체성 연부 조직에 생긴 평활근육종: 1예 보고 = Review Article : Leiomyosarcoma of Somatic Soft Tissue: A Case Report

국문 초록 (Abstract)

체성 연부 조직에 생기는 평활근육종은 매우 드물다. 66세 남자 환자가 방사선 소견상 경계가 좋은 양성 종양이 의심되어 절제술을 시행 받았다. 육안조직소견상 경계가 좋은 둥근 종괴이나, 현미경 소견에서 세포충실도가 증가되고 부분적으로 중증도의 핵이형성을 보였다. 또한 면역조직화학염색상 Smooth muscle actin과 Desmin에 동시에 양성이어 평활근세포 기원으로 생각되었다. 저자들은 괴사가 없고 유사분열은 단 한 개만이 관찰되었으나 중증도의 핵이형성을 보였기에 평활근육종으로 진단한 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

다국어 초록 (Multilingual Abstract)

Leiomyosarcoma of somatic soft tissue is a rare tumor compared with retroperitoneal lesion. We report a case of a leiomyosarcoma of the somatic soft tissue in a 66-year-old man. He presented as an enlarging mass in the left thigh for eight months. Radiologic examinations revealed a well defined round mass, suspicious of benign tumor, such as hemangioma or leiomyoma. He underwent surgical resection. The mass was 3.0 cm in diameter, and it was confined within adductor longus muscle without any connection to adjacent neurovascular bundles. Histologic examination showed moderately cellularity and focal marked atypia with a fascicular growth pattern of spindle cells showing blunt ended nuclei. In addition, the proliferation index was 2~3% by immunohistochemistry using monoclonal antibody MIB-1. But only one definite microscopic mitotic feature was found. Although it showed low mitotic activity without necrosis, this case was diagnosed leiomyosarcoma according to marked cellular atypism.