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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neoplasms arising from smooth muscle of the gastrointestinal (GI) tract are uncommon, comprising only 1% of gastrointestinal tumours. A total of 51 cases of smooth muscle tumour of the GI tract were analysed; 44 leiomyomas and 7 leiomyosarcomas. Lesions occurred in all areas from the oesophagus to the rectum, the stomach being the commonest site. Thirty-six patients had clinical features referable to the tumour. The tumour was detected during investigation or management of an unrelated disease process in 15 patients. The clinical presentation varied depending on tumour location, but abdominal pain and GI bleeding were the commonest presenting symptoms. The lesion was demonstrated preoperatively, mainly by endoscopy and barium studies, in 27 patients. Surgical excision was the treatment of choice, where possible. There was no recurrence in the leiomyoma group but four patients died in the leiomyosarcoma group. Although rare, smooth muscle tumours should be considered in situations where clinical presentation and investigations are not suggestive of any common GI disorder. The preoperative assessment and diagnosis is difficult because of the variability in clinical features and their inaccessibility to routine GI investigation. It is recommended that, where possible, the lesion, whether symptomatic or discovered incidentally, should be excised completely to achieve a cure and prevent future complications.
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PMID:Smooth muscle tumours of the alimentary tract. 222 68

The incidence of leiomyosarcoma in uterine leiomyomas is estimated to be between 0.13 to 0.29%. However, the exact incidence of leiomyosarcoma in uteri removed with a preoperative diagnosis of benign uterine leiomyomas has not been previously reported. Between 1983 and 1988, a total of 1432 patients in Women's Hospital, a self-referred indigent population, had a hysterectomy planned because of abnormal uterine bleeding or abdominal pain associated with the presence of uterine leiomyomas, or because of a pelvic mass thought to be uterine leiomyoma of sufficient size or character to warrant surgical exploration. The ages of these women ranged from 36 to 62 years and the presence of leiomyosarcoma in the hysterectomy specimens increased steadily from the fourth to seventh decades of age (0.2%, 0.9%, 1.4%, and 1.7%, respectively). Preoperative histologic examination of the endometrium was performed in eight patients. Three of the eight patients had a preoperative tissue diagnosis of leiomyosarcoma that was clinically confined to the uterus. After the hysterectomy in the 1429 patients with presumed benign disease, histologic diagnosis of leiomyosarcoma was made in seven (0.49%). There was no evidence of malignancy in the endometrial sampling of any of these seven patients and the diagnosis was suspected intraoperatively in only three. Preoperative uterine size ranged from 8 to 20 weeks' gestational size and postoperative uterine weight ranged from 120 to 1100 gm. Seven of the 10 patients had symptoms of abnormal uterine bleeding. Between the ages of 40 and 60 years, 1% (8 of 817) of women with presumed uterine leiomyomas producing symptoms that necessitated hysterectomy in this series had leiomyosarcoma diagnosis postoperatively. Such treatments as gonadotropin-releasing hormone agonists, endometrial ablation, myomectomy by hysteroscopy or laparotomy instead of hysterectomy in such women could delay the diagnosis and definitive treatment of leiomyosarcoma.
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PMID:Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. 232 66

Leiomyosarcomas of the retroperitoneum are rare neoplasms, belonging to the soft-tissue sarcomas, a group that accounts for less than 1% of all malignancies. Signs and symptoms are nonspecific with abdominal pain being the most frequent complaint. Often the tumors reach a large size before being detected. Diagnosis requires examination of tissue obtained by biopsy. Due to the advanced nature of the lesion at the time of discovery, treatment is difficult and results are often unsatisfactory. Excision is the treatment of choice unless the patient has wide metastasis or is unable to tolerate surgery. Although radiation and adjuvant chemotherapy have been used in some cases, the prognosis for this lesion remains poor. This paper discusses the incidence, epidemiology, clinical presentation, diagnosis, pathology, and treatment of this rare malignancy.
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PMID:Retroperitoneal leiomyosarcoma: a review of the literature. 267 Aug 58

One hundred and seventy one patients with mesentery tumors confirmed by surgery and/or pathology in five hospitals of Hubei Province from 1966 to 1986 are analyzed retrospectively. The main manifestations were abdominal pain, abdominal mass and emaciation. Cyst and leiomyomas were common in benign tumors. Malignant lymphoma, leiomyosarcoma and liposarcoma were predominant in malignant tumors. The morbidity, clinico-pathologic characteristics, diagnosis and differential diagnosis of this group of tumor are discussed.
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PMID:[Mesentery tumor--clinico-pathologic analysis of 171 cases]. 268 Mar 60

The patient was a 45-year-old man with the symptoms of abdominal pain and constipation. Laboratory data showed no remarkable changes. Ultrasonic and CT-scan examinations revealed a mass deeply situated in the abdominal cavity. Ultrasonography guided needle aspiration cytology was performed. Obtained specimen showed a large cluster accompanied by numerous smaller clusters, and dispersed single cells. Most of cells were spindle in shape with abundant cytoplasm, and uniform in size. These cells have moderately hyperchromatic nuclei with finely granular pattern, which were round or oval, and have tiny nucleoli. Some cells were binucleated. The nuclear membrane was sharp and well preserved. Giant cells or mitotic figures were not observed. As a result, cytological diagnosis was "suspicious of leiomyosarcoma". The tumor was resected. The specimen consisted of a segment of the jejunum with an irregularly-shaped, and reddish soft first-sized mass continued to jejunum muscle layer. The cut surface of the mass showed central cavitation and necrosis in part. Histological diagnosis was well differentiated leiomyosarcoma originated from the jejunum. The tumor was composed of smooth muscle like cells arranged in bundles with some bizarre multinucleated cells and rare mitotic figures.
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PMID:[Usefulness of ultrasonography-guided fine needle aspiration cytology in a case of jejunal leiomyosarcoma]. 268 7

A retrospective study of 36 patients with primary retroperitoneal sarcomas treated at The Norwegian Radium Hospital is presented. The median age at presentation was 57 years. The most common presenting symptom was abdominal pain. Leiomyosarcoma and liposarcoma were the most common histologic subtypes. The median survival in the whole series was 25 months. Patients with completely resected tumors had a longer median survival (59 months) than patients with incomplete resection (16 months) but the difference was not statistically significant. The malignancy grade seemed to be the most important prognostic factor and patients with low grade tumors had a significantly better outlook than those with high grade tumors.
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PMID:Primary retroperitoneal sarcomas. A review of 36 cases. 299 85

102 patients with primary tumors of the small intestine proved by pathology in our hospital from 1964 to 1983 are reported. It made up 4% of primary gastrointestinal (GI) neoplasms during this period. Of the 102 patients, 32 were benign tumors, comprising 11.3% of all benign tumors of the GI tract. There were 70 malignant tumors, constituting 3.1% of all malignant tumors of the GI tract. Leiomyomas were very common in benign tumors while malignant lymphomas and carcinomas were predominant in malignant neoplasms. The main clinical manifestations were abdominal pain, mass, obstruction and GI hemorrhage. Eight patients were complicated with perforation, 6 of them were malignant tumors. Multiple lesions were found in 22 and 16 of them were malignant tumors. Only 29.3% of primary tumors of the small intestine could be demonstrated by barium X-ray examination. Correct diagnosis was made preoperatively in 13.7% of all patients. Resectability and operative mortality rates in malignant tumors were 70% and 12.9%, respectively, 62.3% of the patients were followed with an overall 5-year survival rate of 36.9% (malignant lymphoma 62.5% and leiomyosarcoma or carcinoma (18.2%). The 5-year survival rate was 43.8% after radical operation and 38.9% after palliative operation. The overall 10-year survival rate was 16.2%. One patient with lymphosarcoma is alive 21.5 years after operation. The reasons of the low incidence, the high misdiagnosis rate and the related aspects of diagnosis and treatment of this tumor are discussed.
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PMID:[Primary tumor of the small intestine--analysis of 102 patients]. 324 1

We report a case of a grade II leiomyosarcoma of the suprarenal vena cava in a 56-year-old man. It was discovered during exploratory laparotomy for lower back and abdominal pain associated with intermittent renal failure of 8 months' duration and recent exertional dyspnea. The tumor was completely resected, with reimplantation of the right renal vein. Adjuvant radio- and chemotherapy were administered. The postoperative course was uneventful and the patient has been disease-free during follow-up of 12 months. The difficulties of preoperative diagnosis and surgical treatment of leiomyosarcoma of the inferior vena cava are discussed.
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PMID:[Leiomyosarcoma of the inferior vena cava]. 356 46

397 cases of smooth muscle tumor of the alimentary tract were analysed. 385 were collected from the domestic literature in the recent 10 years and 12 are added by the authors. The tumor occurred more frequently in patients 40-60 years old. Diameter of the tumor ranged from 0.5-35 cm. The diameter of leiomyosarcoma was larger than that of leiomyoma on an average. The ratio of benign to malignant incidence was 3.2:1. Exclusive of 204 (51.4%) cases which occurred in the esophagus, the ratio was 1.1:1 in the other 193. In the 12 cases reported by the authors, it was 1:3. In the 193 cases of the GI tract, the lesion occurred in the stomach in 50.8%, in the small intestine in 29.0%, in the colon 1.0% and in the rectum 19.2%. The three most common clinical symptoms of those in the stomach and small intestine were abdominal mass (54.3%), bleeding (49.1%) and abdominal pain (45.7%). These 12 cases reported comprised 0.019% of 62, 088 patients admitted into our hospital, 0.09% of 12,678 tumor inpatients during the same period and 0.61% of 1,983 of malignant tumors in the alimentary tract. The preoperative diagnostic accuracy of this tumor was low, only 7.7% of all the GI neoplasms. On basis of the present data, improving the preoperative diagnostic accuracy is stressed.
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PMID:[Smooth muscle tumors of the alimentary tract--a review of 397 cases]. 375 46

Leiomyosarcoma of the inferior vena cava is reported with increasing frequency but remains a rare lesion. In this article we report one case and review 69 cases. The disease affects mainly women approximately 50 years of age. The symptoms vary according to the location of the tumor; Budd-Chiari syndrome and leg edema occur in the more centrally located tumors and abdominal pain and swelling are seen in the more peripherally located ones. In 40% of the cases distant metastases are evident at the time of the patients' first presentation and are found most commonly in the liver and/or lungs. After resection the majority of the patients eventually die of metastatic disease with a mean survival of approximately 40 months.
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PMID:Leiomyosarcoma of the inferior vena cava. Case report and review of the literature. 395 63


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