google Scholar]
  11. Konomoto T., Fukuda T., Hayashi K., Kumazawa J., Tsuneyoshi M. Leiomyosarcoma in soft tissue: examination of p53 status and cell proliferating factors in different locations. Hum Pathol. 1998 Jan;29(1):74–81. doi: 10.1016/s0046-8177(98)90393-8. [DOI] [PubMed] [Google Scholar]
  12. Kuratsu S., Tomita Y., Myoui A., Uchida A., Ono K., Aozasa K. DNA ploidy pattern and cell cycle stage of tumor cells in soft-tissue sarcomas: clinical implications. Oncology. 1995 Sep-Oct;52(5):363–370. doi: 10.1159/000227490. [DOI] [PubMed] [Google Scholar]
  13. Myhre-Jensen O. A consecutive 7-year series of 1331 benign soft tissue tumours. Clinicopathologic data. Comparison with sarcomas. Acta Orthop Scand. 1981 Jun;52(3):287–293. doi: 10.3109/17453678109050105. [DOI] [PubMed] [Google Scholar]
  14. Nakanishi H., Ohsawa M., Naka N., Uchida A., Ochi T., Aozasa K. Immunohistochemical detection of bcl-2 and p53 proteins and apoptosis in soft tissue sarcoma: their correlations with prognosis. Oncology. 1997 May-Jun;54(3):238–244. doi: 10.1159/000227695. [DOI] [PubMed] [Google Scholar]
  15. Oliver G. F., Reiman H. M., Gonchoroff N. J., Muller S. A., Umbert I. J. Cutaneous and subcutaneous leiomyosarcoma: a clinicopathological review of 14 cases with reference to antidesmin staining and nuclear DNA patterns studied by flow cytometry. Br J Dermatol. 1991 Mar;124(3):252–257. doi: 10.1111/j.1365-2133.1991.tb00569.x. [DOI] [PubMed] [Google Scholar]
  16. Plaat B. E., Molenaar W. M., Mastik M. F., Koudstaal J., van den Berg E., Koops H. S., Hoekstra H. J. Hyperthermic isolated limb perfusion with tumor necrosis factor-alpha and melphalan in patients with locally advanced soft tissue sarcomas: treatment response and clinical outcome related to changes in proliferation and apoptosis. Clin Cancer Res. 1999 Jul;5(7):1650–1657. [PubMed] [Google Scholar]
  17. Plaat B. E., Muntinghe F. L., Molenaar W. M., Hoekstra H. J., Bosveld H. E., Dam A., Dijkhuizen T., van den Berg E. Clinical outcome of patients with previously untreated soft tissue sarcomas in relation to tumor grade, DNA ploidy and karyotype. Int J Cancer. 1997 Aug 22;74(4):396–402. doi: 10.1002/(sici)1097-0215(19970822)74:4<396::aid-ijc6>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  18. Shi S. R., Key M. E., Kalra K. L. Antigen retrieval in formalin-fixed, paraffin-embedded tissues: an enhancement method for immunohistochemical staining based on microwave oven heating of tissue sections. J Histochem Cytochem. 1991 Jun;39(6):741–748. doi: 10.1177/39.6.1709656. [DOI] [PubMed] [Google Scholar]
  19. Spencer J. M., Amonette R. A. Tumors with smooth muscle differentiation. Dermatol Surg. 1996 Sep;22(9):761–768. doi: 10.1111/j.1524-4725.1996.tb00726.x. [DOI] [PubMed] [Google Scholar]
  20. Ueda T., Aozasa K., Tsujimoto M., Ohsawa M., Uchida A., Aoki Y., Ono K., Matsumoto K. Prognostic significance of Ki-67 reactivity in soft tissue sarcomas. Cancer. 1989 Apr 15;63(8):1607–1611. doi: 10.1002/1097-0142(19890415)63:8<1607::aid-cncr2820630827>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  21. Valenti M. T., Azzarello G., Vinante O., Manconi R., Balducci E., Guidolin D., Chiavegato A., Sartore S. Differentiation, proliferation and apoptosis levels in human leiomyoma and leiomyosarcoma. J Cancer Res Clin Oncol. 1998;124(2):93–105. doi: 10.1007/s004320050140. [DOI] [PubMed] [Google Scholar]

Articles from Sarcoma are provided here courtesy of Wiley

RESOURCES