Primary leiomyosarcoma of the thyroid gland with prior malignancy and radiotherapy: A case report and review of literature

Table 1 Markers used

Marker	Clone	Source	Antigen retrieval	Dilutions	Visualization kit manufacturer
α SMA	1A4	DAKO	Microwave oven, citrate, pH 6	1:400	DAKO, EnVision
Calponin	EP798Y	Lab Vision	Microwave oven, citrate, pH 6	1:100	DAKO, EnVision
H-caldesmon	h-CALD	LabVision	Water bath, citrate, pH 6	1:300	DAKO, EnVision
CD34	L-END	NOVOCASTRA	Microwave oven, citrate, pH 6	1:100	DAKO, EnVision
p53	DO-7	NOVOCASTRA	Microwave oven, citrate, pH 6	1:50	DAKO, EnVision
Ki67	MIB-1	DAKO	Microwave oven, DAKO 1700, pH 6	1:100	DAKO, EnVision
ER	6F11	NOVOCASTRA	Microwave oven, citrate, pH 6	1:100	DAKO, EnVision
PR	PGR 312	NOVOCASTRA	Microwave oven, citrate, pH 6	1:100	DAKO, EnVision
EBV	CS.1-4	DAKO	Microwave oven, DAKO 1700, pH 6	1:100	DAKO, EnVision

α SMA: Alpha smooth muscle actin; ER: Estrogen receptor; PR: Progesterone receptor; EBV: Epstein-Barr virus.

Table 2 A summary of primary thyroid LMS as reported in the literature (limited to the English language)

Ref.	Age	Sex	Initial symptoms	Tumor size in cm	ILMN	IDM	Therapy	Outcome
[4]	74	F	Mass ongoing for 4 mo, pain	12	+	+	CT	DWD, 1 mo
[5]	82	M	Mass for 1 mo, dysphonia	5.5	-	-	Lobectomy + ND	DWD 4 mo, RS
[6]	54	F	Mass	?	?	?	Lobectomy	Alive, 15 mo, NED
[7]	?	?	?	?	+	?	?	Alive, 12 mo
[8]	54	F	No symptoms	3.5	?	?	Lobectomy	Alive, 15 mo, NED
[9]	72	F	Mass ongoing for 7 mo	3	-	-	Lobectomy + ND	DWD, 51 mo, MD
[3]	64	F	Mass	7.5	?	+	Uncompleted surgery	DWD, 5 mo, MD
[3]	45	M	Mass ongoing for 1 mo	9	?	+	Lobectomy, CT	Alive, 11 mo, MD
[3]	68	M	Mass, dysphonia	1.9	?	+	Uncompleted surgery	DWD, 18 mo, MD
[3]	83	M	Rapid growing mass, dysphagia	5.5	?	+	Surgery	DWD, 3 mo, MD
[10]	58	F	Mass	5	-	-	Total thyroidectomy + ND	Alive, 25 mo, NED
[11]	6	M	Mass	5	-	+	Tumorectomy	No follow up after 4 mo, MD
[12]	90	F	Breathing disorder and a mass growing for 1 mo	8	?	?	Partial tumorectomy + trachelectomy,	DWD, 2 mo, pneumonia
[13]	66	F	Mass rapidly growing for ? mo	8.5	-	?	Thyroidectomy, laryngectomy	Alive 3 mo, MD, RS
[14]	43	M	Growing mass over 2 mo	6	-	+	Thyroidectomy + ND, CT	DWD 6 mo
[15]	83	F	Mass, pain in the arm	6.7	?	-	Biopsy, palliative therapy	DWD 2 mo, RS
[16]	63	F	Mass, weight loss, dysphagia	7	?	+	Total thyroidectomy	DWD, 5 mo
[17]	65	F	Mass, weight loss, cough	8	-	-	Total thyroidectomy + ND, CT	DWD 4 mo
[18]	-	-	-		-	-	-	-
[19]	65	M	Left arm pain	9	-	-	Total thyroidectomy, partial esophagetomy	Alive after 5 yr of follow up
[20]	72	F	Neck mass with accompanying skin fistulae	8.5	-	-	Lobectomy with mass excision	DWD, 2 mo
[21]	64	F	-	-	-	+	Total thyroidectomy	DWD, 3 mo
[22]	56	M	Neck mass dysphonia, dysphagia	3	-	-	Total thyroidectomy + ND	DWD, 8 mo
[23]	39	M	Weight loss, dysphagia	2.5	-	+	Biopsy + RT	DWD 3 mo
[23]	72	F	Mass, breathing disorder	?	+	+	Trachelectomy + biopsy	DWD, 1.5 mo
[25]	65	F	Neck mass dysphonia	8.3	-	+	Total thyroidectomy + lymphadenectomy	?
[25]	83	M	Neck mass, dysphonia	13	-	-	Lobectomy, partial trachelectomy, CT	DWD, 5 mo, MD
[26]	32	F	Neck mass	5	-	-	Lobectomy, RT + CT	?
Our Case	60	F	Mass, dysphonia, breathing disorder	2.5	-	-	Total thyroidectomy, RT + CT	Alive 17 mo, MD, thrombosis

F: Female; M: Male; IDM: Initial distant metastasis; ILNM: Initial lymph nodes metastasis; CT: Chemotherapy; RT: Radiotherapy; ND: Neck dissection; NED: No evidence of disease; DWD: Died with disease; MD: Metastatic disease.