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Laureline W, Patrick O, Tu N, Stephane C, Ana D, Daniela F, Chiara S, Igor L, Antonia D. Recurrent benign fibrous histiocytoma of the bone benefits from denosumab followed by malignant transformation: a case report. Skeletal Radiol 2024; 53:2537-2543. [PMID: 38374215 PMCID: PMC11410898 DOI: 10.1007/s00256-024-04610-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/21/2024]
Abstract
Benign fibrous histiocytoma of the bone (BFHB) is a rare mesenchymal tumor, representing less than 1% of all benign bone tumors. This controversial entity is characterized by a mixture of fibroblasts arranged in a storiform pattern, varying amounts of osteoclast-type giant cells and foamy macrophages. Curettage or simple resection is usually curative. However, it was reported that up to 11% of the patients suffer from relapse. Here, we report a case of malignant transformation of BFHB after long-lasting disease stabilization under denosumab therapy.
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Affiliation(s)
- Wetterwald Laureline
- Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Omoumi Patrick
- Department of Diagnostic Radiology And Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nguyen Tu
- Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Cherix Stephane
- Department of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland
| | - Dolcan Ana
- Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Ferraro Daniela
- Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Saglietti Chiara
- Institute of Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Letovanec Igor
- Institute of Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Digklia Antonia
- Department of Oncology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
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Arpaia V, Pirolo L, Sfregola S, Licata L, Iovino M, Sanduzzi L, Ferrante A, Varriale E, Iacobelli P, Sandomenico F. Lipoleiomyosarcoma with pleomorphic liposarcoma of the uterus: Computed tomography findings with pathological correlation. A case report and review of literature. Radiol Case Rep 2024; 19:5474-5480. [PMID: 39285970 PMCID: PMC11403635 DOI: 10.1016/j.radcr.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 09/19/2024] Open
Abstract
Uterine lipoleiomyosarcomas (L-LMS) are rare malignant tumors with only few cases descripted in literature. As well, liposarcomas (LPS) arising from uterine corpus are extremely rare since fat tissue is commonly poor or absent in uterus. We report a case of L-LMS of the uterine corpus with an associated component of pleomorphic LPS. As for other female pelvic malignancies, these neoplasms are more common in postmenopausal women and clinical findings are nonspecific. Most frequent signs and symptoms are metrorrhagia and abdominal pain often associated with pelvic distension/mass. We describe diagnostic and therapeutic steps of our patient from acceptation to conclusive diagnosis. In this case, contrast-enhanced computed tomography (CECT) depicted pivotal diagnostic findings and showed a clear distinction between different tumor components. Therefore, our goal with this essay is to stress the role of CECT imaging for diagnosis of these rare neoplasms. We also perform a review of current literature about liposarcomas of the uterine corpus.
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Affiliation(s)
- Valerio Arpaia
- Diagnostic Imaging and Radiotherapy Department, University "Federico II", Naples 80131, Italy
| | - Luigi Pirolo
- Radiology Department, Buon Consiglio Fatebenefratelli Hospital, Naples 80123, Italy
| | - Stefania Sfregola
- Pathological Histology Service, San Pietro Hospital-Fatebenefratelli, Rome 00189, Italy
| | - Luana Licata
- Pathological Histology Service, San Pietro Hospital-Fatebenefratelli, Rome 00189, Italy
| | - Maria Iovino
- Radiology Department, San Giuliano Hospital, Giugliano in Campania, Naples, Italy
| | - Luca Sanduzzi
- Diagnostic Imaging and Radiotherapy Department, University "Federico II", Naples 80131, Italy
| | - Anna Ferrante
- Oncology Unit, Medicine Department, Buon Consiglio Fatebenefratelli Hospital, Naples 80123, Italy
| | - Elisa Varriale
- Oncology Unit, Medicine Department, Buon Consiglio Fatebenefratelli Hospital, Naples 80123, Italy
| | - Pietro Iacobelli
- Ginecology and Obstetrics Department, Buon Consiglio Fatebenefratelli Hospital, Naples 80123, Italy
| | - Fabio Sandomenico
- Radiology Department, Buon Consiglio Fatebenefratelli Hospital, Naples 80123, Italy
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3
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White J, Becktell K, Hopp A, Liberio N, Liu YJ, Hadjiev J. Spindle Cell Neoplasm With a Novel MN1::TAF3 Fusion: A Rare Case in a Toddler. J Pediatr Hematol Oncol 2024:00043426-990000000-00496. [PMID: 39378380 DOI: 10.1097/mph.0000000000002955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 09/14/2024] [Indexed: 10/10/2024]
Abstract
Spindle cell tumors in the pediatric population are uncommonly reported. This case discusses an 18-month-old who presented initially with unilateral ptosis and was found to have an orbital spindle cell tumor. Pathology evaluation of the tissue was extensive with nonspecific morphologic and immunohistochemical features. Molecular testing demonstrated an MN1::TAF3 fusion on RNA sequencing, which has not been previously described in the literature in association with spindle cell neoplasms. This case highlights the challenging nature of classifying and treating a tumor with a novel fusion.
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Affiliation(s)
- Jesse White
- Medical College of Wisconsin Affiliated Hospitals
| | | | - Amanda Hopp
- Pathology, Medical College of Wisconsin, Milwaukee, WI
| | | | - Yajuan J Liu
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA
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4
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Lian Y, Chen J, Han J, Zhao B, Wu J, Li X, Yue M, Hou M, Wu T, Ye T, Han X, Sun T, Tu M, Zhang K, Liu G, An Y. Deciphering the prognostic and therapeutic significance of BAG1 and BAG2 for predicting distinct survival outcome and effects on liposarcoma. Sci Rep 2024; 14:23084. [PMID: 39366981 PMCID: PMC11452671 DOI: 10.1038/s41598-024-67659-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 07/15/2024] [Indexed: 10/06/2024] Open
Abstract
Liposarcoma (LPS) is the second most common kind of soft tissue sarcoma, and a heterogeneous malignant tumor derived from adipose tissue. Up to now, the prognostic value of BAG1 or BAG2 in LPS has not been defined yet. Expression profiling data of LPS patients were collected from TCGA and GEO database. Survival curves were plotted to verify the outcome differences of patients based on BAG1 or BAG2 expression. Univariate and multivariate Cox regression models were used to analyze the prognostic ability of BAG1 or BAG2. Chaperone's regulators BAG1 and BAG2 were identified as prognostic biomarkers for LPS patients, which exhibited distinct expression patterns and survival outcome prediction performances. Patients with high BAG2 expression and/or low BAG1 expression had worse prognosis. Enrichment analysis showed that BAG1 was involved in negative regulation of TGF-β signaling. Low expression of BAG1 was associated with high abundance of regulatory T cells (Tregs). The 2-gene signature model further confirmed the improved risk assessment performance of BAG1 and BAG2: high risk patients displayed poor prognosis. BAG1 and BAG2 are supposed to be potential prognostic biomarkers for LPS and have impacts on liposarcomagenesis and immune infiltration in distinctive manners, which may function as potential therapy targets (BAG1 agonists/BAG2 inhibitors) for LPS.
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Affiliation(s)
- Yingying Lian
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Jiahao Chen
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Jiayang Han
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Binbin Zhao
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Jialin Wu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Xinyu Li
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Man Yue
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Mengwen Hou
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Tinggai Wu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Ting Ye
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Xu Han
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Tiantian Sun
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Mengjie Tu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Kaifeng Zhang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Guangchao Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China
- School of Stomatology, Henan University, Kaifeng, 475004, China
| | - Yang An
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China.
- School of Stomatology, Henan University, Kaifeng, 475004, China.
- Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key laboratory of cell signal transduction, Henan University, Kaifeng, 475004, China.
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Al-Bitar A, Al-Masalma D, Al Helbawi H. Mimicking rib osteochondroma as pulmonary nodule in a pediatric patient: A case report from Damascus, Syria. Radiol Case Rep 2024; 19:4489-4492. [PMID: 39165311 PMCID: PMC11334879 DOI: 10.1016/j.radcr.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 06/27/2024] [Accepted: 07/03/2024] [Indexed: 08/22/2024] Open
Abstract
Osteochondromas, the most frequent type of bone tumor, develop from the metaphysis region of bones. Osteochondroma often occurs in bones, however, it is rare when it comes to rib tumors. It is often asymptomatic and observed incidentally. We present a case of a 14-year-old male patient who had been experiencing cough and mild fever for approximately a week. We requested a CXR PA and LAT. It showed a pulmonary nodule measuring 1.5 cm in diameter in the upper segment of the left lower lobe. Taking into account the unclear nature of the diagnosis, we requested CT scan with contrast of the chest to obtain a better view. It showed: The nodule visualized on the CXR corresponded to a posteriorly directed, well-defined lesion arising from the costal cartilage of the third left rib, measuring 1.2 × 1.3 × 1.1 cm, likely representing an osteochondroma. The case we discussed highlights a rib osteochondroma that initially seemed like a pulmonary nodule on an X-ray, pointing out the importance of using CT scans for accurate diagnosis in such cases, and reminding us to consider osteochondroma when we see similar symptoms and to regularly check the tumor with medical imaging after it's been confirmed by a pathological test.
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Affiliation(s)
- Ahmad Al-Bitar
- Faculty of Medicine, Damascus University, Damascus, Syria
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Sukkari M, Ebedo R, Hulou S, Shami B, Nastah S, Sabbagh A. A rare well-differentiated renal retroperitoneal liposarcoma: a case report. Ann Med Surg (Lond) 2024; 86:6317-6321. [PMID: 39359852 PMCID: PMC11444529 DOI: 10.1097/ms9.0000000000002560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 08/29/2024] [Indexed: 10/04/2024] Open
Abstract
Introduction and importance Retroperitoneal liposarcomas (RPLPSs) are rare tumors that arise from mesenchymal cells in the peritoneum cavity. The sites of PRLPSs vary a lot, but renal PRLPSs are extremely rare (there are only 45 cases of Renal retroperitoneal liposarcomas on PubMed). In this case, the authors present a rare renal retroperitoneal liposarcoma case, describe the major concepts, and raise awareness about this rare tumor. Case presentation A 44-year-old woman presented to the clinic with hirsutism and irregular menstruation; upon physical examination, a large abdominal mass was accidentally identified; the patient had Doppler ultrasound (Doppler US) and MRI, which both showed a mass arising from the right upper pole of the kidney, fine needle aspiration (FNA) confirmed the diagnosis of retroperitoneal liposarcoma, patient underwent surgical removal and her symptoms disappeared. Clinical discussion The retroperitoneum is a cavity behind the abdominal wall containing organs like the pancreas and kidneys. Retroperitoneal tumors (RPTs) are rare neoplasms, primarily of mesenchymal origin. Retroperitoneal liposarcomas (RPLPS) are the most common RPT, often asymptomatic until large, and rarely metastasize but frequently recur. Liposarcomas are classified into five subtypes, with well-differentiated liposarcoma being the most common and characterized by high local recurrence. The presence of specific oncologic mutations affects the prognosis and the response to treatment. Conclusion In rare cases, retroperitoneal liposarcomas can arise from sites near the kidney and compress the adjoining adrenal gland.
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Affiliation(s)
| | | | - Saad Hulou
- Faculty of Medicine, University of Aleppo
| | | | - Samer Nastah
- Department of Surgical Oncology, Aleppo University Hospital
| | - Aziz Sabbagh
- Department of Urology, Aleppo University Hospital, Aleppo, Syria
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7
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Li T, Dong Y, Wei Y, Wang S, Liu Y, Chen J, Xiong W, Lin N, Huang X, Liu M, Yan X, Ye Z, Li B. First-Line Anlotinib Treatment for Soft-Tissue Sarcoma in Chemotherapy-Ineligible Patients: An Open-Label, Single-Arm, Phase 2 Clinical Trial. Clin Cancer Res 2024; 30:4310-4317. [PMID: 38483309 PMCID: PMC11443219 DOI: 10.1158/1078-0432.ccr-23-3983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/21/2024] [Accepted: 03/12/2024] [Indexed: 10/02/2024]
Abstract
PURPOSE Standard treatment for patients with unresectable locally advanced or metastatic soft-tissue sarcoma (LA/M STS) is chemotherapy based on anthracyclines, but patient tolerance of chemotherapy is limited. The present trial (NCT03792542) investigated the use of anlotinib as first-line treatment for patients with advanced STS, in particular liposarcoma. PATIENTS AND METHODS Eligible patients were previously untreated, pathologically confirmed, unresectable LA/M STS cases. Anlotinib was given orally at a dose of 12 mg once daily from days 1 to 14 every 3 weeks until disease progression or intolerable adverse events (AE) occurred. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), objective response rate, and disease control rate (DCR). The safety profile was also evaluated. RESULTS Forty patients were enrolled from April 2019 to June 2022 and are included in the intention-to-treat analysis. The median PFS was 6.83 months [95% confidence interval (CI), 4.17-8.71] and the median OS 27.40 months (95% CI, 16.43-not evaluable); 1 patient reached partial response and 26 attained stable disease, with a DCR of 67.5% (27/40). Median PFS and OS times for liposarcoma patients were 8.71 and 16.23 months, respectively. Ten (25.0%) patients had treatment-related AEs ≥ grade 3, with in particular a higher incidence of hypertension (15.0%) and proteinuria (7.5%). CONCLUSIONS The findings suggest a potential benefit in using front-line anlotinib to treat patients with STS, who are not eligible for cytotoxic chemotherapy. Of note, the clinical outcomes for the liposarcoma subgroup of patients were encouraging. See related commentary by Napolitano et al., p. 4257.
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Affiliation(s)
- Tao Li
- Department of Bone and Soft-tissue Surgery, Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.
| | - Ying Dong
- Medical Oncology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
| | - Yongzhong Wei
- Department of Orthopaedics, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Shoufeng Wang
- Division of Musculoskeletal Tumor, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
| | - Yunxia Liu
- Department of Oncology, Hangzhou Third People’s Hospital, Hangzhou, China.
| | - Jia Chen
- Department of Oncology, Jiangsu Cancer Hospital, Nanjing, China.
| | - Wenhua Xiong
- Department of Orthopaedics, Ningbo Second Hospital, Ningbo, China.
| | - Nong Lin
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Xin Huang
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Meng Liu
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Xiaobo Yan
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Zhaoming Ye
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Binghao Li
- Department of Orthopaedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Wu KA, Cardona DM, Eward WC. Novel Technique for Biopsying Osteofibrous Dysplasia Using a Vacuum-assisted Bone Harvester: A Case Report. J Orthop Case Rep 2024; 14:113-117. [PMID: 39381320 PMCID: PMC11458238 DOI: 10.13107/jocr.2024.v14.i10.4830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 08/10/2024] [Indexed: 10/10/2024] Open
Abstract
Introduction Osteofibrous dysplasia (OFD) is a rare benign bone lesion primarily affecting the tibia, characterized by fibrous tissue proliferation with varying osseous involvement. Diagnosis involves clinical evaluation, imaging, and histopathological analysis. Traditional bone biopsies for OFD can be challenging due to the lesion's nature. Case Report We present a case report of a young patient presenting with pain concerning for OFD and describe a novel technique for biopsy and curettage using a vacuum-assisted bone harvester. Conclusion The vacuum-assisted bone harvester allows the surgeon to effectively obtain a biopsy and curettage.
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Affiliation(s)
- Kevin A Wu
- Department of Orthopaedic Surgery, Duke University Hospital, Durham, North Carolina, United States
| | - Diana M Cardona
- Department of Pathology, Duke University Hospital, Durham, North Carolina, United States
| | - William C Eward
- Department of Orthopaedic Surgery, Duke University Hospital, Durham, North Carolina, United States
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9
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Mattmann A, Glanzmann C, Fuchs B, Bode B, Studer G. Preoperative Ultrahypofractionated Radiation Therapy for Soft Tissue Sarcomas: Low Rate of Wound Complications. Adv Radiat Oncol 2024; 9:101562. [PMID: 39314903 PMCID: PMC11417144 DOI: 10.1016/j.adro.2024.101562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/08/2024] [Indexed: 09/25/2024] Open
Abstract
Purpose Normofractionated preoperative radiation therapy (nRT) with 50 Gy applied in 25 fractions represents the most widely used radiation therapy (RT) regimen in combined local treatment of soft tissue sarcomas (STSs). STSs are characterized by a low α/β ratio of 4 to 5 Gy, which may translate into a higher sensitivity for hypofractionation. Increasing data from cohorts and phase 2 trials on ultrahypofractionated RT (uhRT) regimens are available. We prospectively assessed our preoperative uhRT sarcoma patient cohort with a focus on short-term wound complications (WCs). Methods and Materials This is a prospective registry analysis of a single-center patient cohort, treated from 03.2020 to 10.2023 with uhRT (25 Gy in 5 fractions in 1 week). The same radiation oncologists (G.S./C.G.) and surgeon (B.F.) performed the treatment (61/61 and 58/60), as well as the same reference pathologist (B.B.) confirmed all histopathologic diagnoses. WC (according to CAN-NCIC-SR2 trial) and intermediate local control (LC) rates were assessed and compared with outcome data of a previously published cohort of 67 extremity/trunk sarcoma patients treated with nRT by the same authors (7% WC, 98% LC at 3 years). Results After a mean/median follow-up of 19/19 months (range, 0-46), LC at 1.5 years was 94%. Surgery was performed at a mean/median of 20/16 days (range, 4-60) after uhRT completion. WC were observed in 7/60 operated patients (12%), and in 5/51 (10%) extremity/trunk lesions. Early tolerance was excellent, limited to G0 to G1, even in 3 patients with prior RT to the same region. Clear resection margins were achieved in 55/60 patients (92%). Pathologic necrosis of ≥95% was reported in 5% and 75% achieved less than 50% necrosis. Conclusions These results show low rates of WC and high LC for uhRT and are comparable with our previously published nRT data. This study supports the routine use of preoperative uhRT for STS.
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Affiliation(s)
- Alexander Mattmann
- Radiation Oncology, University Teaching Hospital LUKS, Sarcoma Service, University of Lucerne, 6000 Lucerne, Switzerland
| | - Christoph Glanzmann
- Radiation Oncology, University Teaching Hospital LUKS, Sarcoma Service, University of Lucerne, 6000 Lucerne, Switzerland
| | - Bruno Fuchs
- University Teaching Hospital LUKS, Sarcoma Surgery, University of Lucerne, 6000 Lucerne, Switzerland
- Kantonsspital Winterthur, Sarcoma Service, 8400 Winterthur, Switzerland
| | - Beata Bode
- Pathologie Institut Enge, SSN Reference Sarcoma Pathology, University of Zurich, 8000 Zurich, Switzerland
| | - Gabriela Studer
- Radiation Oncology, University Teaching Hospital LUKS, Sarcoma Service, University of Lucerne, 6000 Lucerne, Switzerland
| | - Swiss Sarcoma Network
- Radiation Oncology, University Teaching Hospital LUKS, Sarcoma Service, University of Lucerne, 6000 Lucerne, Switzerland
- University Teaching Hospital LUKS, Sarcoma Surgery, University of Lucerne, 6000 Lucerne, Switzerland
- Kantonsspital Winterthur, Sarcoma Service, 8400 Winterthur, Switzerland
- Pathologie Institut Enge, SSN Reference Sarcoma Pathology, University of Zurich, 8000 Zurich, Switzerland
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10
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Cunha BSA, Cassini Marques LO, Chahud F, Cruz AAV. Large congenital myopericytoma of the lower eyelid. Orbit 2024:1-4. [PMID: 39352797 DOI: 10.1080/01676830.2024.2403457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 09/06/2024] [Indexed: 10/04/2024]
Abstract
Congenital fibrous soft tissue tumors in the eyelids are exceptionally rare, with only seven cases of neonatal myofibromas reported. Myopericytoma, a variant with pericytic differentiation, has not previously been described in neonatal eyelid tumors. This report details a case of a massive congenital myopericytoma in a newborn's lower eyelid. The lesion had a broad area of adhesion to the anterior lamella of the lid. After resection, when the child was 11 days old, the resulting defect was successfully reconstructed with a V-Y type perforator-based flap.
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Affiliation(s)
- Barbara Salomão A Cunha
- Department of Ophthalmology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
- Department of Ophthalmology, Santa Casa of Belo Horizonte, Belo Horizonte, Brazil
| | | | - Fernando Chahud
- Department of Pathology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Antonio Augusto V Cruz
- Department of Ophthalmology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
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11
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Valenzuela RF, Duran-Sierra E, Canjirathinkal M, Amini B, Torres KE, Benjamin RS, Ma J, Wang WL, Hwang KP, Stafford RJ, Wu C, Zarzour AM, Bishop AJ, Lo S, Madewell JE, Kumar R, Murphy WA, Costelloe CM. Perfusion-weighted imaging with dynamic contrast enhancement (PWI/DCE) morphologic, qualitative, semiquantitative, and radiomics features predicting undifferentiated pleomorphic sarcoma (UPS) treatment response. Sci Rep 2024; 14:21681. [PMID: 39289469 PMCID: PMC11408515 DOI: 10.1038/s41598-024-72780-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Accepted: 09/10/2024] [Indexed: 09/19/2024] Open
Abstract
Undifferentiated pleomorphic sarcoma (UPS) is the largest subgroup of soft tissue sarcomas. This study determined the value of perfusion-weighted imaging with dynamic-contrast-enhancement (PWI/DCE) morphologic, qualitative, and semiquantitative features for predicting UPS pathology-assessed treatment effect (PATE). This retrospective study included 33 surgically excised extremity UPS patients with pre-surgical MRI. Volumetric tumor segmentation from PWI/DCE was obtained at Baseline (BL), Post-Chemotherapy (PC), and Post-Radiation Therapy (PRT). The surgical specimens' PATE separated cases into Responders (R) (≥ 90%, 16 patients), Partial-Responders (PR) (89 - 31%, 10 patients), and Non-Responders (NR) (≤ 30%, seven patients). Seven semiquantitative kinetic parameters and maps were extracted from time-intensity curves (TICs), and 107 radiomic features were derived. Statistical analyses compared R vs. PR/NR. At PRT, 79% of R displayed a "Capsular" morphology (P = 1.49 × 10-7), and 100% demonstrated a TIC-type II (P = 8.32 × 10-7). 80% of PR showed "Unipolar" morphology (P = 1.03 × 10-5), and 60% expressed a TIC-type V (P = 0.06). Semiquantitative wash-in rate (WiR) was able to separate R vs. PR/NR (P = 0.0078). The WiR radiomics displayed significant differences in the first_order_10 percentile (P = 0.0178) comparing R vs. PR/NR at PRT. The PWI/DCE TIC-type II curve, low WiR, and "Capsular" enhancement represent PRT patterns typically observed in successfully treated UPS and demonstrate potential for UPS treatment response assessment.
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Affiliation(s)
- R F Valenzuela
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - E Duran-Sierra
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - M Canjirathinkal
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - B Amini
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - K E Torres
- Department of Surgical Oncology, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - R S Benjamin
- Department of Sarcoma Medical Oncology, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - J Ma
- Department of Imaging Physics, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - W L Wang
- Department of Anatomical Pathology, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - K P Hwang
- Department of Imaging Physics, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - R J Stafford
- Department of Imaging Physics, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - C Wu
- Department of Imaging Physics, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - A M Zarzour
- Department of Sarcoma Medical Oncology, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - A J Bishop
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - S Lo
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - J E Madewell
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - R Kumar
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - W A Murphy
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
| | - C M Costelloe
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1475, Houston, TX, 77030-4009, USA
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12
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Wu H, Ghanem AK, Abbas KS, Abdalshafy H, Abdelazeem B, Wang H, Zhang J, Zhang C. The diagnosis, genetic alternation, and treatment of the primary pleomorphic liposarcoma of the femur in a rare age: Case report and literature review. Heliyon 2024; 10:e36953. [PMID: 39296074 PMCID: PMC11407983 DOI: 10.1016/j.heliyon.2024.e36953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 08/22/2024] [Accepted: 08/26/2024] [Indexed: 09/21/2024] Open
Abstract
Introduction Liposarcoma of the bone is an extremely rare and aggressive primary bone tumor. We aimed to review all liposarcoma cases in the literature and present our new young female patient with liposarcoma. Methods of literature review and case presentation: Electronic databases (PubMed, Scopus, Web of Science (WOS), and Google Scholar) were searched to retrieve the related cases on liposarcoma. Extraction for important clinical data was done independently by two authors to present age, gender, site, histological type, the treatment used, and clinical outcomes of survival or recurrence. In our presented case, we followed the CARE checklist. Results A total of 33 patients were included in the literature search: 19 (57.6 %) male and 14 (42.4 %) female, with a mean age of 42.85 ± 18.83. Seven patients (21.2 %) were less than the age of 20 years old. The most frequent subtype was primary pleomorphic liposarcoma. Most treatment options were resection, excision, and amputation with or without chemotherapy. Recurrence was reported in four cases. However, most patients died due to late diagnosis with distant organ metastasis. Case presentation we report a case of primary pleomorphic liposarcoma of the left distal femur of a twelve-year-old female. The patient presented with a painful lower thigh swelling, not responding to analgesics. Imaging studies were done and showed a lesion extended across the distal physeal plate laterally and centrally with scattered lesions medially. Histologically, the tumor showed a uniformly pleomorphic liposarcomatous pattern with extensive necrosis. Genetic analysis showed frequent mutations in LATS2, CREBBP, and SMAD2 genes in addition to deletions and amplifications in different genetic pathways. Two cycles of MAP chemotherapy were completed before tumor excision and total left knee replacement, followed by two other MAP cycles postoperatively. Multiple lung metastases were detected on chest CT 10 months postoperatively. The patient died 13 months postoperatively. Conclusion Primary pleomorphic liposarcoma can present as sclerotic and aggressive malignant bone tumors at an early age. Excision, MAP, and MAPI chemotherapy are not enough to treat this tumor.
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Affiliation(s)
- Haixiao Wu
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Ahmed K Ghanem
- The Lundquist Institute at Harbor-UCLA, Los Angeles, CA, USA
| | | | | | - Basel Abdelazeem
- McLaren Health Care, Flint, MI, USA
- Michigan State University, East Lansing, MI, USA
| | - Hangchi Wang
- Clinical Medical College of Tianjin Medical University, Tianjin, China
| | - Jin Zhang
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Chao Zhang
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
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Stergiopoulos GM, Siontis BL, Petersen IA, Houdek MT, Ho TP, Okuno SH, Robinson SI. Cardiac Metastasis from Myxoid Liposarcoma Managed Successfully with Chemotherapy and Radiotherapy: Case Report and Review of the Literature. Curr Oncol 2024; 31:5384-5398. [PMID: 39330026 PMCID: PMC11431419 DOI: 10.3390/curroncol31090398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 08/30/2024] [Accepted: 09/10/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Liposarcoma, one of the most prevalent sarcoma histologies, is recognized for its tendency for extra-pulmonary metastases. While oligometastatic cardiac disease is rarely reported, it poses a unique challenge as oligometastatic sarcomas are often managed with surgical resection. CASE REPORT We present a case of a 62-year-old man diagnosed with an oligometastatic myxoid liposarcoma (MLPS) to the heart 19 years after the primary tumor resection from the lower limb. The metastatic mass, situated in the pericardium adjacent and infiltrating the left ventricle, was not managed surgically but with a combination of chemotherapy and radiotherapy. The patient's disease remains stable to date, for more than 10 years. LITERATURE REVIEW We conducted a review of the literature to determine the preferred management approach for solitary cardiac metastases of sarcomas. We also conducted an in-depth analysis focusing on reported cases of MLPS metastasizing to the heart, aiming to extract pertinent data regarding the patient characteristics and the corresponding management strategies. CONCLUSIONS Although clinical diagnoses of solitary or oligometastatic cardiac metastases from sarcomas are infrequent, this case underscores the significance of aggressive management employing chemotherapy and radiotherapy for chemosensitive and radiosensitive sarcomas, especially when surgical removal is high-risk. Furthermore, it challenges the notion that surgery is the exclusive therapeutic option leading to long-term clinical benefit in patients with recurrent sarcomas.
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Affiliation(s)
| | | | - Ivy A Petersen
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Matthew T Houdek
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Thanh P Ho
- Department of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Scott H Okuno
- Department of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA
| | - Steven I Robinson
- Department of Molecular Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA
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14
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Ng IAT, Tan HJ, Chiow AKH, Nita T. Surgical management of rare hepatobiliary sarcomas in a regional teaching hospital: a collaborative model for optimal care with case studies. BMJ Case Rep 2024; 17:e260975. [PMID: 39266040 DOI: 10.1136/bcr-2024-260975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024] Open
Abstract
Sarcomas are challenging and conventionally referred to sarcoma specialist centres. In select cases with required surgical expertise, collaboration with a quaternary sarcoma centre rather than an upfront transfer of care may reduce logistic challenges without compromising patient care.We present a case series of three rare tumours of hepatobiliary origin-two cases of undifferentiated embryonal liver sarcoma in adults and one case of follicular dendritic sarcoma of the cystic lymph node.All three patients underwent surgery in a non-sarcoma specialist centre by hepatobiliary specialist surgeons with concurrent remote referrals to a sarcoma specialist quaternary centre. Both centres belong to the same cluster. R0 resection and no significant postoperative morbidity were achieved. All three patients currently remain disease-free.The unique and integrated healthcare systems within Singapore render cross-institution management possible. This case series suggests that an established setup for cross-centre collaboration facilitates wholistic patient care with good outcomes.
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Affiliation(s)
- Irene Ai Ting Ng
- Hepatopancreatobiliary Service, Department of Surgery, Changi General Hospital, Singapore
| | - Hiang Jin Tan
- Hepatopancreatobiliary Service, Department of Surgery, Changi General Hospital, Singapore
- Duke-NUS Medical School, Singapore
| | - Adrian Kah Heng Chiow
- Hepatopancreatobiliary Service, Department of Surgery, Changi General Hospital, Singapore
- Duke-NUS Medical School, Singapore
| | - Thiruchelvam Nita
- Hepatopancreatobiliary Service, Department of Surgery, Changi General Hospital, Singapore
- Duke-NUS Medical School, Singapore
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15
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Qiu Y, Zhang Q, Liu X. CCDC88A could serve as a prognostic biomarker for SARC patients. Asian J Surg 2024:S1015-9584(24)01888-8. [PMID: 39266353 DOI: 10.1016/j.asjsur.2024.08.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/11/2024] [Accepted: 08/20/2024] [Indexed: 09/14/2024] Open
Affiliation(s)
- Yunpeng Qiu
- Department of Orthopaedics, The Second People's Hospital of Futian, Shenzhen, 27 Zhongkang Road, Shangmeilin, Futian District, 518049, Shenzhen, Guangdong, China
| | - Qiao Zhang
- Department of Orthopaedics, The Second People's Hospital of Futian, Shenzhen, 27 Zhongkang Road, Shangmeilin, Futian District, 518049, Shenzhen, Guangdong, China
| | - Xing Liu
- Department of Emergency, The Second People's Hospital of Futian, Shenzhen, 27 Zhongkang Road, Shangmeilin, Futian District, 518049, Shenzhen, Guangdong, China.
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16
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Chen H, Wang W, Chang S, Huang X, Wang N. A useful mTORC1 signaling-related RiskScore model for the personalized treatment of osteosarcoma patients by using the bulk RNA-seq analysis. Discov Oncol 2024; 15:418. [PMID: 39251459 PMCID: PMC11383908 DOI: 10.1007/s12672-024-01301-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 09/02/2024] [Indexed: 09/11/2024] Open
Abstract
AIMS This research developed a prognostic model for OS patients based on the Mechanistic Target of Rapamycin Complex 1 (mTORC1) signature. BACKGROUND The mTORC1 signaling pathway has a critical role in the maintenance of cellular homeostasis and tumorigenesis and development through the regulation of cell growth, metabolism and autophagy. However, the mechanism of action of this signaling pathway in Osteosarcoma (OS) remains unclear. OBJECTIVE The datasets including the TARGET-OS and GSE39058, and 200 mTORC1 genes were collected. METHODS The mTORC1 signaling-related genes were obtained based on the Molecular Signatures Database (MSigDB) database, and the single sample gene set enrichment analysis (ssGSEA) algorithm was utilized in order to calculate the mTORC1 score. Then, the WGCNA were performed for the mTORC1-correlated gene module, the un/multivariate and lasso Cox regression analysis were conducted for the RiskScore model. The immune infiltration analysis was performed by using the ssGSEA method, ESTIMATE tool and MCP-Count algorithm. KM survival and Receiver Operating Characteristic (ROC) Curve analysis were performed by using the survival and timeROC package. RESULTS The mTORC1 score and WGCNA with β = 5 screened the mTORC1 positively correlated skyblue2 module that included 67 genes, which are also associated with the metabolism and hypoxia pathways. Further narrowing of candidate genes and calculating the regression coefficient, we developed a useful and reliable RiskScore model, which can classify the patients in the training and validation set into high and low-risk groups based on the median value of RiskScore as an independent and robust prognostic factor. High-risk patients had a significantly poor prognosis, lower immune infiltration level of multiple immune cells and prone to cancer metastasis. Finally, we a nomogram model incorporating the metastasis features and RiskScore showed excellent prediction accuracy and clinical practicability. CONCLUSION We developed a useful and reliable risk prognosis model based on the mTORC1 signaling signature.
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Affiliation(s)
- Hongxia Chen
- Department of Hematology, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
| | - Wei Wang
- Department of Oncology, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
| | - Shichuan Chang
- Department of Oncology, Chongqing University Three Gorges Hospital, Chongqing, 404000, China
| | - Xiaoping Huang
- Department of Oncology, Chongqing University Three Gorges Hospital, Chongqing, 404000, China.
| | - Ning Wang
- Department of Oncology, Chongqing University Three Gorges Hospital, Chongqing, 404000, China.
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17
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de Mattos VDA, Ferman SE, Magalhães DMA, da Costa FV, Antunes HS, Junior AS. Late dental and bone alterations in patients after orbital rhabdomyosarcoma treatment. Support Care Cancer 2024; 32:642. [PMID: 39243302 DOI: 10.1007/s00520-024-08843-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 08/27/2024] [Indexed: 09/09/2024]
Abstract
PURPOSE Orbital rhabdomyosarcoma is a rare soft tissue sarcoma in childhood but with a good prognosis. Treatment usually includes surgery, chemotherapy, and radiotherapy. This study aimed to evaluate long-term alterations in teeth and cranial bones in children, adolescents, and young adults after oncologic treatment for childhood orbital rhabdomyosarcoma. METHOD This was a cross-sectional study that evaluated patients treated for orbital rhabdomyosarcoma between 1988 and 2011. Demographic, clinical, and treatment data were collected during the study period; also, panoramic radiographs, cephalometric study, and photographs of the face were taken. RESULTS Eight long-term survivors were studied. Of those, 50% were male, 75% had less than 5 years of treatment, and 88% had only one of the orbits affected by the tumor. Regarding treatment, 50% received 50.4 Gy of radiotherapy in the orbit; the chemotherapy included vincristine, actinomycin D, and cyclophosphamide in 75% of the cases and also ifosfamide and etoposide in 25%. The children presented craniofacial alterations, mainly when radiotherapy occurred between 0 and 5 years old (p = 0.01). The mandibles also showed dental alterations, probably due to chemotherapy. CONCLUSION In conclusion, orbital RMS patients treated with chemoradiotherapy, important dental, and facial bone alterations were found. The most significant were in the maxilla and close to the irradiation field. Dental and mandibular bone alterations were also found, indicating the probable chemotherapy action, as this region was not included in the irradiation field.
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Affiliation(s)
- Valkiria D Aiuto de Mattos
- Pediatric Oncology Division, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sima Esther Ferman
- Pediatric Oncology Division, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Felipe Vieira da Costa
- Private Practice and Pathology Department, Universidade Federal Fluminense (UFF), Niterói, Rio de Janeiro, Brazil
| | - Héliton Spíndola Antunes
- Clinical Research Division, Instituto Nacional de Câncer (INCA), Rua André Cavalcante, N° 37, 2° Andar, Rio de Janeiro, RJ, CEP-20231-050, Brazil.
| | - Arley Silva Junior
- Pathology Department, Universidade Federal Fluminense (UFF), Niterói, Rio de Janeiro, Brazil
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18
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Wu Y, Sun B, Tang Y, Shen A, Lin Y, Zhao X, Li J, Monteiro MJ, Gu W. Bone targeted nano-drug and nano-delivery. Bone Res 2024; 12:51. [PMID: 39231955 PMCID: PMC11375042 DOI: 10.1038/s41413-024-00356-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 07/04/2024] [Accepted: 07/16/2024] [Indexed: 09/06/2024] Open
Abstract
There are currently no targeted delivery systems to satisfactorily treat bone-related disorders. Many clinical drugs consisting of small organic molecules have a short circulation half-life and do not effectively reach the diseased tissue site. This coupled with repeatedly high dose usage that leads to severe side effects. With the advance in nanotechnology, drugs contained within a nano-delivery device or drugs aggregated into nanoparticles (nano-drugs) have shown promises in targeted drug delivery. The ability to design nanoparticles to target bone has attracted many researchers to develop new systems for treating bone related diseases and even repurposing current drug therapies. In this review, we shall summarise the latest progress in this area and present a perspective for future development in the field. We will focus on calcium-based nanoparticle systems that modulate calcium metabolism and consequently, the bone microenvironment to inhibit disease progression (including cancer). We shall also review the bone affinity drug family, bisphosphonates, as both a nano-drug and nano-delivery system for bone targeted therapy. The ability to target and release the drug in a controlled manner at the disease site represents a promising safe therapy to treat bone diseases in the future.
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Affiliation(s)
- Yilun Wu
- College of Biotechnology and Pharmaceutical Engineering, Nanjing Tech University, Nanjing, China
| | - Bing Sun
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St. Lucia, QLD, Australia
| | - Ying Tang
- Science and Technology Innovation Centre, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Aining Shen
- Shenzhen Bay Laboratory, Shenzhen, Guangdong, China
| | - Yanlin Lin
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St. Lucia, QLD, Australia
| | - Xiaohui Zhao
- GMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, China
| | - Jingui Li
- School of Veterinary Medicine, Jiangsu Co-innovation Centre for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China
| | - Michael J Monteiro
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St. Lucia, QLD, Australia
| | - Wenyi Gu
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, St. Lucia, QLD, Australia.
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Sato A, Yusa N, Takamori H, Shimizu E, Yokoyama K, Ichikawa S, Yokoyama H, Kasahara Y, Enda K, Fujishima F, Ichinohasama R, Ota Y, Imoto S, Nannya Y. Common progenitor origin for Rosai-Dorfman disease and clear cell sarcoma. J Pathol 2024. [PMID: 39225049 DOI: 10.1002/path.6345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/22/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024]
Abstract
Histiocytic neoplasms (HNs) in adults have been reported to be associated with a high prevalence of coexisting haematological and solid malignancies. While a proportion of coexisting HNs and haematological malignancies share identical genetic alterations, the genetic association between HNs and solid malignancies has scarcely been reported. We report a case of Rosai-Dorfman disease (RDD) complicated by coexisting clear cell sarcoma (CCS). RDD is a rare HN. CCS is an ultrarare soft tissue sarcoma with a poor prognosis. Mutation analysis with whole-exome sequencing revealed six shared somatic alterations including NRAS p.G12S and TP53 c.559+1G>A in both the RDD and CCS tissue. This is the first evidence of a clonal relationship between RDD and solid malignancies using mutational analysis. We hypothesise that neural crest cells, which originate in CCS, are likely the common cells of origin for RDD and CCS. This case helps to unravel the underlying clinicopathological mechanisms of increased association of solid malignancies in HNs. © 2024 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Aki Sato
- Department of Hematology and Oncology, The Institute of Medical Science Research Hospital, The University of Tokyo, Tokyo, Japan
| | - Nozomi Yusa
- Department of Laboratory Medicine, The Institute of Medical Science Research Hospital, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Takamori
- Division of Hematopoietic Disease Control, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Eigo Shimizu
- Division of Health Medical Intelligence, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kazuaki Yokoyama
- Department of Hematology and Oncology, The Institute of Medical Science Research Hospital, The University of Tokyo, Tokyo, Japan
| | - Satoshi Ichikawa
- Department of Hematology, Tohoku University Hospital, Sendai, Japan
- Department of Hematology and Rheumatology, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan
| | - Hisayuki Yokoyama
- Department of Hematology, Tohoku University Hospital, Sendai, Japan
- Division of Hematology and Cell Therapy, Yamagata University Hospital, Yamagata, Japan
| | - Yuki Kasahara
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Kodai Enda
- Department of Pathology, Tohoku University Hospital, Sendai, Japan
| | - Fumiyoshi Fujishima
- Department of Pathology, Tohoku University Hospital, Sendai, Japan
- Division of Diagnostic Pathology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Ryo Ichinohasama
- Division of Hematopathology, Tohoku University Hospital, Sendai, Japan
| | - Yasunori Ota
- Department of Diagnostic Pathology, The Institute of Medical Science Research Hospital, The University of Tokyo, Tokyo, Japan
| | - Seiya Imoto
- Division of Health Medical Intelligence, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yasuhito Nannya
- Department of Hematology and Oncology, The Institute of Medical Science Research Hospital, The University of Tokyo, Tokyo, Japan
- Division of Hematopoietic Disease Control, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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20
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Spalato-Ceruso M, Ghazzi NE, Italiano A. New strategies in soft tissue sarcoma treatment. J Hematol Oncol 2024; 17:76. [PMID: 39218932 PMCID: PMC11368005 DOI: 10.1186/s13045-024-01580-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/22/2024] [Indexed: 09/04/2024] Open
Abstract
Soft tissue sarcomas (STS) have long been a formidable challenge in oncology, partly because of their rarity and diversity, which complicates large-scale studies and slows the advent of new treatments. Traditionally anchored by anthracycline-based chemotherapy, the landscape of STS treatment hasn't shifted dramatically in the past twenty years. However, recent strides in research are starting to paint a more hopeful picture. Leveraging advanced molecular profiling, researchers are now tailoring treatments to the unique genetic makeup of tumors, with targeted therapies showing promise. Innovations such as NTRK inhibitors for NTRK-rearranged sarcomas and gamma-secretase inhibitors for desmoid tumors are changing clinical practices. The rise of immunotherapy, including novel agents like LAG-3 inhibitors and bifunctional proteins that target both TGF-β and PD-L1, offers new avenues for treatment, particularly when combined with traditional therapies like chemotherapy. Meanwhile, the approval of epigenetic treatments for specific sarcoma subtypes heralds a new wave of strategy based on histological specificity, which could lead to more personalized and effective care. While challenges remain, the field of STS treatment is evolving, driven by a deeper understanding of the disease's biological underpinnings and a commitment to innovative research approaches.
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Affiliation(s)
| | - Nathan El Ghazzi
- Sarcoma Unit, Institut Bergonié, Bordeaux, France
- INSERM U1312, Bordeaux, France
| | - Antoine Italiano
- Sarcoma Unit, Institut Bergonié, Bordeaux, France.
- INSERM U1312, Bordeaux, France.
- Université de Bordeaux, Bordeaux, France.
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21
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Cuenin M, Levy A, Peiffert D, Sunyach MP, Ducassou A, Cordoba A, Gillon P, Thibouw D, Lapeyre M, Lerouge D, Helfre S, Leroux A, Salleron J, Sirveaux F, Marchal F, P.Teixeira, Debordes PA, G.Vogin. Local relapse patterns after preoperative radiotherapy of limb and trunk wall soft tissue sarcomas: Prognostic role of imaging and pathologic response factors. Clin Transl Radiat Oncol 2024; 48:100825. [PMID: 39192877 PMCID: PMC11347830 DOI: 10.1016/j.ctro.2024.100825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 07/24/2024] [Indexed: 08/29/2024] Open
Abstract
Purpose To retrospectively identify clinical, pathologic, or imaging factors predictive of local relapse (LR) after preoperative radiotherapy (RT) for soft tissue sarcomas (STS). Methods and Materials This is a retrospective multicenter study of patients who underwent preoperative RT and surgery for limb or trunk wall STS between 2007 and 2018 in French Sarcoma Group centers and were enrolled in the "Conticabase". Patterns of LR were investigated taking into account the multimodal response after preoperative RT. Diagnostic and surgical samples were compared after systematic review by expert pathologists and patients were stratified by tumor grade. Log-rank tests and Cox models were used to identify prognostic factors for radiation response and LR. Results 257 patients were included; 17 % had low-grade (LG), 72.5 % had high-grade (HG) sarcomas. In HG group, tumors were larger, mostly undifferentiated, and displayed more necrosis and perilesional edema after RT. Median follow-up was 32 months. Five-year cumulative incidence of LR was 20.3 % in the HG group versus 9.7 % in the LG group (p = 0.026). In multivariate analysis, trunk wall location (HR 6.79, p = 0.012) and proportion of viable tumor cellularity ≥ 20 % (HR 3.15, p = 0.018) were associated with LR. After adjusting for tumor location, combination of histotype and cellularity rate significantly correlated with LR. We described three prognostic subgroups for HG sarcomas, listed from the highest to lowest risk: undifferentiated sarcoma (US) with cellularity rates ≥ 20 %; non-US (NUS) with cellularity rates ≥ 20 % or US with cellularity rates < 20 %; and NUS with cellularity rates < 20 %, which shared similar prognostic risks with LG sarcomas. Conclusions HG and LG tumors have different morphological and biological behaviors in response to RT. Combination of cellularity rate with histotype could be a major prognostic for LR. Patients with undifferentiated HG sarcomas with cellularity rates ≥ 20 % after preoperative RT had the highest risk of LR and disease-specific death.
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Affiliation(s)
- M. Cuenin
- Department of Radiation Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - A. Levy
- Department of Radiation Oncology, Gustave Roussy, Thoracic Oncology Institute (IOT), Villejuif, France
| | - D. Peiffert
- Department of Radiation Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - MP. Sunyach
- Department of Radiation Oncology, Centre Léon-Bérard, Lyon, France
| | - A. Ducassou
- Department of Radiation Oncology, IUCT-oncopole, Institut Claudius-Regaud, Toulouse, France
| | - A. Cordoba
- Department of Radiation Oncology, Centre Oscar-Lambret, Lille, France
| | - P. Gillon
- Department of Radiation Oncology, Institut Bergonié, Bordeaux, France
| | - D. Thibouw
- Department of Radiation Oncology, Centre Régional De Lutte Contre Le Cancer Georges-François Leclerc C.G.F., Dijon, France
| | - M. Lapeyre
- Department of Radiation Oncology, Centre Jean-Perrin, Clermont-Ferrand, France
| | - D. Lerouge
- Department of Radiation Oncology, Centre François-Baclesse, Caen, France
| | - S. Helfre
- Department of Radiation Oncology, Institut Curie, PSL Research University, Paris, France
| | - A. Leroux
- Department of Pathology, Institut de Cancérologie de Lorraine, Vandoeuvre-les Nancy, France
| | - J. Salleron
- Department of Statistics, Institut de Cancérologie de Lorraine, Vandoeuvre-les Nancy, France
| | - F. Sirveaux
- Department of Orthopedic Surgery, Centre Chirurgical Emile Gallé, University Hospital of Nancy, Nancy, France
| | - F. Marchal
- Department of Surgical Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - P.Teixeira
- Guilloz Department of Imaging, Central Hospital, Nancy, France
| | - PA. Debordes
- Department of Orthopedic Surgery, Hopitaux universitaires de Strasbourg, Strasbourg, France
| | - G.Vogin
- CNRS, Université de Lorraine, France
- National Center of Radiotherapy, Grand-Duché du Luxembourg, Centre François Baclesse, Esch sur Alzette, Luxembourg
- Department of Oncology, Luxembourg Institute of Health, Luxembourg
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22
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Mick P, Rohner M, Renkawitz T, Lehner B, Geisbüsch A, Tsitlakidis S, Hariri M, Deisenhofer J, Müller M, Doll J. From Benign Lipoma to G3 Liposarcoma: Contrast-Enhanced Ultrasound Reveals Tumor Microperfusion and Indicates Malignancy. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1472-1478. [PMID: 38955624 DOI: 10.1016/j.ultrasmedbio.2024.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/27/2024] [Accepted: 05/31/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE Lipomatous soft tissue tumors (STT), ranging from benign lipomas to malignant liposarcomas, require accurate differentiation for timely treatment. Complementary to MRI, Contrast-enhanced ultrasound (CEUS) is emerging as a promising tool, providing insight into tumor microperfusion in real-time. This study aims to explore the potential of preoperative CEUS in differentiating benign lipomatous tumors from malignant liposarcoma subtypes. METHODS Eighty-seven patients with lipomatous STT scheduled for surgery were enrolled. Clinical and MRI assessments were conducted to obtain general tumor characteristics. CEUS was used for a standardized tumor perfusion evaluation. Perfusion analysis included peak enhancement, rise time, wash-in perfusion index, and wash-out rate, reflecting the perfusion kinetics. Histopathological results were obtained for every STT and compared to perfusion characteristics. RESULTS In total, 48 lipoma, 23 ALT and 11 liposarcoma were identified. Significant differences in tumor microperfusion were demonstrated, with higher perfusion levels indicating higher malignancy (Peak enhancement [a.u.] of Lipoma: 145 ± 238; ALT: 268 ± 368; Liposarcoma: 3256 ± 4333; p (ALT vs. Liposarcoma) < 0.001). A perfusion-based identification of a benign lipoma or ALT versus sarcoma resulted in a positive predictive value of 93%. Patient-related factors (age, gender, BMI, ASA score, smoking status) had no significant impact on the CEUS-based perfusion parameters. CONCLUSION Our study suggests CEUS as a capable non-invasive tool for improving preoperative assessment of lipomatous STT. It can assist in the distinction between benign and malignant STT, accelerating treatment decisions and enhancing patient outcomes. Significant correlations between CEUS-derived parameters and malignancy highlight its risk assessment potential.
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Affiliation(s)
- Paul Mick
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
| | - Marie Rohner
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Tobias Renkawitz
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Burkhard Lehner
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas Geisbüsch
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefanos Tsitlakidis
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Mustafa Hariri
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Julian Deisenhofer
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Michelle Müller
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Julian Doll
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
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23
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Zhang L, Li W, Wang X, Yu S, Zhuang R, Zhou Y. A real-world study of active vitamin D as a prognostic marker in patients with sarcoma. Discov Oncol 2024; 15:384. [PMID: 39207640 PMCID: PMC11362410 DOI: 10.1007/s12672-024-01152-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 07/09/2024] [Indexed: 09/04/2024] Open
Abstract
PURPOSE The assessment of sarcoma during clinical practice is primarily based on imaging examination, with no effective biomarkers available. Although it has been established that 1,25(OH)2D3 is abnormally expressed in patients with sarcoma, it remains unclear whether 1,25(OH)2D3 level could be used as an evaluation marker in these patient population. METHODS This real-world study investigated 1,25(OH)2D3 level and its association with clinical features in sarcoma patients. Data on 1,25(OH)2D3, parathyroid hormone, calcium, and calcitonin were collected from 331 patients with sarcoma, while the imaging results and the variation in 1,25(OH)2D3 among 213 patients with sarcoma before and after treatment was further analyzed. RESULTS We found that the serum 1,25(OH)2D3 level was predominantly decreased in patients with sarcoma, with a mean of 45.68 nmol/L. 1,25(OH)2D3 was significantly correlated with the gender and age of sarcoma patients, with more substantial reductions in women and younger patients. Among sarcoma patients, those with progressive disease exhibited a 7.08 nmol/L (-13.73%) decrease in serum 1,25(OH)2D3 levels compared to baseline, while patients with non-progressive disease showed a 1.11 nmol/L (+ 7.0%) increase. CONCLUSION The variation of serum 1,25(OH)2D3 can predict the disease status of patients with sarcoma. Decreased serum 1,25(OH)2D3 levels are indicative of disease progression in sarcoma patients, suggesting its potential for application as a prognostic marker for disease assessment in this patient population.
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Affiliation(s)
- Lingyun Zhang
- Department of Medical Oncology, Shanghai Geriatric Medical Center, Shanghai, China
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Li
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiao Wang
- Department of Medical Oncology, Shanghai Geriatric Medical Center, Shanghai, China
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shan Yu
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rongyuan Zhuang
- Department of Medical Oncology, Shanghai Geriatric Medical Center, Shanghai, China
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuhong Zhou
- Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China.
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24
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Ipponi E, Bechini E, Cordoni M, Gentili F, Cosseddu F, D'Arienzo A, Andreani L. Myxoid Liposarcomas of the Thigh: Pre-Operative Presentation, Clinical Outcomes, and Functional Results of Surgical Treatment. Healthcare (Basel) 2024; 12:1718. [PMID: 39273742 PMCID: PMC11395618 DOI: 10.3390/healthcare12171718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 08/14/2024] [Accepted: 08/27/2024] [Indexed: 09/15/2024] Open
Abstract
Myxoid liposarcomas are malignant soft-tissue sarcomas whose treatment represents a challenge, even for the most experienced surgeon. In this study, we report on our experience with the treatment of myxoid liposarcomas of the thigh. Our retrospective analysis included myxoid liposarcomas of the thigh treated with surgical resection between 2016 and 2022. Resection margins, complications, local recurrences, and metastases were recorded. The oncological outcome of each case was evaluated at their latest follow-up. Adjuvant therapies were administered according to the ESMO guidelines. Functionality was assessed with the MSTS score before surgery and at the patients' latest follow-up. Thirty cases (ten high-grade and 20 low-grade) were included. The mean diameter was 11.8 cm. Twenty-four cases had wide margins (80%) and six (20%) were marginal. Five cases (60% marginal) had local recurrences (17%). Marginal resection was associated with a higher risk of local recurrence (p = 0.041). Three cases with high-grade tumors (10%) developed metastases. At the patients' latest follow-up, their mean MSTS score had risen from 22.9 to 27.3. While tumor grade influences the risk of metastases, the quality of resection margins can determine the local recurrence rate. An adequate surgery can lead to good post-operative functional outcomes.
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Affiliation(s)
- Edoardo Ipponi
- Department of Orthopedics and Trauma Surgery, University of Pisa, 56126 Pisa, Italy
| | - Elena Bechini
- Department of Orthopedics and Trauma Surgery, University of Pisa, 56126 Pisa, Italy
| | - Martina Cordoni
- Department of Orthopedics and Trauma Surgery, University of Pisa, 56126 Pisa, Italy
| | - Fabrizia Gentili
- Department of Orthopedics and Trauma Surgery, University of Pisa, 56126 Pisa, Italy
| | - Fabio Cosseddu
- Department of Orthopedics and Trauma Surgery, University of Pisa, 56126 Pisa, Italy
| | - Antonio D'Arienzo
- Department of Orthopedics and Trauma Surgery, University of Pisa, 56126 Pisa, Italy
| | - Lorenzo Andreani
- Department of Orthopedics and Trauma Surgery, University of Pisa, 56126 Pisa, Italy
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25
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Samà L, Rodda GA, Ruspi L, Sicoli F, D'Amato V, Renne SL, Laffi A, Baldaccini D, Clerici E, Navarria P, Scorsetti M, Bertuzzi AF, Quagliuolo VL, Cananzi FCM. Mesenchymal Tumor Management: Integrating Surgical and Non-Surgical Strategies in Different Clinical Scenarios. Cancers (Basel) 2024; 16:2965. [PMID: 39272823 PMCID: PMC11394309 DOI: 10.3390/cancers16172965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 08/20/2024] [Accepted: 08/25/2024] [Indexed: 09/15/2024] Open
Abstract
Mesenchymal tumors originate from mesenchymal cells and can be either benign or malignant, such as bone, soft tissue, and visceral sarcomas. Surgery is a cornerstone treatment in the management of mesenchymal tumors, often requiring complex procedures performed in high-volume referral centers. However, the COVID-19 pandemic has highlighted this need for alternative non-surgical approaches due to limited access to surgical resources. This review explores the role of non-surgical treatments in different clinical scenarios: for improving surgical outcomes, as a bridge to surgery, as better alternatives to surgery, and for non-curative treatment when surgery is not feasible. We discuss the effectiveness of active surveillance, cryoablation, high-intensity focused ultrasound, and other ablative techniques in managing these tumors. Additionally, we examine the use of tyrosine kinase inhibitors in gastrointestinal stromal tumors and hypofractionated radiotherapy in soft tissue sarcomas. The Sarculator tool is highlighted for its role in stratifying high-risk sarcoma patients and personalizing treatment plans. While surgery remains the mainstay of treatment, integrating advanced non-surgical strategies can enhance therapeutic possibilities and patient care, especially in specific clinical settings with limitations. A multidisciplinary approach in referral centers is vital to determine the optimal treatment course for each patient.
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Affiliation(s)
- Laura Samà
- Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Giorgia Amy Rodda
- Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
| | - Laura Ruspi
- Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Federico Sicoli
- Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Vittoria D'Amato
- Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Salvatore Lorenzo Renne
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Department of Pathology, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Alice Laffi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Davide Baldaccini
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Elena Clerici
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Pierina Navarria
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Marta Scorsetti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Alexia Francesca Bertuzzi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Vittorio Lorenzo Quagliuolo
- Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Ferdinando Carlo Maria Cananzi
- Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
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26
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Burkhard-Meier A, Grube M, Jurinovic V, Agaimy A, Albertsmeier M, Berclaz LM, Di Gioia D, Dürr HR, von Eisenhart-Rothe R, Eze C, Fechner K, Fey E, Güler SE, Hecker JS, Hendricks A, Keil F, Klein A, Knebel C, Kovács JR, Kunz WG, Lenze U, Lörsch AM, Lutz M, Meidenbauer N, Mogler C, Schmidt-Hegemann NS, Semrau S, Sienel W, Trepel M, Waldschmidt J, Wiegering A, Lindner LH. Unraveling the role of local ablative therapies for patients with metastatic soft tissue sarcoma - A retrospective multicenter study of the Bavarian university hospitals. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108619. [PMID: 39270516 DOI: 10.1016/j.ejso.2024.108619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 08/15/2024] [Accepted: 08/21/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Local ablative therapies (LAT) are increasingly used in patients with metastatic soft tissue sarcoma (STS), yet evidence-based standards are lacking. This study aimed to assess the impact of LAT on survival of metastatic STS patients and to identify prognostic factors. METHODS In this retrospective multicenter study, 246 STS patients with metastatic disease who underwent LAT on tumor board recommendation between 2017 and 2021 were analyzed. A mixed effects model was applied to evaluate multiple survival events per patient. RESULTS Median overall survival (OS) after first metastasis was 5.4 years with 1-, 2- and 5-year survival rates of 93.7, 81.7, and 53.1 %, respectively. A treatment-free interval ≥12 months and treatment of liver metastases were positively correlated with progression-free survival (PFS) after LAT (HR = 0.61, p = 0.00032 and HR = 0.52, p = 0.0081, respectively). A treatment-free interval ≥12 months and treatment of metastatic lesions in a single organ site other than lung and liver were positive prognostic factors for OS after first LAT (HR = 0.50, p = 0.028 and HR = 0.40, p = 0.026, respectively) while rare histotypes and LAT other than surgery and radiotherapy were negatively associated with OS after first LAT (HR = 2.56, p = 0.020 and HR = 3.87, p = 0.025). Additional systemic therapy was independently associated with a PFS benefit in patients ≤60 years with ≥4 metastatic lesions (for max. diameter of treated lesions ≤2 cm: HR = 0.32, p = 0.02 and >2 cm: HR = 0.20, p = 0.0011, respectively). CONCLUSION This multicenter study conducted at six German university hospitals underlines the value of LAT in metastatic STS. The exceptionally high survival rates are likely to be associated with patient selection and treatment in specialized sarcoma centers.
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Affiliation(s)
- Anton Burkhard-Meier
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Matthias Grube
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Vindi Jurinovic
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology, University Hospital, LMU Munich, Munich, Germany
| | - Abbas Agaimy
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Institute of Pathology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Markus Albertsmeier
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of General, Visceral and Transplantation Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Luc M Berclaz
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Dorit Di Gioia
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Hans Roland Dürr
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Orthopedics and Trauma Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Rüdiger von Eisenhart-Rothe
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Orthopaedics and Sports Orthopaedics, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Chukwuka Eze
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Katja Fechner
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Emma Fey
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Sinan E Güler
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Judith S Hecker
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Medicine III, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Anne Hendricks
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Felix Keil
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Institute of Pathology, University Regensburg, Regensburg, Germany
| | - Alexander Klein
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Orthopedics and Trauma Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Carolin Knebel
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Orthopaedics and Sports Orthopaedics, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Julia R Kovács
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Thoracic Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang G Kunz
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Ulrich Lenze
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Orthopaedics and Sports Orthopaedics, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Alisa M Lörsch
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Medicine III, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Mathias Lutz
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Medicine II, Hematology and Oncology, University Hospital of Augsburg, Augsburg, Germany
| | - Norbert Meidenbauer
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Medicine 5, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Carolin Mogler
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Institute of Pathology, Technical University of Munich, Munich, Germany
| | - Nina-Sophie Schmidt-Hegemann
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Sabine Semrau
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Radiation Oncology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Wulf Sienel
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Thoracic Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Martin Trepel
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Medicine II, Hematology and Oncology, University Hospital of Augsburg, Augsburg, Germany
| | - Johannes Waldschmidt
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Armin Wiegering
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany; Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Lars H Lindner
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany.
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27
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Giusti V, Miserocchi G, Sbanchi G, Pannella M, Hattinger CM, Cesari M, Fantoni L, Guerrieri AN, Bellotti C, De Vita A, Spadazzi C, Donati DM, Torsello M, Lucarelli E, Ibrahim T, Mercatali L. Xenografting Human Musculoskeletal Sarcomas in Mice, Chick Embryo, and Zebrafish: How to Boost Translational Research. Biomedicines 2024; 12:1921. [PMID: 39200384 PMCID: PMC11352184 DOI: 10.3390/biomedicines12081921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/08/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024] Open
Abstract
Musculoskeletal sarcomas pose major challenges to researchers and clinicians due to their rarity and heterogeneity. Xenografting human cells or tumor fragments in rodents is a mainstay for the generation of cancer models and for the preclinical trial of novel drugs. Lately, though, technical, intrinsic and ethical concerns together with stricter regulations have significantly curbed the employment of murine patient-derived xenografts (mPDX). In alternatives to murine PDXs, researchers have focused on embryonal systems such as chorioallantoic membrane (CAM) and zebrafish embryos. These systems are time- and cost-effective hosts for tumor fragments and near-patient cells. The CAM of the chick embryo represents a unique vascularized environment to host xenografts with high engraftment rates, allowing for ease of visualization and molecular detection of metastatic cells. Thanks to the transparency of the larvae, zebrafish allow for the tracking of tumor development and metastatization, enabling high-throughput drug screening. This review will focus on xenograft models of musculoskeletal sarcomas to highlight the intrinsic and technically distinctive features of the different hosts, and how they can be exploited to elucidate biological mechanisms beneath the different phases of the tumor's natural history and in drug development. Ultimately, the review suggests the combination of different models as an advantageous approach to boost basic and translational research.
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Affiliation(s)
- Veronica Giusti
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
| | - Giacomo Miserocchi
- Preclinic and Osteoncology Unit, Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (G.M.); (A.D.V.); (C.S.)
| | - Giulia Sbanchi
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
| | - Micaela Pannella
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
| | - Claudia Maria Hattinger
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
| | - Marilena Cesari
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
| | - Leonardo Fantoni
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Ania Naila Guerrieri
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
| | - Chiara Bellotti
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
| | - Alessandro De Vita
- Preclinic and Osteoncology Unit, Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (G.M.); (A.D.V.); (C.S.)
| | - Chiara Spadazzi
- Preclinic and Osteoncology Unit, Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (G.M.); (A.D.V.); (C.S.)
| | - Davide Maria Donati
- Orthopaedic Oncology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
| | - Monica Torsello
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
| | - Enrico Lucarelli
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
| | - Toni Ibrahim
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
| | - Laura Mercatali
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (V.G.); (G.S.); (M.P.); (C.M.H.); (M.C.); (L.F.); (A.N.G.); (C.B.); (T.I.); (L.M.)
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Silan F, Ortega Fernandez L, Parcet Riu J, Alvarez Alonso S, Montes Moreno S. Intramuscular hemangioma of the infraspinatus muscle: a rare presentation. Case Reports Plast Surg Hand Surg 2024; 11:2393819. [PMID: 39170854 PMCID: PMC11338197 DOI: 10.1080/23320885.2024.2393819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Intramuscular hemangiomas (IMH) are extremely rare, accounting for 0.8% of all hemangiomas. IMH must be included in the differential diagnosis of soft tissue masses, and unexplained muscular pain. We herein describe the case of a patient who presented with an atypical localization of IMH in the infraspinatus muscle.
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Affiliation(s)
- Francesco Silan
- Department of Plastic and Reconstructive Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Lara Ortega Fernandez
- Department of Plastic and Reconstructive Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Josep Parcet Riu
- Department of Plastic and Reconstructive Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Sara Alvarez Alonso
- Department of Pathology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
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Ceddia S, Onesti CE, Vari S, Torchia A, Cosimati A, Riva F, Maccallini MT, Cerro M, Benvenuti G, Russillo M, Anelli V, Sperduti I, Biagini R, Ferraresi V. Radiological evaluation of response in patients with locally advanced/metastatic soft tissue sarcoma treated with trabectedin. Front Pharmacol 2024; 15:1411707. [PMID: 39228518 PMCID: PMC11368780 DOI: 10.3389/fphar.2024.1411707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/02/2024] [Indexed: 09/05/2024] Open
Abstract
Background: Trabectedin is an antineoplastic drug approved for patients (pts) with advanced soft tissue sarcomas (STS). Interestingly, the radiological evaluation of response during trabectedin therapy is peculiar. Methods: The aim of this single-center retrospective study is to analyze the concordance of response assessment according to RECIST compared with Choi criteria in patients with STS treated with trabectedin between 2009 and 2020 at Regina Elena National Cancer Institute in Rome. Results: We present the preliminary data collected in the last 2 months (mos) on 37 pts who received the diagnosis between 2015 and 2020, with a median age of 52.5 years (range 32-78). The median number of trabectedin cycles administered was four (range 2-50) for a median follow up of 5.83 months (range 1-60). Histological subtypes of STS were five (13.5%) leiomyosarcoma, 14 (37.8%) liposarcoma, nine (24.3%) undifferentiated pleomorphic sarcoma, three (8.1%) synovial sarcoma, and six (16.2%) other rare histological subtypes. Eight pts (21.6%) received trabectedin in the first line setting, 21 (56.8%) in the second line, and seven (18.9%) received it in subsequent lines. One pt received trabectedin as neoadjuvant therapy in a clinical trial (ISG-STS 1001). Median progression-free survival was 3.6 months (CI95% 2.7-4.6); median overall survival was 34.3 months (CI95% 0-75.4). The radiological responses were evaluated with both RECIST and Choi criteria; responses matched in 33 pts (89.2%) but not in four (10.8%). The best responses obtained according to RECIST criteria were two (5.4%) partial response (PR), 13 (35.1%) stable disease (SD), and 22 (59.5%) progressive disease (PD). Instead, two (5.4%), 13 (35.1%), and 22 (59.5%) pts obtained PR, SD, and PD respectively, according to Choi criteria. Cohen's kappa coefficient of concordance was 0.792 (p-value <0.002). A specialized radiologist performed all imaging examinations using a dedicated workstation in the same center. Conclusion: In this first analysis, the concordance between RECIST and Choi assessments demonstrates no statistically significant difference. Responses did not match for four pts. We are expanding the analysis to all pts included in the original cohort to confirm or deny these initial results.
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Affiliation(s)
- S. Ceddia
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - C. E. Onesti
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - S. Vari
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - A. Torchia
- Scienze Radiologiche, Oncologiche e Anatomo-Patologiche, Sapienza Università di Roma, Rome, Italy
| | - A. Cosimati
- UOC Oncologia Territoriale Ausl Latina, Aprilia, Italy
| | - F. Riva
- Scienze Radiologiche, Oncologiche e Anatomo-Patologiche, Sapienza Università di Roma, Rome, Italy
| | - M. T. Maccallini
- Scienze Radiologiche, Oncologiche e Anatomo-Patologiche, Sapienza Università di Roma, Rome, Italy
| | - M. Cerro
- Scienze Radiologiche, Oncologiche e Anatomo-Patologiche, Sapienza Università di Roma, Rome, Italy
| | - G. Benvenuti
- Radiology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - M. Russillo
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - V. Anelli
- Radiology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - I. Sperduti
- Unit of Biostatistical, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - R. Biagini
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - V. Ferraresi
- UOSD Sarcomas and Rare Tumors, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Li YM, Zhu HH, Wang XQ, Shi MZ, ShangGuan CL. Giant mucinous liposarcoma of the abdominal cavity: A case report. Medicine (Baltimore) 2024; 103:e39282. [PMID: 39151522 PMCID: PMC11332703 DOI: 10.1097/md.0000000000039282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/13/2024] [Accepted: 07/23/2024] [Indexed: 08/19/2024] Open
Abstract
RATIONALE Mucinous liposarcoma myxoid liposarcoma is a malignant mucoid soft tissue tumor derived from undifferentiated stromal cells in perivascular, subbody cavity and intermuscular space, and composed of cells at different stages of differentiation from preadipocytes to mature cells. In rare cases, it may change from lipoma malignancy. The main manifestations is painless mass, relatively slow growth, the course can last decades, the prevalence of liposarcoma in the population is 14% to 18%, mainly in adults, male prevalence is higher than women, but not significant. The main good hair part is the thigh, have mucinous sex, high differentiation type, dedifferentiation type, polymorphic type. Clinical diagnosis is difficult, and there are no obvious symptoms in the early stage, so the diagnosis should be combined with B ultrasound, MRI, CT, and other auxiliary examinations. The gold standard is pathological examination. In December 2023, our department admitted a patient with a mucinous abdominal mass. The report is as follows. PATIENT CONCERNS Does liposarcoma metastasize? Is any chemotherapy required after surgery? Will it ever relapse in the future? What is the survival period after surgery? DIAGNOSIS Mucinous liposarcoma. INTERVENTIONS Surgical resection of the sarcoma. RESULTS The nodule sample was 33 * 28 * 13 cm, with complete capsule, gray and yellow sections, fine texture, soft, gray, red, grayish, and yellow mucoid nodules in some areas, and the maximum diameter of the nodules was 21cm. Immunohistochemistry was: CD34 (+), CDK 4 (+), CK (-), Desmin (weak +), Ki67 (index 5%), MDM 2 (-), p16 (weak +), S-100P (+), Vimentin (+), BCL-2 (+). He was also sent to the Department of Pathology of Peking Union Medical College Hospital for consultation with Professor Lu Zhaohui, whose consultation opinion was in line with myxoliposarcoma. CONCLUSION Retroperitoneal liposarcoma is a common retroperitoneal tumor, but it is relatively rare in clinical practice; the overall morbidity is low, mainly manifested as abdominal pain and abdominal distension, abdominal distension, and a long course of disease; it is not sensitive to radiotherapy and chemotherapy, and should be closely follow up by CT examination to understand the recurrence and metastasis.
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Affiliation(s)
- Yi-Ming Li
- The Graduate School, Qinghai University, Xining, PR China
| | - Hai-Hong Zhu
- Qinghai Provincial People’s Hospital, Xining, PR China
| | | | - Meng-Zhen Shi
- The Graduate School, Qinghai University, Xining, PR China
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Xi Z, Zhuang A, Li X, Ming TM, Cheng Y, Zhang C, Xie F, Wang Y, Yan G, Zheng J, Lin Z, Zhang G, Li H, Wu T, He Q, Li W. Exploring the biological behavior differences between retroperitoneal and non-retroperitoneal liposarcomas. Heliyon 2024; 10:e34878. [PMID: 39157358 PMCID: PMC11327569 DOI: 10.1016/j.heliyon.2024.e34878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/13/2024] [Accepted: 07/17/2024] [Indexed: 08/20/2024] Open
Abstract
Background Liposarcoma is a malignant tumor that originates from adipose tissue and can occur in any part of the body. There is currently no clear conclusion on whether there are significant differences in prognosis between liposarcoma at different anatomical locations, especially retroperitoneal liposarcoma (RLPS) and non retroperitoneal liposarcoma (NRLPS). The aim of this study is to reveal whether there are differences in prognosis between these two locations of liposarcoma, and further explore the fundamental reasons behind these differences. Methods We conducted an in-depth investigation into the factors affecting the prognosis of patients with liposarcoma by analyzing the data from the Surveillance, Epidemiology, and End Results Program (SEER) database. Then, we used propensity score matching (PSM) to balance these prognostic factors for comparative analysis of survival between RLPS and NRLPS. In addition, by analyzing transcriptome and whole exome data from TCGA and the Japan Genotypic Phenotype Archive (JGA), we identified genes with significant expression differences and explored changes in the immune microenvironment. Result Through analysis of RLPS and NRLPS patients in the SEER database, we observed significant prognostic differences between the two groups, with RLPS exhibiting worse prognosis (p < 0.001). Even after adjusting for confounding factors through PSM, these survival rate differences remained significant, with RLPS still showing worse prognosis (p = 0.017). Furthermore, our analysis of transcriptomic data led to the identification of 467 differentially expressed genes. Additionally, we noted significant differences in the immune microenvironment and whole exome sequencing data between the two groups. Conclusion There are significant differences between patients with RLPS and NRLPS. Therefore, from clinical research to treatment strategies, RLPS and NRLPS should be considered as two distinct types of tumors, necessitating differentiated approaches for their study and treatment.
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Affiliation(s)
- Zhe Xi
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Aobo Zhuang
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Xi Li
- Harvard University School of Public Health, USA
| | - Turhong Maimaiti Ming
- Tuerhong Maimaitiming, Department of Anorectal Surgery, Hotan People's Hospital, Xinjiang, PR China
| | - Yingxue Cheng
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Chenhe Zhang
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Fuan Xie
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Yue Wang
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Guangting Yan
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Jialiang Zheng
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Zhenhang Lin
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Geng Zhang
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Huichen Li
- Tuerhong Maimaitiming, Department of Anorectal Surgery, Hotan People's Hospital, Xinjiang, PR China
| | - Ting Wu
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Qi He
- Department of Medical Oncology, The First Affiliated Hospital of Xiamen University, Fujian, PR China
| | - Wengang Li
- Cancer Research Center, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
- Department of Hepatobiliary and Pancreatic & Organ Transplantation Surgery, Xiang'an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, 361102, PR China
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Poradowski D, Chrószcz A, Spychaj R, Wolińska J, Onar V. Influence of Metamizole on Antitumour Activity of Risedronate Sodium in In Vitro Studies on Canine (D-17) and Human (U-2 OS) Osteosarcoma Cell Lines. Biomedicines 2024; 12:1869. [PMID: 39200333 PMCID: PMC11351487 DOI: 10.3390/biomedicines12081869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 08/11/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024] Open
Abstract
The availability of metamizole varies greatly around the world. There are countries such as the USA, UK, or Australia where the use of metamizole is completely forbidden, and there are also countries where this drug is available only on prescription (e.g., Greece, Italy, Spain, etc.) and those in which it is sold OTC-over the counter (e.g., most Asian and South American countries). Metamizole, as a drug with a strong analgesic effect, is used as an alternative to other non-steroidal anti-inflammatory drugs, alone or in combination with opioid drugs. Risedronate sodium is a third-generation bisphosphonate commonly used in orthopaedic and metabolic diseases of the musculoskeletal system, including hypercalcemia, postmenopausal osteoporosis, Paget's disease, etc. The aim of this study was to check whether there were any pharmacological interactions between metamizole and risedronate sodium in in vitro studies. Cell viability was assessed using the MTT method, the number of apoptotic cells was assessed using the labelling TUNEL method, and the cell cycle assessment was performed with a flow cytometer and propidium iodide. This was a pilot study, which is why only two cancer cell lines were tested: D-17 of canine osteosarcoma and U-2 OS of human osteosarcoma. Exposure of the canine osteosarcoma cell line to a combination of risedronate sodium (100 µg/mL) and metamizole (50, 5, and 0.5 µg/mL) resulted in the complete abolition of the cytoprotective activity of metamizole. In the human osteosarcoma cell line, the cytotoxic effect of risedronate sodium was entirely eliminated in the presence of 50 µg/mL of metamizole. The cytoprotective and anti-apoptotic effect of metamizole in combination with risedronate sodium in the tested human and canine osteosarcoma cell lines indicates an urgent need for further in vivo studies to confirm or disprove the potential dose-dependent undesirable effect of such a therapy.
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Affiliation(s)
- Dominik Poradowski
- Department of Biostructure and Animal Physiology, Division of Animal Anatomy, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Kożuchowska 1, 51-631 Wrocław, Poland
| | - Aleksander Chrószcz
- Department of Biostructure and Animal Physiology, Division of Animal Anatomy, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Kożuchowska 1, 51-631 Wrocław, Poland
| | - Radosław Spychaj
- Department of Fermentation and Cereals Technology, Faculty of Biotechnology and Food Science, Wroclaw University of Environmental and Life Sciences, J. Chełmońskiego 37, 51-630 Wrocław, Poland
| | - Joanna Wolińska
- Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wrocław, Poland
| | - Vedat Onar
- Osteoarchaeology Practice and Research Centre & Department of Anatomy, Faculty of Veterinary Medicine, Istanbul University-Cerrahpaşa, 34320 Avcılar, Istanbul, Türkiye
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Li S, Zhang H, Yu H, Wu Y, Yan L, Guan X, Dong B, Zhao M, Tian X, Hao C, Wu J. Combination of eribulin and anlotinib exerts synergistic cytotoxicity in retroperitoneal liposarcoma by inducing endoplasmic reticulum stress. Cell Death Discov 2024; 10:355. [PMID: 39117615 PMCID: PMC11310505 DOI: 10.1038/s41420-024-02103-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 07/11/2024] [Accepted: 07/15/2024] [Indexed: 08/10/2024] Open
Abstract
Primary retroperitoneal liposarcoma (RLPS) is a rare heterogeneous tumor occurring within retroperitoneal space, and its overall survival has not improved much in the past few decades. Based on a small-sample clinical practice at our center, patients with RLPS can greatly benefit from anlotinib and eribulin combination. In this study, we investigated the combinational effect of anlotinib and eribulin on RLPS. In vitro experiments revealed that a low dose of anlotinib significantly enhances the cytotoxic effects of eribulin, leading to a remarkable suppression of RLPS cell proliferation, viability, colony formation, migration, and cell-cycle progression compared to individual drug treatments. At the organoid level, the combination treatment causes the spheroids in Matrigel to disintegrate earlier than the single-drug group. In vivo, RLPS patient-derived xenograft (PDX) models demonstrated that the combination of these two drugs can obviously exert a safe and effective anti-tumor effect. Through transcriptome analysis, we uncovered and validated that the synergistic effect mainly is induced by the endoplasmic reticulum stress (ERS) pathway both in vitro and in vivo. Further analyses indicate that anlotinib plus eribulin treatment results in micro-vessel density and PD-L1 expression alterations, suggesting a potential impact on the tumor microenvironment. This study extensively explored the combination regimen at multiple levels and its underlying molecular mechanism in RLPS, thus providing a foundation for translational medicine research.
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Affiliation(s)
- Shuquan Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, China
| | - Hongtao Zhang
- Guowen (Changchun) International Hospital, Changchun, Jilin Province, China
| | - Hao Yu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yifan Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, China
| | - Liang Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaoya Guan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, China
| | - Bin Dong
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Central Laboratory, Peking University Cancer Hospital & Institute, Beijing, China
| | - Min Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiuyun Tian
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, China.
| | - Chunyi Hao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, China.
| | - Jianhui Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, China.
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Amir AP, Raja S, Ram J, Sekar A. Understanding multicentric haemangioendothelioma: diagnostic dilemmas and treatment strategies. BMJ Case Rep 2024; 17:e260727. [PMID: 39122376 DOI: 10.1136/bcr-2024-260727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2024] Open
Abstract
Epithelioid haemangioendothelioma (EH) is a rare malignant vascular tumour occurring mainly in the liver and lungs, with bones being a rare site and primarily seen in the adult population. This case presents a male patient in his 40s who presented to the outpatient department with a chief issue of a painless swelling over the inguinal region for 4 months, gradually increasing in size, along with a history of a gradually enlarging, painless mass on his left knee over the past 5 years. Despite occasional discomfort during physical activities, the mass exhibited no associated trauma, fever, weight loss or systemic symptoms. Physical examination revealed a firm mass on the left knee and a matted lymph nodal swelling in the left inguinal region. Subsequent imaging studies identified multiple soft tissue lesions, osseous involvement and pulmonary metastases, suggestive of multicentric haemangioendothelioma. The patient underwent surgical excision of the inguinal mass and fixation of a pathological fracture in the left femur. He is currently undergoing chemotherapy and is scheduled for regular follow-up appointments. This case underscores the importance of thorough diagnostic evaluation and multidisciplinary management in complex oncological conditions like multicentric haemangioendothelioma.
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Affiliation(s)
- Aashika Parveen Amir
- Radio-Diagnosis, SIMATS Deemed University Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Sam Raja
- Department of Radio Diagnosis, SIMATS Deemed University Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Jasvant Ram
- Radio Diagnosis, SIMATS Deemed University Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Aadithiyan Sekar
- Department of Radiodiagnosis, SIMATS Deemed University Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India
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Wu H, Xu Z, Qi M, Liu P, Zhang B, Wang Z, Chen G, Liu X, Liu J, Wei W, Duan W, Chen Z. Interleukin-7 expression by CAR-T cells improves CAR-T cell survival and efficacy in chordoma. Cancer Immunol Immunother 2024; 73:188. [PMID: 39093440 PMCID: PMC11297017 DOI: 10.1007/s00262-024-03756-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/06/2024] [Indexed: 08/04/2024]
Abstract
Chordoma is a rare bone tumor that frequently recurs after surgery, and the prognosis is poor with current treatments. This study aimed to identify potential novel immunotherapeutic targets for chordomas by identifying target proteins in clinical samples as well as tumor microenvironmental factors to enhance efficacy. Fourteen chordoma samples were analyzed by single-cell RNA sequencing, and B7-H3 and IL-7 were identified as potential targets and potentiators, respectively. B7-H3-targeted chimeric antigen receptor T (CAR-T) cells and B7-H3 CAR-T cells expressing IL-7 were synthesized and their anti-tumor activity evaluated in vitro, including in primary chordoma organoid models. The B7-H3 CAR-T/IL-7 therapy showed enhanced cytotoxicity and prolonged duration of action against tumor cells. Additionally, IL-7 modulated favorable subpopulations of cultured CAR-T cells, diminished immune checkpoint expression on T-cell surfaces, and enhanced T-cell functionality. The incorporation of IL-7 molecules into the B7-H3 CAR structure augmented CAR-T-cell function and improved CAR-T-cell efficacy, thus providing a novel dual therapeutic strategy for chordoma treatment.
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Affiliation(s)
- Huantong Wu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Zhuofan Xu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Maoyang Qi
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Penghao Liu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Boyan Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China
| | - Zhenglin Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ge Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaohai Liu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Junqi Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wei Wei
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wanru Duan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China.
| | - Zan Chen
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Lab of Spinal Cord Injury and Functional Reconstruction, China International Neuroscience Institute (CHINA-INI), Beijing, China.
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Patrichi AI, Gurzu S. Pathogenetic and molecular classifications of soft tissue and bone tumors: A 2024 update. Pathol Res Pract 2024; 260:155406. [PMID: 38878666 DOI: 10.1016/j.prp.2024.155406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/06/2024] [Accepted: 06/12/2024] [Indexed: 08/09/2024]
Abstract
Soft tissue and bone tumors comprise a wide category of neoplasms. Their diversity frequently raises diagnostic challenges, and therapeutic options are continuously developing. The therapeutic success rate and long-term prognosis of patients have improved substantially due to new advances in immunohistochemical and molecular biology techniques. A fundamental contribution to these achievements has been the study of the tumor microenvironment and the reclassification of new entities with the updating of the molecular pathogenesis in the revised 5th edition of the Classification of Soft Tissue Tumors, edited by the World Health Organization. The proposed molecular diagnostic techniques include the well-known in situ hybridization and polymerase chain reaction methods, but new techniques such as copy-number arrays, multiplex probes, single-nucleotide polymorphism, and sequencing are also proposed. This review aims to synthesize the most recent pathogenetic and molecular classifications of soft tissue and bone tumors, considering the major impact of these diagnostic tools, which are becoming indispensable in clinicopathological practice.
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Affiliation(s)
- Andrei Ionut Patrichi
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania; Research Center of Oncopathology and Translational Medicine (CCOMT), Targu-Mures, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania; Research Center of Oncopathology and Translational Medicine (CCOMT), Targu-Mures, Romania; Romanian Academy of Medical Sciences, Romania.
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Hassan RE, Raza M, Hamad SB, Vasudevan K, Abbas J. An Unexpected Giant: A Case of Massive Paratesticular Extra-mammary Myofibroblastoma. Cureus 2024; 16:e66856. [PMID: 39280406 PMCID: PMC11398836 DOI: 10.7759/cureus.66856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 09/18/2024] Open
Abstract
Mammary-type myofibroblastomas (MFBs) are benign spindle cell tumors, typically presenting in common locations such as the breast, abdomen, and inguinal region. We present a case of a 66-year-old male with a four-year history of painless scrotal swelling. The preoperative diagnosis was challenging, with an initial suspicion of soft tissue sarcoma. A complete surgical excision was performed, revealing a well-circumscribed, encapsulated mass. The tumor measured 30 x 20 x 14 cm, weighing 5.28 kg. Histopathology confirmed an MFB. This exceptionally large paratesticular MFB emphasizes the diagnostic difficulty of such tumors. Surgical resection remains the treatment of choice, with an excellent prognosis. This case highlights the importance of considering MFB in the differential diagnosis of scrotal masses, even with atypical presentations.
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Affiliation(s)
- Rao E Hassan
- Orthopaedics and Trauma, Khyber Teaching Hospital Medical Teaching Institute (MTI), Peshawar, PAK
| | - Muhammad Raza
- General Surgery, Ayub Medical College, Abbottabad, PAK
| | | | | | - Johar Abbas
- General Surgery, Ayub Medical College, Abbottabad, PAK
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Shibui Y, Kohashi K, Hino Y, Tamaki A, Kinoshita I, Yamamoto H, Nakashima Y, Tajiri T, Oda Y. Expression of Forkhead Box M1 and Anticancer Effects of FOXM1 Inhibition in Epithelioid Sarcoma. J Transl Med 2024; 104:102093. [PMID: 38857782 DOI: 10.1016/j.labinv.2024.102093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/09/2024] [Accepted: 05/29/2024] [Indexed: 06/12/2024] Open
Abstract
Epithelioid sarcoma (ES) is a rare aggressive sarcoma that, unlike most soft-tissue sarcomas, shows a tendency toward local recurrence and lymph node metastasis. Novel antitumor agents are needed for ES patients. Forkhead box transcription factor 1 (FOXM1) is a member of the Forkhead transcription factor family and is associated with multiple oncogenic functions; FOXM1 is known to be overexpressed and correlated with pathogenesis in various malignancies. In this study, we immunohistochemically analyzed FOXM1 expression levels and their clinical, clinicopathologic, and prognostic significance in 38 ES specimens. In addition, to investigate potential correlations between FOXM1 downregulation and oncologic characteristics, we treated ES cell lines with thiostrepton, a naturally occurring antibiotic that inhibits both small interfering RNA (siRNA) and FOXM1. In the analyses using ES samples, all 38 specimens were diagnosed as positive for FOXM1 by immunohistochemistry. We separated specimens into high (n = 19) and low (n = 19) FOXM1-protein expression groups by staining index score, and into large (n = 12), small (n = 25), and unknown (n = 1) tumor-size groups using a cutoff of 5 cm maximum diameter. Although there were significantly more samples with high FOXM1 expression in the large tumor group (P = .013), there were no significant differences with respect to age (P = 1.00), sex (P = .51), primary site of origin (P = .74), histologic subtypes (P = 1.00), depth (P = .74), or survival rate (P = .288) between the high and low FOXM1-protein expression groups. In the in vitro experiments using ES cell lines, FOXM1 siRNA and thiostrepton successfully downregulated FOXM1 mRNA and protein expression. Furthermore, downregulation of FOXM1 inhibited cell proliferation, drug resistance against chemotherapeutic agents, migration, and invasion and caused cell cycle arrest in the ES cell lines. Finally, cDNA microarray analysis data showed that FOXM1 regulated cIAP2, which is one of the apoptosis inhibitors activated by the TNFα-mediated NF-κB pathway. In conclusion, the FOXM1 gene may be a promising therapeutic target for ES.
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Affiliation(s)
- Yuichi Shibui
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yuko Hino
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akihiko Tamaki
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Izumi Kinoshita
- Department of Pathology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tatsuro Tajiri
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Montatore M, Masino F, Muscatella G, Gifuni R, Fascia G, Sciacqua A, Guglielmi G. An aggressive soft-tissue sarcoma of the extremity: A myxofibrosarcoma, grade 3 (FNCLCC system). Radiol Case Rep 2024; 19:2911-2917. [PMID: 38737183 PMCID: PMC11087895 DOI: 10.1016/j.radcr.2024.03.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/28/2024] [Accepted: 03/31/2024] [Indexed: 05/14/2024] Open
Abstract
We report a case of myxofibrosarcoma of the posterior region of the femur, part of the group of soft-tissue sarcomas: a set of rare and heterogeneous tumors with various subtypes and different prognostic. It is characterized by local infiltrative activity and an extremely high rate of local recurrence. A 58-year-old man came to the Radiology Department to examine a voluminous round and expansive formation of the posterior thigh region. The patient stated that the mass had grown suddenly for about 3 months, maybe after a trauma, increasing in volume exponentially and causing him discomfort, embarrassment, and pain. The result of the first diagnostic approach, with the US, was unexpected and suspicious, and the radiologist wanted to do first a CT, and then maybe plan an MRI. The CT revealed an inhomogeneous density formation and in MRI the mass resulted to be compatible, with the radiologic pattern, with the diagnosis of a sarcoma of the soft tissue. The physicians had already alerted the pathological anatomy, as they suspected something malignant. So, some days after the MRI examination, the patient underwent histological sampling, confirming the suspicion: a myxofibrosarcoma (stage III) of the posterior region of the femoral region. The patient started on radio and chemotherapy, which increases survival and in the hope of reducing the size of the mass, and a strict follow-up was posed before doing the surgery.
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Affiliation(s)
- Manuela Montatore
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Federica Masino
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Gianmichele Muscatella
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Rossella Gifuni
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Giacomo Fascia
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Alessio Sciacqua
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Giuseppe Guglielmi
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
- Radiology Unit, “Dimiccoli” Hospital, Viale Ippocrate 15, 70051, Barletta (BT), Italy
- Radiology Unit, “IRCCS Casa Sollievo della Sofferenza” Hospital, Viale Cappuccini 1,71013 San Giovanni Rotondo, (FG) Italy
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40
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Anderson JA, Laucis N, Symanski J, Blankenbaker D. Imaging of Disease and Normal Variant Patterns in Pediatric Hips. Semin Musculoskelet Radiol 2024; 28:447-461. [PMID: 39074727 DOI: 10.1055/s-0044-1786153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
The pediatric hip undergoes significant changes from infancy through adolescence. Proper maturation is crucial for the development of a stable and functional hip joint. Imaging interpretation of the pediatric hip requires distinguishing normal variants and maturation patterns from pathology. We review femoral ossification centers, variants, and conditions that affect the proximal femur, such as Legg-Calvé-Perthes disease; the acetabulum, such as developmental hip dysplasia; the acetabular labrum, such as femoroacetabular impingement; and synovial pathology in children through adolescence. Understanding the spectrum of hip conditions and using advanced imaging techniques are essential for the accurate diagnosis and effective management of pediatric hip disorders.
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Affiliation(s)
- Jade A Anderson
- Department of Radiology, Musculoskeletal Imaging and Intervention, UW Health: University of Wisconsin Hospitals and Clinics, Madison, Wisconsin
| | - Nicholas Laucis
- Department of Radiology, Musculoskeletal Imaging and Intervention, UW Health: University of Wisconsin Hospitals and Clinics, Madison, Wisconsin
| | - John Symanski
- Department of Radiology, Musculoskeletal Imaging and Intervention, UW Health: University of Wisconsin Hospitals and Clinics, Madison, Wisconsin
| | - Donna Blankenbaker
- Department of Radiology, Musculoskeletal Imaging and Intervention, UW Health: University of Wisconsin Hospitals and Clinics, Madison, Wisconsin
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Behrendt P, Grunow T, K-H F, Krause M, Fahlbusch H, Priemel M. Not every knee tumour is a ganglion - retrospective analysis of benign and malign tumour entities around the knee. Arch Orthop Trauma Surg 2024; 144:3227-3234. [PMID: 38904683 PMCID: PMC11417069 DOI: 10.1007/s00402-024-05401-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 06/13/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Due to a lack of routine, there is often uncertainty regarding diagnostics of tumours around the knee joint. This study aimed to provide knowledge about the frequency, distribution and diagnostic algorithm of different bone and soft tissue tumour entities of the knee at a large referral university hospital in Germany. METHODS Retrospective, longitudinal, single-centre study that reviewed adult patients from 2010 until 2020 with a suspected tumours diagnosis around the knee at a university cancer centre. Inclusion criteria were adults with true bone or soft-tissue tumours in the knee joint and in its adjacent compartments. Suspected diagnosis, histological tumour entity, localization and its surgical treatment by biopsy, resection, osteosynthesis or tumour endoprosthesis were investigated. RESULTS A total number of 310 adult patients were included with a mean age of 54.2 ± 18.8 years. In total 160 (51.6%) soft-tissue tumours (69/43.1% benign; 74/46.2% malignant; 17/10.6% intermediate), 92 (29.6%) primary bone tumours (46/50% benign; 39/42.3% malignant; 7/7.6% intermediate), 36 (11.6%) metastases and 22 (7.1%) lymphomas were detected. 171 (55.1%) tumours were classified as malignant. Suspected diagnosis was matched with histology in 74.5% (231/310) of all cases. In 6 cases a primarily suspected benign diagnosis turned out to be malignant. The majority of primary bone tumours was cartilage derived (63.1%;58/92) and located in the distal 2/3 of the femur, whereas intracapsular tumours of the knee joint were rare (13.0%). Soft-tissue tumours were located primarily in the middle third of the thigh (36.8%). The MRI was the diagnostic tool of choice in 98.1% of soft tissue tumours and 82.6% bone tumours. CONCLUSION Awareness is crucial for detecting rare and malignant tumours around the knee, with adipocytic tumours being the most common soft tissue tumour and chondrogenic tumours as the most prevalent malignant bone tumour. Accurate diagnosis of bone tumours necessitates radiographs and frequently an additional MRI scan, while soft tissue tumours require mandatory MRI scans. Incorrectly diagnosing a tumour can have severe consequences, emphasizing the need for histological confirmation in all cases. Additionally, malignant tumours within joint capsules in adults are infrequent.
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Affiliation(s)
- Peter Behrendt
- Department of Orthopedic and Trauma Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
- Department of Anatomy, Christian-Albrechts- University, Kiel, Germany.
| | - T Grunow
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frosch K-H
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany
| | - M Krause
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Fahlbusch
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Priemel
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Batra S, Nguy L, Moino D, Ordobazari A, Shahzad MM. Atypical vulvar lipoma - A case report and literature review. Gynecol Oncol Rep 2024; 54:101434. [PMID: 39006220 PMCID: PMC11239455 DOI: 10.1016/j.gore.2024.101434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/16/2024] Open
Abstract
Atypical spindle cell lipomatous tumors of the vulva are rare masses. We report a case of atypical spindle cell lipoma of the vulva and provide a succinct review of the current understanding of these benign masses. Specifically, this report describes a case of a 20-year-old nulligravid female who presented for evaluation of a labial mass that had been growing for one year. A pelvic MRI revealed a 7 cm fatty growth. The vulvar mass was surgically resected. This case report describes the pathologic staining pattern for these masses and reviews characteristics of these benign tumors such that they are not mistaken for malignancy.
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Affiliation(s)
- Sadhvi Batra
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, United States
| | - Lindsey Nguy
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, United States
| | - Daniela Moino
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, United States
| | - Atousa Ordobazari
- Department of Pathology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, United States
| | - Mian M Shahzad
- Department of Gynecologic Oncology, H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, United States
- Department of Oncologic Sciences, Morsani School of Medicine, University of South Florida, Tampa, FL 33612, United States
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Weadick CS, Goggin C, Keogh RJ, Murphy JF, Feeley L, Bennett MW, O’Reilly S, Redmond HP, Kelly J, O’Mahony D, Noonan S, Clover AJP, Bambury RM. Risk Stratification Tools to Aid Decisions on Adjuvant Chemotherapy Usage in Resected Soft Tissue Sarcomas: A Ten-Year Review of an Irish Sarcoma Center Experience. World J Oncol 2024; 15:640-647. [PMID: 38993253 PMCID: PMC11236376 DOI: 10.14740/wjon1863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/01/2024] [Indexed: 07/13/2024] Open
Abstract
Background Soft tissue sarcoma (STS) is comprised of approximately 80 subtypes, with an incidence of 4 - 5 per 100,000 annually in Europe. The National Comprehensive Cancer Network (NCCN) guidelines recommend consideration of neoadjuvant/adjuvant chemotherapy in tumors at high risk of recurrence based on the American Joint Committee on Cancer (AJCC) staging. Alternatively, the Sarculator is a risk prediction tool that has identified a threshold of risk, above which chemotherapy may provide an overall survival (OS) benefit. Using this nomogram, patients with a 10-year predicted OS < 60% are classified as high risk and should be considered for chemotherapy. The aim of this study was to assess the prognostic accuracy of these two risk prediction methods in an Irish population. Methods All newly diagnosed patients with resected STS discussed in the STS tumor board in Cork University Hospital between January 2012 and December 2021 were identified. Clinicopathological data were collected. Risk assessment using AJCC and Sarculator nomogram was performed on all patients with an extremity/trunk sarcoma. The OS was calculated including Kaplan-Meier method for time to event analysis. Results In total, 200 STS patients were reviewed, of whom 134 had truncal or extremity tumors. Sarculator score was calculated for 60 of these (well differentiated liposarcomas, desmoid tumors and dermatofibrosarcoma protuberans were excluded). Using the Sarculator nomogram to calculate 10-year predicted OS, 19 patients were categorized as high risk and 41 were categorized as low risk. Using AJCC staging, 25 patients were categorized as high risk and 35 as low risk. The 5-year OS rate in the Sarculator high-risk group was 60.2%, compared with 87.1% in the low-risk group (P = 0.009). The 5-year OS rate in the AJCC high-risk group was 67.6%, compared with 86.3% in the low-risk group (P = 0.083). Conclusions Our cohort is representative of the broad histological subtypes expected. In our population, Sarculator score results correlate with international outcomes and higher scores were associated with increased mortality. The Sarculator was more predictive of clinical outcome than AJCC staging, and its use would lower the proportion of patients being considered for adjuvant chemotherapy thereby sparing toxicity, which is important in the setting of uncertain clinical benefit.
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Affiliation(s)
| | - Caitriona Goggin
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Rachel J. Keogh
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Jake F. Murphy
- Department of Radiation Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Linda Feeley
- Department of Histopathology, Cork University Hospital, Wilton, Cork, Ireland
| | - Michael W. Bennett
- Department of Histopathology, Cork University Hospital, Wilton, Cork, Ireland
| | - Seamus O’Reilly
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
- Cancer Research @UCC, University College Cork, Cork, Ireland
| | - H. Paul Redmond
- Department of Surgery, Cork University Hospital, Wilton, Cork, Ireland
| | - Jason Kelly
- Department of Surgery, Cork University Hospital, Wilton, Cork, Ireland
| | - Deirdre O’Mahony
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
| | - Sinead Noonan
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
- Cancer Research @UCC, University College Cork, Cork, Ireland
| | - A. James P Clover
- Department of Plastic Surgery, Cork University Hospital, Wilton, Cork, Ireland
| | - Richard M. Bambury
- Department of Medical Oncology, Cork University Hospital, Wilton, Cork, Ireland
- Cancer Research @UCC, University College Cork, Cork, Ireland
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Bianchi G, Laginestra MA, Simonetti E, Ibrahim T, Macrì F, Ostetto F, Tuzzato G, Paioli A, Gambarotti M, Cocchi S, Donati DM, Scotlandi K, Laranga R. Extraskeletal Ewing Sarcoma of the Extremities and Trunk: A Retrospective Analysis of a Mono-Institutional Series. Oncol Res Treat 2024; 47:496-508. [PMID: 39084202 DOI: 10.1159/000540613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
INTRODUCTION Extraskeletal Ewing sarcoma (EEwS) is a rare malignant tumor, and current international recommendations indicate systemic and local treatment like bone Ewing sarcoma (BEwS); to the best of our knowledge, very few studies tried to explore the clinical and genetic characteristics of this tumor, and the most appropriate treatment strategy remains uncertain. METHODS We reviewed 35 EEwS cases enrolled at Rizzoli Orthopedic Institute in Bologna, Italy, between 1988-2022. We performed RNA sequencing in 18 Ewing sarcoma cases, including 12 BEwSs and 6 EEwSs. We analyzed overall survival (OS), local relapse-free survival (LRFS), and metastasis-free survival (MFS) and the risk factors associated to survival. RESULTS Unsupervised hierarchical clustering showed no differences in the transcriptional profile between EEwS and BEwS. Five-year OS was 67% (95% confidence interval [CI]: 47-80), 5-year LRFS was 61% (95% CI: 43-75), and 5-year MFS was 55% (95% CI: 38-70). Recurrent tumors, larger than 8 cm, and elevated lactate dehydrogenase (LDH) serum value resulted to be negative prognostic factors. CONCLUSIONS The finding/detection of a genetic profile that is indistinguishable between EEwS and BEwS confirms the view that the two subgroups belong to the same tumor entity and supports the use of a single therapeutic approach for Ewing sarcoma, regardless of the site of origin. Statistical evaluation showed that size bigger than 8 cm, elevated LDH, and recurrent tumors had a worse prognosis, suggesting a risk-stratification method for identifying patients for specific therapy treatment. However, larger, multicenter, prospective trials are called for to validate our findings.
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Affiliation(s)
- Giuseppe Bianchi
- 3rd Orthopedic and Traumatologic Clinic prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Elisa Simonetti
- Laboratory of Experimental Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Toni Ibrahim
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Fabiana Macrì
- 3rd Orthopedic and Traumatologic Clinic prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Federico Ostetto
- 3rd Orthopedic and Traumatologic Clinic prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Gianmarco Tuzzato
- 3rd Orthopedic and Traumatologic Clinic prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Anna Paioli
- Osteoncology, Bone and Soft Tissue Sarcomas and Innovative Therapies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Gambarotti
- Pathology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefania Cocchi
- Pathology Department, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Davide Maria Donati
- 3rd Orthopedic and Traumatologic Clinic prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Katia Scotlandi
- Laboratory of Experimental Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Roberta Laranga
- 3rd Orthopedic and Traumatologic Clinic prevalently Oncologic IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Achour Y, Bakali Y, Bahij M, Sekkat H, Mhamdi Alaoui M, Sabbah F, Hrora A, Raiss M. Surgical management of giant retroperitoneal liposarcoma: Case report. Rare Tumors 2024; 16:20363613241266047. [PMID: 39056072 PMCID: PMC11271108 DOI: 10.1177/20363613241266047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
Tumors originating from soft tissues are uncommon, among these tumors, liposarcomas are the most frequent. These tumors remain asymptomatic for a long time, and only revealing themselves when they reach an important size. In such cases, treatment is difficult, requiring extensive surgery procedures that can excise several adjacent structures, potentially completed by adjuvant radiotherapy. Despite successful treatment, the recurrence rate remains very high. We report the case of a giant liposarcoma requiring a monobloc extensive resection involving the removal of the tumor, left kidney, left adrenal gland, and a portion of the posterior abdominal wall.
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Affiliation(s)
- Youssef Achour
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Youness Bakali
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Mahdi Bahij
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Hamza Sekkat
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Mouna Mhamdi Alaoui
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Farid Sabbah
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Abdelmalek Hrora
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
| | - Mohammed Raiss
- Digestive Surgical Department C, Ibn Sina University Hospital, Rabat, Morocco
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
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Bhat S, Palepu K, Hong L, Mao J, Ye T, Iyer R, Zhao L, Chen T, Vincoff S, Watson R, Wang T, Srijay D, Kavirayuni VS, Kholina K, Goel S, Vure P, Desphande AJ, Soderling SH, DeLisa MP, Chatterjee P. De Novo Design of Peptide Binders to Conformationally Diverse Targets with Contrastive Language Modeling. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.06.26.546591. [PMID: 39091799 PMCID: PMC11291000 DOI: 10.1101/2023.06.26.546591] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
Designing binders to target undruggable proteins presents a formidable challenge in drug discovery, requiring innovative approaches to overcome the lack of putative binding sites. Recently, generative models have been trained to design binding proteins via three-dimensional structures of target proteins, but as a result, struggle to design binders to disordered or conformationally unstable targets. In this work, we provide a generalizable algorithmic framework to design short, target-binding linear peptides, requiring only the amino acid sequence of the target protein. To do this, we propose a process to generate naturalistic peptide candidates through Gaussian perturbation of the peptidic latent space of the ESM-2 protein language model, and subsequently screen these novel linear sequences for target-selective interaction activity via a CLIP-based contrastive learning architecture. By integrating these generative and discriminative steps, we create a Peptide Prioritization via CLIP (PepPrCLIP) pipeline and validate highly-ranked, target-specific peptides experimentally, both as inhibitory peptides and as fusions to E3 ubiquitin ligase domains, demonstrating functionally potent binding and degradation of conformationally diverse protein targets in vitro. Overall, our design strategy provides a modular toolkit for designing short binding linear peptides to any target protein without the reliance on stable and ordered tertiary structure, enabling generation of programmable modulators to undruggable and disordered proteins such as transcription factors and fusion oncoproteins.
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Affiliation(s)
- Suhaas Bhat
- Department of Biomedical Engineering, Duke University
| | - Kalyan Palepu
- Department of Biomedical Engineering, Duke University
| | - Lauren Hong
- Department of Biomedical Engineering, Duke University
| | - Joey Mao
- Department of Cell Biology, Duke University
| | - Tianzheng Ye
- Robert F. Smith School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, NY, USA
| | - Rema Iyer
- Cancer Genome and Epigenetics Program, Sanford Burnham Prebys Institute, San Diego, CA, USA
| | - Lin Zhao
- Department of Biomedical Engineering, Duke University
| | - Tianlai Chen
- Department of Biomedical Engineering, Duke University
| | | | - Rio Watson
- Department of Biomedical Engineering, Duke University
| | - Tian Wang
- Department of Biomedical Engineering, Duke University
| | - Divya Srijay
- Department of Biomedical Engineering, Duke University
| | | | | | - Shrey Goel
- Department of Biomedical Engineering, Duke University
| | - Pranay Vure
- Department of Biomedical Engineering, Duke University
| | - Aniruddha J Desphande
- Cancer Genome and Epigenetics Program, Sanford Burnham Prebys Institute, San Diego, CA, USA
| | | | - Matthew P DeLisa
- Robert F. Smith School of Chemical and Biomolecular Engineering, Cornell University, Ithaca, NY, USA
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
- Cornell Institute of Biotechnology, Cornell University, Ithaca, NY, USA
| | - Pranam Chatterjee
- Department of Biomedical Engineering, Duke University
- Department of Computer Science, Duke University
- Department of Biostatistics and Bioinformatics, Duke University
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Cristalli C, Scotlandi K. Targeting DNA Methylation Machinery in Pediatric Solid Tumors. Cells 2024; 13:1209. [PMID: 39056791 PMCID: PMC11275080 DOI: 10.3390/cells13141209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/08/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
DNA methylation is a key epigenetic regulatory mechanism that plays a critical role in a variety of cellular processes, including the regulation of cell fate during development, maintenance of cell identity, and genome stability. DNA methylation is tightly regulated by enzymatic reactions and its deregulation plays an important role in the development of cancer. Specific DNA methylation alterations have been found in pediatric solid tumors, providing new insights into the development of these tumors. In addition, DNA methylation profiles have greatly contributed to tune the diagnosis of pediatric solid tumors and to define subgroups of patients with different risks of progression, leading to the reduction in unwanted toxicity and the improvement of treatment efficacy. This review highlights the dysregulated DNA methylome in pediatric solid tumors and how this information provides promising targets for epigenetic therapies, particularly inhibitors of DNMT enzymes (DNMTis). Opportunities and limitations are considered, including the ability of DNMTis to induce viral mimicry and immune signaling by tumors. Besides intrinsic action against cancer cells, DNMTis have the potential to sensitize immune-cold tumors to immunotherapies and may represent a remarkable option to improve the treatment of challenging pediatric solid tumors.
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Affiliation(s)
- Camilla Cristalli
- Laboratory of Experimental Oncology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy
| | - Katia Scotlandi
- Laboratory of Experimental Oncology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italy
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Osama MA, Chatterjee P, Singh S, Pandey A, Mohta A. Myxoid liposarcoma diagnosed on fine needle aspiration cytology: There is more to it than meets the eye. J Cancer Res Ther 2024:01363817-990000000-00095. [PMID: 39016314 DOI: 10.4103/jcrt.jcrt_419_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/14/2024] [Indexed: 07/18/2024]
Abstract
ABSTRACT Liposarcoma is a rare mesenchymal neoplasm commonly involving deep soft tissues and the retroperitoneum. Among the various types of liposarcoma, myxoid liposarcoma is the most frequently encountered in adolescents and young adults, with a predilection for lower extremities. Fine needle aspiration allows easy assessment and rapid on-site evaluation for distinguishing benign from malignant lipomatous lesions. Here, we present a case of myxoid liposarcoma in the calf region of a 19-year-old boy, diagnosed via fine needle aspiration cytology, and subsequently confirmed by histopathological examination after surgical resection. The intention behind this case report is to highlight the cytological features of myxoid liposarcoma and to improve understanding of this tumor entity, aiming to prevent misdiagnosis by inexperienced pathologists when evaluating cytology specimens.
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Affiliation(s)
- Md Ali Osama
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Priti Chatterjee
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Smita Singh
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Ankita Pandey
- Department of Pathology, Lady Hardinge Medical College, New Delhi, India
| | - Anup Mohta
- Departments of Surgery, Lady Hardinge Medical College, New Delhi, India
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Asunis E, Cini C, De Robertis M, Griffoni C, Bandiera S, Righi A, Ghermandi R, Pipola V, Girolami M, Tedesco G, Gambarotti M, Gasbarrini A. Epithelioid Hemangioma of the Spine: A Case Series and Treatment Flow Chart-Experience from a Single Centre. Cancers (Basel) 2024; 16:2557. [PMID: 39061195 PMCID: PMC11274583 DOI: 10.3390/cancers16142557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/05/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Epithelioid hemangioma is recognized by the World Health Organization as a distinct benign neoplasm; however, it is characterized by locally aggressive and rarely metastasizing behavior. Epithelioid vascular tumors are rare bony vascular lesions with varying degrees of malignant potential that remain controversial because of their rarity, unusual morphological features, and unpredictable biological behavior. The application of new molecular tools, such as massive parallel sequencing technologies, have provided new diagnostic markers and an opportunity to further refine the classification of bone vascular neoplasms. Very few cases of EH of the spine have been reported in the literature; therefore, it is difficult to make evidence-based therapeutic decisions for these patients. We report herein our experience with eleven patients suffering from EH of the spine. The study population included three males and eight females treated in our center from 2016 to the present; the average age was 44.8 years (range 14-75 years). The surgical, clinical, and radiographic data were retrospectively analyzed. The mean follow-up was 34.8 months. All patients presented lytic vertebral body lesions, six of them with pathological fracture. The majority of patients (80%) presented myelo-radicular compression. All patients were surgically treated, and preoperative embolization was performed in all cases. In light of the literature review and the clinical experience of our center, we can consider EH a locally aggressive tumor that requires surgical treatment in case of symptoms. Here, we propose a treatment algorithm that could be useful in the management of patients with this rare disease.
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Affiliation(s)
- Emanuela Asunis
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.A.); (C.C.); (S.B.); (R.G.); (V.P.); (M.G.); (G.T.); (A.G.)
| | - Chiara Cini
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.A.); (C.C.); (S.B.); (R.G.); (V.P.); (M.G.); (G.T.); (A.G.)
| | - Mario De Robertis
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy;
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Cristiana Griffoni
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.A.); (C.C.); (S.B.); (R.G.); (V.P.); (M.G.); (G.T.); (A.G.)
| | - Stefano Bandiera
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.A.); (C.C.); (S.B.); (R.G.); (V.P.); (M.G.); (G.T.); (A.G.)
| | - Alberto Righi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (A.R.); (M.G.)
| | - Riccardo Ghermandi
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.A.); (C.C.); (S.B.); (R.G.); (V.P.); (M.G.); (G.T.); (A.G.)
| | - Valerio Pipola
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.A.); (C.C.); (S.B.); (R.G.); (V.P.); (M.G.); (G.T.); (A.G.)
| | - Marco Girolami
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.A.); (C.C.); (S.B.); (R.G.); (V.P.); (M.G.); (G.T.); (A.G.)
| | - Giuseppe Tedesco
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.A.); (C.C.); (S.B.); (R.G.); (V.P.); (M.G.); (G.T.); (A.G.)
| | - Marco Gambarotti
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (A.R.); (M.G.)
| | - Alessandro Gasbarrini
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (E.A.); (C.C.); (S.B.); (R.G.); (V.P.); (M.G.); (G.T.); (A.G.)
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy
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50
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Van Tine BA, Ingham MA, Attia S, Meyer CF, Baird JD, Brooks-Asplund E, D'Silva D, Kong R, Mwatha A, O'Keefe K, Weetall M, Spiegel R, Schwartz GK. Phase Ib Study of Unesbulin (PTC596) Plus Dacarbazine for the Treatment of Locally Recurrent, Unresectable or Metastatic, Relapsed or Refractory Leiomyosarcoma. J Clin Oncol 2024; 42:2404-2414. [PMID: 38684039 PMCID: PMC11227303 DOI: 10.1200/jco.23.01684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 12/13/2023] [Accepted: 02/28/2024] [Indexed: 05/02/2024] Open
Abstract
PURPOSE This multicenter, single-arm, open-label, phase Ib study was designed to determine the recommended phase II dose (RP2D) and to evaluate the safety and preliminary efficacy of unesbulin plus dacarbazine (DTIC) in patients with advanced leiomyosarcoma (LMS). PATIENTS AND METHODS Adult subjects with locally advanced, unresectable or metastatic, relapsed or refractory LMS were treated with escalating doses of unesbulin orally twice per week in combination with DTIC 1,000 mg/m2 intravenously (IV) once every 21 days. The time-to-event continual reassessment method was used to determine the RP2D on the basis of dose-limiting toxicities (DLTs) assessed during the first two 21-day treatment cycles. All explored doses of unesbulin (200 mg up to 400 mg) were in combination with DTIC. An expansion cohort was enrolled to evaluate the safety and efficacy of unesbulin at the RP2D. RESULTS Unesbulin 300 mg administered orally twice per week in combination with DTIC 1,000 mg/m2 IV once every 21 days was identified as the RP2D. On the basis of data from 27 subjects who were deemed DLT-evaluable, toxicity was higher in the unesbulin 400 mg group, with three of four subjects (75%) experiencing DLTs versus one of four subjects (25%) in the 200 mg group and three of 19 subjects (15.8%) in the 300 mg group. The most commonly reported DLTs and treatment-related grade 3 and 4 adverse events were thrombocytopenia and neutropenia. At the RP2D, seven subjects who were efficacy evaluable achieved partial response for an objective response rate of 24.1%. CONCLUSION Unesbulin 300 mg twice per week plus DTIC 1,000 mg/m2 once every 21 days was identified as the RP2D, demonstrating a favorable benefit-risk profile in a heavily pretreated population of adults with advanced LMS.
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