Hepatic tumors of long duration with eventual metastases. Two cases of leiomyosarcomatosis possibly arising from hamartomas of liver

Our plain-English summary of Hepatic tumors of long duration with eventual metastases. Two cases of leiomyosarcomatosis possibly arising from hamartomas of liver, by R.A. Echevarria, V.M. Arean, L. Galindo (American Journal of Clinical Pathology, 1978).

The study

• Authors: R.A. Echevarria, V.M. Arean, L. Galindo
• Journal: American Journal of Clinical Pathology
• Published: 1978;69(6):624-31
• Type of article: Case report
• Cited by: 25 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The cases of two patients who had hepatic tumors of long duration interpreted as hamartomas in whom, after many years, widespread metastases of malignant smooth muscle cells developed in a pattern of "carcinomatous lymphangitis" in the lungs are described. In one of the cases calcification of the hepatic nodules was prominent. The smooth muscle origin of the malignant cells was established only on electron microscopic examination. These cases appear similar to others variously reported as mixed tumors, hepatic cell carcinomas, and mesotheliomas.

In plain English

This article reported two patients whose liver tumors were present for years before cancer spread widely. It did not mention asbestos exposure. Case 1 was a 59-year-old man with shoulder pain, nodules in both lungs and calcifications over the liver. He developed heart failure within two months of a lung biopsy and died at home. Case 2 was a 46-year-old Spanish woman whose liver biopsy was diagnosed as "hepatic hamartoma". She died in 1969, nine years after her symptoms began. In both patients, tumor cells had spread through the lungs along lymph and blood vessels, and in Case 1 also to lymph nodes and bone. Under the electron microscope the cells had features of smooth muscle cells, which ordinary microscope stains had not shown. The authors considered the liver a reasonable primary site and interpreted the liver tumors as hamartomas. They thought it possible that earlier published cases, described as mixed liver tumors, liver cell carcinoma and malignant pleural mesothelioma, may represent the same condition. They said further studies were needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (two cases)
• Who was studied: Two patients: a 59-year-old white man admitted to Shands Teaching Hospital (Florida), and a 46-year-old Spanish woman referred to the Hospital de la Santa Cruz y San Pablo (Barcelona) whose symptoms began in 1960
• Main results:
  • In both cases the tumor had spread to the lungs along lymphatic and blood vessels; in Case 1 it had also spread to lymph nodes and bone
  • Ordinary light microscopy, including special stains, did not readily establish what the tumor cells were
  • Electron microscopy showed features (cytoplasmic filaments, pinocytotic vesicles, basement membranes around the cells) that the authors described as consistent with origin from smooth muscle cells or related cells
  • In Case 1, the structure of the liver nodules at autopsy suggested hamartomas
  • Case 1 developed congestive heart failure within two months after the lung biopsy and died at home
  • Case 2 died of hepatic and respiratory failure nine years after symptoms began
• The authors' conclusion: The authors considered the liver a reasonable primary site. They thought it possible that previously reported cases (interpreted as mixed tumors of the liver, liver cell carcinoma and malignant pleural mesothelioma) may represent the same entity as their cases.
• Limitations the authors state:
  • The authors said the site where the tumor originated was difficult to prove
  • All material from Case 2 was obtained after death and was poorly preserved
  • The authors said further ultrastructural studies of similar cases are needed to confirm their findings

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Carcinoma, Mesothelioma.

Related studies

• Benign tumors of the liver — K.G. Ishak, L. Rabin (1975)
• Hamartoma of mature cardiomyocytes in right atrium: A case report and literature review — X. Zhou, Y. Zhou, et al. (2019)
• Pleural mesothelioma with calcified liver metastases — G.D. Campbell, S.D. Greenberg (1981)
• Solitary fibrous tumor of the liver: a clinicopathologic and immunohistochemical study of nine cases — C.A. Moran, K.G. Ishak, et al. (1998)
• Giant solitary fibrous tumor of the liver with metastasis to the skeletal system successfully treated with trisegmentectomy — S. Yilmaz, V. Kirimlioglu, et al. (2000)
• Genetic alterations in cancer knowledge system: analysis of gene mutations in mouse and human liver and lung tumors — M.A. Jackson, I. Lea, et al. (2006)

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