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Functional And Survival Outcome Of Egyptian Children And Adolescents With Malignant Bone Tumors: An Experience In A Setting Of Limited Health Resource. FORUM OF CLINICAL ONCOLOGY 2019. [DOI: 10.2478/fco-2018-0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
Evaluate outcome of paediatric malignant bone tumours at Ain Shams University, Egypt, from January 2003 to July 2016.
Methods
Retrospective data analysis regarding clinico-epidemiological aspects, treatment outcomes, survival analysis and musculoskeletal tumour society score (MSTS score).
Results
The study included 37 patients; 22 had Ewing sarcoma (ES) and 15 had osteosarcoma, male: female ratio 0.85:1, median ages of 11. The overall frequency was 2.3% among all cancers. There is wide range of time lag until diagnosis. Patients with ES were significantly younger than those with osteosarcoma were. Swelling was the most common presenting symptom and femur was the most common affected site. Fifteen patients fulfilled MSTS criteria; most of them had excellent MSTS score, which significantly affected by type of surgery. ES patients were treated with POG#9354/CCG#7942 protocols and osteosarcoma with CCG#7921 protocol. Limb salvage was the most common type for surgical local control. Most common cause of death was relapse, whereas infection was the most common complication of treatment. 1-year, 2-year, 3-year overall-survival of osteosarcoma were 93.3%, 40%, and 13.3% respectively and 77.3%, 40.9%, and 18.2% respectively for ES. 1-year, 2-year, 3-year event-free-survival were 80%, 40%, and 13.3% respectively and 72.7%, 22.7%, and 18.2% respectively for ES patients.
Conclusion
Although survival rates for malignant bone tumours are still unsatisfactory, the functional outcome of extremity tumours after limb salvage procedures is promising
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PET-CT imaging features that differentiate between positive and negative EWSR1 translocation in Ewing sarcoma. Nucl Med Commun 2019; 40:827-834. [PMID: 31107830 DOI: 10.1097/mnm.0000000000001031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Ewing sarcoma breakpoint region 1 (EWSR1) translocation-negative tumors represent a minor portion of small round cell tumors consistent with Ewing sarcoma morphology. The purpose of this study was to differentiate EWSR1 translocation-positive tumors from EWSR1 translocation-negative tumors using PET-computed tomography features. MATERIALS AND METHODS In this retrospective study 27, Ewing sarcoma patients (December 2011 to November 2016) were divided into two groups, EWSR1 translocation-positive and EWSR1 translocation-negative based on cytogenetic analysis. Pretreatment standardized uptake value maximum (SUVmax) and Hounsfield Units (HU) were measured in the primary tumor in the axial slice with the largest tumor diameter.The associations between SUVmax, HU and the presence of EWSR1 translocation were evaluated. Receiver operating characteristic curve analysis was used to determine cut-off levels of SUVmax and HU suggestive of EWSR1-negative tumors. RESULTS Twenty-one patients were classified as EWSR1-positive and six as EWSR1-negative. Eighteen had SUVmax and 21 had HU measurements. EWSR1-negative tumors had significantly higher SUVmax values (P = 0.003) and significantly lower HU values (P = 0.008). Receiver operating characteristic curve analysis showed that SUVmax had diagnostic ability to discriminate between EWSR1-negative and EWSR1-positive tumors (area under the curve = 0.964, P = 0.006). A SUVmax of at least 10 had a sensitivity of 100% and specificity of 85.7% for EWSR1-negative tumors. HU had lower diagnostic ability than SUVmax (area under the curve = 0.881, P = 0.012). A HU up to 57 had a sensitivity of 81.3% and specificity of 80.0% for EWSR1-negative tumors. CONCLUSION Higher SUVmax and lower HU may differentiate between EWSR1-positive and EWSR1-negative tumors. This may reflect EWSR1-negative tumor aggressiveness.
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Lu VM, Goyal A, Alvi MA, Kerezoudis P, Haddock MG, Bydon M. Primary intradural Ewing’s sarcoma of the spine: a systematic review of the literature. Clin Neurol Neurosurg 2019; 177:12-19. [DOI: 10.1016/j.clineuro.2018.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/28/2018] [Accepted: 12/13/2018] [Indexed: 12/20/2022]
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Abstract
A 39-year-old woman with primary spinal Ewing sarcoma and known lung metastases presented with painless bilateral decreased visual acuity over a 1-month period. Examination revealed bilateral disc edema. MRI of the brain/orbits showed metastatic lesions to the dura and bilateral orbits. Venous sinus thrombosis extending to the jugular vein was also noted. To the authors' knowledge, this is the first case of bilateral orbital metastasis and papilledema secondary to Ewing sarcoma and related hypercoagulability.
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Sarigul B, Uysal E, Avci İ, Peker H, Celik S. Giant Calvarial Ewing's Sarcoma: A Case Report. J Neurol Surg Rep 2018; 79:e79-e82. [PMID: 30302304 PMCID: PMC6173587 DOI: 10.1055/s-0038-1673626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/28/2018] [Indexed: 01/18/2023] Open
Abstract
Ewing's sarcoma (EWS) is the second most common primary bone tumor seen in children and adolescents, first being osteosarcoma. Skull lesions are seen in 6 to 9% of cases. The tumor tends to reside most frequently on frontal and parietal bones. In the literature, majority of papers on calvarial EWS present cases with intracranial involvement; extracranial extension is reported in only eight cases. The case that we are presenting in this report is a 23-year-old male patient with multiple infiltrations in femur, costal bones, and calvarium which had been diagnosed radiologically and histopathologically as EWS. The calvarial metastasis had reached a very huge size with dimensions of approximately 7.5 × 7.5 × 9.5 cm and was successfully excised totally. Twelve months of follow-up revealed no recurrence in the surgical site showing that total removal of giant cranial EWS may improve morbidity of these patients.
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Affiliation(s)
- Buse Sarigul
- Department of Neurosurgery, Okmeydani Education Hospital, Istanbul, Turkey
| | - Ece Uysal
- Department of Neurosurgery, Okmeydani Education Hospital, Istanbul, Turkey
| | - İdris Avci
- Department of Neurosurgery, Okmeydani Education Hospital, Istanbul, Turkey
| | - Halil Peker
- Department of Neurosurgery, Okmeydani Education Hospital, Istanbul, Turkey
| | - Suat Celik
- Department of Neurosurgery, Okmeydani Education Hospital, Istanbul, Turkey
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Louati S, Senhaji N, Chbani L, Bennis S. EWSR1 Rearrangement and CD99 Expression as Diagnostic Biomarkers for Ewing/PNET Sarcomas in a Moroccan Population. DISEASE MARKERS 2018; 2018:7971019. [PMID: 30319719 PMCID: PMC6167566 DOI: 10.1155/2018/7971019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/16/2018] [Accepted: 08/18/2018] [Indexed: 11/23/2022]
Abstract
Ewing sarcoma/primitive neuroectodermal tumor (Ewing/PNET sarcomas or EPS) are a group of round cell tumors. Malignant round cell tumors form a large and diverse group that includes rhabdomyosarcoma, synovial sarcoma, non-Hodgkin's lymphoma, neuroblastoma, hepatoblastoma, Wilm's tumor, desmoplastic small round cell tumor, and other morphologically similar entities. Differential diagnosis of Ewing sarcoma/primitive neuroectodermal tumor (Ewing/PNET sarcomas or EPS) is difficult. In addition to morphology and immunohistochemistry (IHC), differential diagnosis of these tumors is based on molecular analysis of the EWSR1 gene rearrangement using fluorescent in situ hybridization (FISH) technique. We investigated the diagnostic value of combined CD99 immunostaining and EWSR1 t(22q12) alteration using a dual-color, break-apart rearrangement probe in forty-one formalin-fixed paraffin-embedded (FFPE) tissue samples from pediatric and adult patients diagnosed with EPS. IHC was performed in all cases using the CD99 antibody and showed a positivity of 92.7% in the enrolled cases (38/41) followed by FISH analysis where 48.8% of the cases (20/41) were rearranged. Sensitivity and specificity for IHC assays were 88% and 58%, respectively. Notably, FISH had a sensitivity of 100% and a specificity of 87%. In addition, CD99 positivity was found to correlate with EWSR1 rearrangement (p < 0.05). This report shows that FISH has better sensitivity and specificity than IHC in the Moroccan population, and supports its combination with CD99 immunostaining as diagnostic biomarkers for this rare malignant entity."
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Affiliation(s)
- Sara Louati
- Bioactive Molecules, Structure and Functions Laboratory, Faculty of Sciences and Techniques, Sidi Mohamed ben Abdellah University of Fez, Morocco
- Pathological Anatomy and Molecular Pathology Department, Hassan II University Hospital of Fez, Morocco
| | - Nadia Senhaji
- Bioactive Molecules, Structure and Functions Laboratory, Faculty of Sciences and Techniques, Sidi Mohamed ben Abdellah University of Fez, Morocco
| | - Laila Chbani
- Pathological Anatomy and Molecular Pathology Department, Hassan II University Hospital of Fez, Morocco
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed ben Abdellah University of Fez, Morocco
| | - Sanae Bennis
- Pathological Anatomy and Molecular Pathology Department, Hassan II University Hospital of Fez, Morocco
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed ben Abdellah University of Fez, Morocco
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Bong C, Thomson I, Lampe G. Case report and literature review of Ewing's sarcoma in the gastrointestinal tract. SURGICAL PRACTICE 2018; 22:84-92. [DOI: 10.1111/1744-1633.12292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Christopher Bong
- Department of Upper Gastrointestinal Surgery and Soft Tissue; Princess Alexandra Hospital; Woolloongabba Queensland Australia
| | - Iain Thomson
- Department of Upper Gastrointestinal Surgery and Soft Tissue; Princess Alexandra Hospital; Woolloongabba Queensland Australia
| | - Guy Lampe
- Department of Anatomical Pathology; Princess Alexandra Hospital; Woolloongabba Queensland Australia
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Kaliki S, Rathi SG, Palkonda VAR. Primary orbital Ewing sarcoma family of tumors: a study of 12 cases. Eye (Lond) 2018; 32:615-621. [PMID: 29219959 PMCID: PMC5848293 DOI: 10.1038/eye.2017.278] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 10/27/2017] [Indexed: 12/31/2022] Open
Abstract
PurposeThe purpose of this study is to discuss the clinical presentation, management, and outcomes of patients with primary orbital Ewing sarcoma family of tumors (ESFTs).Patients and methodsRetrospective study of 12 patients with biopsy-proven primary orbital ESFT.ResultsThe mean age at presentation of primary orbital ESFT was 12 years (median, 8 years; range, 5 months to 28 years). There were seven (58%) females and five (42%) males. The presenting complaints included proptosis (n=10; 83%) and swelling in the upper eyelid (n=2; 17%). The mean duration of symptoms was 9 weeks (median, 5 weeks; range, 2-24 weeks). Tumor epicenter was located in the superior orbit (n=6; 50%), lateral orbit (n=3; 25%), inferior orbit (n=2; 17%), and medial orbit (n=1; 8%). Computed tomography of the orbits revealed predominant bony lesion (n=10; 83%) or isolated soft tissue/extraosseous lesion (n=2, 17%). At presentation, extraorbital extension was noticed in 10 patients including intra cranial extension (n=7; 58%), extension into temporal fossa (n=4; 33%), nasal cavity (n=2; 17%), maxillary sinus (n=2; 17%), and ethmoid sinus (n=1, 8%). Systemic metastases at presentation was detected in five (42%) patients involving the bone marrow (n=4; 33%), kidney (n=1; 8%), and retroperitoneal lymphnode (n=1; 8%). Multi-modal treatment including a combination of neoadjuvant chemotherapy, excision biopsy/debulking, and/or radiotherapy was given. Over a mean follow-up period of 21 months (median, 7 months; range, 1-152 months), disease-related death occurred in 11 (92%) cases.ConclusionPrimary orbital ESFT is aggressive at presentation and is associated with poor prognosis.
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Affiliation(s)
- S Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India
| | - S G Rathi
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India
| | - V A R Palkonda
- The Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, India
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Alqasim E, Aljowder A, Alammari N, Joudeh AA. Total patellectomy with extensor mechanism reconstruction following pathological fracture due to patellar Ewing's sarcoma. BMJ Case Rep 2018; 2018:bcr-2017-222853. [PMID: 29437710 DOI: 10.1136/bcr-2017-222853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A young patient presented with a progressive right knee pain and swelling that was worse on ambulation. Following appropriate investigations, he was confirmed having Ewing's sarcoma of the right patella. Two cycles of chemotherapy were initiated before he sustained a fall and a resultant pathological patellar fracture. He finally underwent a total right patellectomy and extensor mechanism reconstruction using Achilles tendon allograft in an attempt to eradicate the disease and salvage his knee extensor mechanism. At 1-year follow-up, no disease recurrence was observed, and the patient had a full range of motion but with slight weakness of the extensor mechanism.
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Affiliation(s)
- Eyad Alqasim
- Orthopaedic Surgery, King Hamad University Hospital, Muharraq, Bahrain
| | - Abdulla Aljowder
- Orthopaedic Surgery, Bahrain Defence Force Royal Medical Services, Riffa, Bahrain
| | - Naji Alammari
- Orthopaedic Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Amani A Joudeh
- Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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Lo Vasco VR, Leopizzi M, Scotto d’Abusco A, Rocca CD. Different Expression and Localization of Phosphoinositide Specific Phospholipases C in Human Osteoblasts, Osteosarcoma Cell Lines, Ewing Sarcoma and Synovial Sarcoma. AVICENNA JOURNAL OF MEDICAL BIOCHEMISTRY 2017. [DOI: 10.15171/ajmb.2017.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Bone hardness and strength depends on mineralization, which involves a complex process in which calcium phosphate, produced by bone-forming cells, was shed around the fibrous matrix. This process is strictly regulated, and a number of signal transduction systems were interested in calcium metabolism, such as the phosphoinositide (PI) pathway and related phospholipase C (PLC) enzymes. Objectives: Our aim was to search for common patterns of expression in osteoblasts, as well as in ES and SS. Methods: We analysed the PLC enzymes in human osteoblasts and osteosarcoma cell lines MG-63 and SaOS-2. We compared the obtained results to the expression of PLCs in samples of patients affected with Ewing sarcoma (ES) and synovial sarcoma (SS). Results: In osteoblasts, MG-63 cells and SaOS-2 significant differences were identified in the expression of PLC δ4 and PLC η subfamily isoforms. Differences were also identified regarding the expression of PLCs in ES and SS. Most ES and SS did not express PLCB1, which was expressed in most osteoblasts, MG-63 and SaOS-2 cells. Conversely, PLCB2, unexpressed in the cell lines, was expressed in some ES and SS. However, PLCH1 was expressed in SaOS-2 and inconstantly expressed in osteoblasts, while it was expressed in ES and unexpressed in SS. The most relevant difference observed in ES compared to SS regarded PLC ε and PLC η isoforms. Conclusion: MG-63 and SaOS-2 osteosarcoma cell lines might represent an inappropriate experimental model for studies about the analysis of signal transduction in osteoblasts
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Affiliation(s)
| | - Martina Leopizzi
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino –Sapienza University, Latina, Rome, Italy
| | - Anna Scotto d’Abusco
- Department of Biochemical Sciences A. Rossi Fanelli, Sapienza University of Rome, Rome, Italy
| | - Carlo Della Rocca
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino –Sapienza University, Latina, Rome, Italy
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Lombardi D, Mattavelli D, Redaelli De Zinis LO, Accorona R, Morassi ML, Facchetti F, Ferrari V, Farina D, Bertulli R, Nicolai P. Primary Ewing's sarcoma of the sinonasal tract in adults: A challenging disease. Head Neck 2016; 39:E45-E50. [PMID: 27898190 DOI: 10.1002/hed.24649] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 08/19/2016] [Accepted: 10/21/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sinonasal localization of Ewing's sarcoma in adults is an exceedingly rare event. METHODS The clinical records of 5 patients with primary sinonasal Ewing's sarcoma treated from 1992 to 2012 were retrospectively analyzed. All pathologic slides were reviewed by 2 experienced pathologists. All patients underwent multimodality treatments. RESULTS Median age was 36 years (range, 25-52 years). At referral, 2 patients had the original diagnosis changed by review of the histologic slides. Tumors were classified as T4aN0M0 (4 patients) and T2N0M0 (1 patient). Median follow-up was 110 months (range, 70-139 months). Only 1 patient, who started treatment elsewhere based on an incorrect histologic diagnosis, experienced multiple recurrences and eventually died of widespread metastasis. CONCLUSION Correct pathologic diagnosis can have a crucial impact on treatment planning and outcome. Multimodality therapy is the key for long-term successful results. Because of the rarity of the tumor, referral to highly experienced care centers is strongly recommended. © 2016 Wiley Periodicals, Inc. Head Neck 39: E45-E50, 2017.
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Affiliation(s)
- Davide Lombardi
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Luca O Redaelli De Zinis
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Remo Accorona
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Maria L Morassi
- Unit of Pathology, Department of Translational and Molecular Medicine, University of Brescia, Brescia, Italy
| | - Fabio Facchetti
- Unit of Pathology, Department of Translational and Molecular Medicine, University of Brescia, Brescia, Italy
| | - Vittorio Ferrari
- Unit of Medical Oncology, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Davide Farina
- Unit of Radiology, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Rossella Bertulli
- Adult Mesenchymal Tumor Medical Oncology Unit, Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Piero Nicolai
- Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
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Flores M, Caram A, Derrick E, Reith JD, Bancroft L, Scherer K. Ewing Sarcoma of the Pelvis with an Atypical Radiographic Appearance: A Mimicker of Non-malignant Etiologies. Cureus 2016; 8:e787. [PMID: 27774356 PMCID: PMC5071172 DOI: 10.7759/cureus.787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Ewing sarcoma (ES) is a primary malignant bone tumor which most commonly arises in children and young adults. The common clinical presentation with ES includes nighttime pain or pain related to activity, though patients may also present with a combination of localized swelling, a palpable mass, pathologic fracture, and constitutional symptoms. Clinical diagnosis may be delayed when a patient presents with clinical or imaging findings that overlap with non-malignant etiologies, such as fibrous dysplasia (FD) or osteomyelitis. Furthermore, multimodality imaging, including computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine may prove inconclusive in particular cases. Suspicion for malignancy should not be overlooked. A biopsy must be considered, unless the diagnosis is evident, such as a clinical response to antibiotics in the setting of osteomyelitis.
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Ewing's Sarcoma as a Second Malignancy in Long-Term Survivors of Childhood Hematologic Malignancies. Sarcoma 2016; 2016:5043640. [PMID: 27524931 PMCID: PMC4976151 DOI: 10.1155/2016/5043640] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 06/19/2016] [Indexed: 12/20/2022] Open
Abstract
Modern multimodal treatment has significantly increased survival for patients affected by hematologic malignancies, especially in childhood. Following remission, however, the risk of developing a further malignancy is an important issue. The long-term estimated risk of developing a sarcoma as a secondary malignancy is increased severalfold in comparison to the general population. Ewing's sarcoma family encompasses a group of highly aggressive, undifferentiated, intra- and extraosseous, mesenchymal tumors, caused by several types of translocations usually involving the EWSR1 gene. Translocation associated sarcomas, such as Ewing sarcoma, are only rarely encountered as therapy associated secondary tumors. We describe the clinical course and management of three patients from a single institution with Ewing's sarcoma that followed successfully treated lymphoblastic T-cell leukemia or non-Hodgkin lymphoma. The literature on secondary Ewing's sarcoma is summarized and possible pathogenic mechanisms are critically discussed.
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Wong T, Goldsby RE, Wustrack R, Cash T, Isakoff MS, DuBois SG. Clinical features and outcomes of infants with Ewing sarcoma under 12 months of age. Pediatr Blood Cancer 2015; 62:1947-51. [PMID: 26173989 DOI: 10.1002/pbc.25635] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 05/18/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Ewing sarcoma peaks in incidence in adolescence. Infants <12 months old have rarely been reported. We aimed to compare clinical features, treatment, and survival of infants <12 months to those of older pediatric patients with Ewing sarcoma. PROCEDURE We utilized the SEER database to identify patients <12 months of age diagnosed with Ewing sarcoma between 1973 and 2011. We used Fisher exact tests to compare clinical features and treatment modalities between these patients and patients aged 1-19 years. We used Kaplan-Meier methods to describe overall survival in these two groups. RESULTS Of 1,957 patients in the cohort, 39 (2.0%) were diagnosed at <12 months of age. Infants had a different distribution of primary tumor sites, with lower extremity tumors under represented. Compared to older patients, infants were more likely to have soft tissue tumors (81.6% vs. 27.1%; P < 0.001); have primitive neuroectodermal tumor/Askin tumor (61.5% vs. 19.9%; P < 0.001); and have tumors <8 cm (81.0% vs. 53.2%; P < 0.014). Infants were less likely to receive radiation therapy (13.2% vs. 53.3%; P < 0.001). Infants were at increased risk for early death (P < 0.013 by Wilcoxon), though long-term overall survival was not different between age groups (P < 0.25 by log rank). CONCLUSIONS Ewing sarcoma is rare in infants, with different clinical presentations and treatment approaches. These patients appear to be at higher risk for early death, but long-term survival is similar to older pediatric patients.
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Affiliation(s)
- Thalia Wong
- Department of Pediatrics, San Francisco School of Medicine, UCSF Benioff Children's Hospital, University of California, San Francisco, California
| | - Robert E Goldsby
- Department of Pediatrics, San Francisco School of Medicine, UCSF Benioff Children's Hospital, University of California, San Francisco, California
| | - Rosanna Wustrack
- Department of Orthopedics, San Francisco School of Medicine, UCSF Benioff Children's Hospital, University of California, California
| | - Thomas Cash
- Department of Pediatrics, Emory University, Atlanta, Georgia
| | - Michael S Isakoff
- Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, University of Connecticut, Hartford, Connecticut
| | - Steven G DuBois
- Department of Pediatrics, San Francisco School of Medicine, UCSF Benioff Children's Hospital, University of California, San Francisco, California
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Chen Q, Zhou Z, Shan L, Zeng H, Hua Y, Cai Z. The importance of Src signaling in sarcoma. Oncol Lett 2015; 10:17-22. [PMID: 26170970 DOI: 10.3892/ol.2015.3184] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 01/22/2015] [Indexed: 12/23/2022] Open
Abstract
Src is a tyrosine kinase that is of significance in tumor biology. The present review focuses on Src, its molecular structure, and role in cancer, in addition to its expression and function in sarcoma. In addition, the feasibility of Src as a potential drug target for the treatment of sarcoma is also discussed. Previous studies have suggested that Src has essential functions in cell proliferation, apoptosis, invasion, metastasis and the tumor microenvironment. Thus, it may be a potential target for cancer therapy. Src has been found to enhance proliferation, reduce apoptosis and promote metastasis in certain subtypes of sarcoma, including osteosarcoma, chondrosarcoma and Ewing's sarcoma. Furthermore, a number of novel effective therapeutic agents, such as SI-83, which target Src have been investigated in vitro and in vivo. Bosutinib and dasatinib, which inhibit Src, have been approved by the U.S. Food and Drug Administration for the treatment of chronic myelogenous leukemia. In addition, vandetanib is approved for the treatment of medullary thyroid cancer. Furthermore, the Src inhibitor, saracatinib, is currently in clinical trials for the treatment of a variety of solid tumors, including breast and lung cancers. Thus, Src is considered to be an important factor in sarcoma progression and may present a novel clinical therapeutic target. This review demonstrates the importance and clinical relevance of Src in sarcoma, and discusses a number of small molecular inhibitors of src kinase, such as dasatinib and sarcatinib, which are currently in clinical trials for the treatment of sarcoma patients.
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Affiliation(s)
- Quanchi Chen
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Zifei Zhou
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Liancheng Shan
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Hui Zeng
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Yingqi Hua
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
| | - Zhengdong Cai
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China
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Zia H, Murray GI, Vyhlidal CA, Leeder JS, Anwar AE, Bui MM, Ahmed AA. CYP3A isoforms in Ewing's sarcoma tumours: an immunohistochemical study with clinical correlation. Int J Exp Pathol 2015; 96:81-6. [PMID: 25670065 DOI: 10.1111/iep.12115] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 12/01/2014] [Indexed: 12/14/2022] Open
Abstract
Ewing's sarcoma is an aggressive malignancy of bone and soft tissue with high incidence of metastasis and resistance to chemotherapy. Cytochrome P450 (CYP) monooxygenases are a family of enzymes that are involved in the metabolism of exogenous and endogenous compounds, including anti-cancer drugs, and have been implicated in the aggressive behaviour of various malignancies. Tumour samples and clinical information including age, sex, tumour site, tumour size, clinical stage and survival were collected from 36 adult and paediatric patients with Ewing's sarcoma family tumours. Tissue microarrays slides were processed for immunohistochemical labelling for CYP3A4, CYP3A5 and CYP3A7 using liver sections as positive control. The intensity of staining was scored as negative, low or high expression and was analysed statistically for any association with patients' clinical information. Four cases were later excluded due to inadequate viable tissue. CYP3A4 staining was present in 26 (81%) cases with high expression noted in 13 (40%) of 32 cases. High expression was significantly associated with distant metastases (P < 0.05). CYP3A5 and CYP3A7 were expressed in 5 and 13 cases respectively (15.6%, 40.6%). There was no association between the expression of CYP3A isoforms and age, sex, tumour size, or location (pelvic or extra-pelvic). None of the biomarkers showed any correlation with overall or disease-free survival. In conclusion, expression of CYP3A isoforms is noted in Ewing's sarcoma tumours and high CYP3A4 expression may be associated with metastasis. Additional studies are needed to further investigate the role of CYP3A4 in the prognosis of these tumours.
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Affiliation(s)
- Hamid Zia
- Department of Pathology, University of Missouri, Kansas City, MO, USA
| | - Graeme I Murray
- Department of Pathology, University of Aberdeen, Aberdeen, UK
| | - Carrie A Vyhlidal
- Department of Clinical Pharmacology, Children's Mercy Hospital, Kansas City, MO, USA
| | - J Steven Leeder
- Department of Clinical Pharmacology, Children's Mercy Hospital, Kansas City, MO, USA
| | - Ahmed E Anwar
- Department of Epidemiology and Biostatistics, College of Public Health and Health Informatics, King Saud Bin Abdulaziz University, Riyadh, Saudi Arabia
| | - Marilyn M Bui
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, FL, USA
| | - Atif A Ahmed
- Department of Pathology, Children's Mercy Hospital, Kansas City, MO, USA
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Bone- and cartilage-forming tumors and ewing sarcoma: an update with a gnathic emphasis. Head Neck Pathol 2014; 8:454-62. [PMID: 25409851 PMCID: PMC4245414 DOI: 10.1007/s12105-014-0587-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/03/2014] [Indexed: 12/16/2022]
Abstract
Over the past decade, there have been remarkable advances in bone tumor pathology. Insights into the genetic basis and pathobiology of many tumor types have impacted diagnosis, classification, and treatment. However, because gnathic lesions may comprise only a small proportion of cases overall for many tumors, clinicopathologic features and management considerations specific to this subset may be overlooked. Here we provide a summary of recent developments in the following tumor types: osteosarcoma (OS), chondrosarcoma (CS), osteoid osteoma (OO), osteoblastoma (OB), and Ewing sarcoma (ES). In particular, we will give special consideration to cases arising in the jaws.
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