RESPONSE OF LEIOMYOSARCOMA TO CRYOSURGERY - CLINICOPATHOLOGICAL AND ULTRASTRUCTURAL-STUDY

Two elderly patients with primary leiomyosarcoma (LMS) of the scalp we re treated cryosurgically. Complete involution of both tumours with fu ll epithelialization of the affected sites was achieved. Pretreatment biopsies and sequential biopsies obtained after treatment allowed obse rvation of microscopical changes taking place during tumour involution . Gradual shrinkage of both LMS, closely monitored under the operating microscope, started immediately after the initial freezing. Light and electron microscopic observation of the shrinking LMS revealed a rapi d disappearance of the tumoral architecture. Early accumulation of eos inophils and erythrocytes was followed by migration of lymphocytes and plasma cells. Capillary neoformation, fibroblasts and newly formed co nnective tissue fibres became apparent during the later stages of heal ing. Two years after treatment, both patients showed no signs of recur rence. These results suggest cryosurgery-performed in an extended prot racted fashion-can be a valuable therapeutic choice in the management of LMS, particularly when surgical excision is not feasible.