151
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Vierra BM, Saadat LV, Hornick JL, Jagannathan JP, Ferrone ML, Wagner AJ, Wang J, Baldini EH, Raut C, Fairweather M. Distribution and Rate of Myxoid Liposarcoma Spine Metastases: Impact on Surveillance Imaging. Ann Surg Oncol 2023; 30:8647-8652. [PMID: 37773566 DOI: 10.1245/s10434-023-14309-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/30/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Myxoid liposarcoma (LPS) has a unique tendency to spread to extrapulmonary sites, including osseous sites such as the spine, and adjacent sites such as the paraspinous tissue. No clear consensus exists to guide the approach to imaging in these patients. OBJECTIVE The aim of this study was to investigate the rate and distribution of spine metastases in patients with myxoid LPS and detection modality. METHODS Records of all patients with myxoid LPS evaluated at our sarcoma center were retrospectively reviewed. Disease patterns and imaging modality utilization were analyzed. RESULTS Between 2000 and 2020, 164 patients with myxoid LPS were identified. The majority (n = 148, 90%) presented with localized disease, with half (n = 82, 50%) of all patients developing metastases or recurrence during their disease course. With a median follow-up of 69.2 months, spine/paraspinous metastases developed in 38 patients (23%), of whom 35 (92%) already had synchronous, non-spine metastases. Spine disease was only visible on magnetic resonance imaging (MRI), as opposed to other imaging modalities, for over one-quarter of patients with spine metastases (n = 10). For patients with metastatic disease, spine metastases were associated with worse median overall survival (2.1 vs. 8.7 years, p < 0.001). CONCLUSION Spine metastases occurred in nearly one-quarter of patients with myxoid LPS and represented an advanced disease state, as they primarily presented in the setting of synchronous, non-spine metastases, and were associated with worse overall survival. Routine surveillance with spine MRI in patients with localized disease likely provides no benefit but may be considered in those with known metastatic disease.
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Affiliation(s)
- Benjamin M Vierra
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Lily V Saadat
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Marco L Ferrone
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
| | - Andrew J Wagner
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jiping Wang
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
| | - Elizabeth H Baldini
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
- Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, USA
| | - Chandrajit Raut
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
| | - Mark Fairweather
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA.
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152
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Dhungel D, Rastogi V, Maddheshiya N, Chaurasia S, Ramalingam K. Osteochondroma of the Mandibular Condyle: A Rare Case Presentation With Literature Review. Cureus 2023; 15:e50355. [PMID: 38213345 PMCID: PMC10781615 DOI: 10.7759/cureus.50355] [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: 12/11/2023] [Indexed: 01/13/2024] Open
Abstract
Osteochondromas (OCs) are benign bone tumors characterized by their growth with a cartilage cap and typically occurring at the ends of long bones. Their occurrence in the head and neck region is infrequent, accounting for only around 1% of head and neck tumors. Notably, the mandibular coronoid process and the mandibular condyle are the primary sites where an OC is reported. Patients often exhibit facial asymmetry, limited mouth opening, and malocclusion. Possible treatment options depending on the condition include partial or total condylectomy, vertical ramus osteotomy, and supplementary orthognathic surgery. The recurrence rate of under 1%- 2% is reported after local resection. In this case report, we present a unique case of an OC in a 27-year-old woman. It involved the mandibular condyle, resulting in a left-sided mouth deviation while opening and closing her mouth. The purpose of this article is to detail the clinical and radiographic features, histopathological aspects, and treatment strategies and differentiate potential diagnoses, for such OCs.
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Affiliation(s)
- Dilasha Dhungel
- Department of Oral Pathology, Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, NPL
| | - Varun Rastogi
- Department of Oral Pathology, Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, NPL
| | - Nisha Maddheshiya
- Department of Oral Medicine and Radiology, Faculty of Medical Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
| | - Sandhya Chaurasia
- Department of Oral Pathology, Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, NPL
| | - Karthikeyan Ramalingam
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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153
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Bilić M, Jaman J, Gorjanc B, Žic R. Massive dedifferentiated thigh liposarcoma growing for 10 years and extending into the retroperitoneum: a case report. Case Reports Plast Surg Hand Surg 2023; 10:2285051. [PMID: 38229695 PMCID: PMC10790800 DOI: 10.1080/23320885.2023.2285051] [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: 06/19/2023] [Accepted: 11/13/2023] [Indexed: 01/18/2024]
Abstract
Liposarcomas are rare, malignant tumors of adipocyte differentiation. Surgery is the main treatment method. We are reporting a rare case of a 65- year- old female patient with a massive dedifferentiated thigh liposarcoma that was growing for 10 years and spread to the retroperitoneum.
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Affiliation(s)
- Miro Bilić
- Department of Plastic Surgery, University Hospital "Dubrava", Zagreb, Croatia
| | - Josip Jaman
- Department of Plastic Surgery, University Hospital "Dubrava", Zagreb, Croatia
| | - Božo Gorjanc
- Department of Plastic Surgery, University Hospital "Dubrava", Zagreb, Croatia
| | - Rado Žic
- Department of Plastic Surgery, University Hospital "Dubrava", Zagreb, Croatia
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154
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Eghtedari AR, Vaezi MA, Safari E, Salimi V, Safizadeh B, Babaheidarian P, Abiri A, Mahdinia E, Alireza Mirzaei, Mokhles P, Tavakoli-Yaraki M. The expression changes of PD-L1 and immune response mediators are related to the severity of primary bone tumors. Sci Rep 2023; 13:20474. [PMID: 37993664 PMCID: PMC10665336 DOI: 10.1038/s41598-023-47996-8] [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: 04/08/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023] Open
Abstract
The expression pattern, diagnostic value, and association of PD-L1, IFN-γ and TGF-β with bone tumor type, severity, and relapse are determined in this study. 300 human samples from patients with osteosarcoma, Ewing sarcoma, and GCT were enrolled. The PD-L1 gene and protein expression were assessed by qRT-PCR and immunohistochemistry, respectively. ELISA and flow cytometry was used to detect cytokines and CD4/CD8 T cell percentages, respectively. A considerable increase in PD-L1 level was detected in bone tumor tissues at both gene and protein levels that was considerable in osteosarcoma and Ewing sarcoma. A positive correlation was detected regarding the PD-L1 and tumor metastasis and recurrence in osteosarcoma and Ewing sarcoma. The increased IFN-γ level was detected in patients with metastatic, and recurrent osteosarcoma tumors that were in accordance with the level of TGF-β in these samples. The simultaneous elevation of IFN-γ and TGF-β was detected in Ewing sarcoma and GCT, also the CD4 + /CD8 + ratio was decreased significantly in patients with osteosarcoma compared to GCT tumors. The elevated levels of PD-L1, TGF- β, and IFN-γ were associated with bone tumor severity that can provide insights into the possible role of this axis in promoting immune system escape, suppression, and tumor invasion.
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Affiliation(s)
- Amir Reza Eghtedari
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, P.O. Box: 1449614535, Tehran, Iran
| | - Mohammad Amin Vaezi
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, P.O. Box: 1449614535, Tehran, Iran
| | - Elaheh Safari
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Salimi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Banafsheh Safizadeh
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, P.O. Box: 1449614535, Tehran, Iran
| | - Pegah Babaheidarian
- Department of Pathology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Amene Abiri
- Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran
| | - Elmira Mahdinia
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, P.O. Box: 1449614535, Tehran, Iran
| | - Alireza Mirzaei
- Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Parisa Mokhles
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Tavakoli-Yaraki
- Department of Biochemistry, School of Medicine, Iran University of Medical Sciences, P.O. Box: 1449614535, Tehran, Iran.
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155
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Kokkali S, Georgaki E, Mandrakis G, Valverde C, Theocharis S. Genomic Profiling and Clinical Outcomes of Targeted Therapies in Adult Patients with Soft Tissue Sarcomas. Cells 2023; 12:2632. [PMID: 37998367 PMCID: PMC10670373 DOI: 10.3390/cells12222632] [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: 10/01/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Genomic profiling has improved our understanding of the pathogenesis of different cancers and led to the development of several targeted therapies, especially in epithelial tumors. In this review, we focus on the clinical utility of next-generation sequencing (NGS) to inform therapeutics in soft tissue sarcoma (STS). The role of NGS is still controversial in patients with sarcoma, given the low mutational burden and the lack of recurrent targetable alterations in most of the sarcoma histotypes. The clinical impact of genomic profiling in STS has not been investigated prospectively. A limited number of retrospective, mainly single-institution, studies have addressed this issue using various NGS technologies and platforms and a variety of criteria to define a genomic alteration as actionable. Despite the detailed reports on the different gene mutations, fusions, or amplifications that were detected, data on the use and efficacy of targeted treatment are very scarce at present. With the exception of gastrointestinal stromal tumors (GISTs), these targeted therapies are administered either through off-label prescription of an approved drug or enrollment in a matched clinical trial. Based mainly on anecdotal reports, the outcome of targeted therapies in the different STS histotypes is discussed. Prospective studies are warranted to assess whether genomic profiling improves the management of STS patients.
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Affiliation(s)
- Stefania Kokkali
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece;
- Oncology Unit, 2nd Department of Medicine, Medical School, Hippocratio General Hospital of Athens, National and Kapodistrian University of Athens, V. Sofias 114, 11527 Athens, Greece;
| | - Eleni Georgaki
- Oncology Unit, 2nd Department of Medicine, Medical School, Hippocratio General Hospital of Athens, National and Kapodistrian University of Athens, V. Sofias 114, 11527 Athens, Greece;
| | - Georgios Mandrakis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece;
| | - Claudia Valverde
- Medical Oncology Department, Vall d’Hebron University Hospital, Pg. Vall d’Hebron 119-12, 08035 Barcelona, Spain;
| | - Stamatios Theocharis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece;
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156
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Costa A, Gozzellino L, Nannini M, Astolfi A, Pantaleo MA, Pasquinelli G. Preclinical Models of Visceral Sarcomas. Biomolecules 2023; 13:1624. [PMID: 38002306 PMCID: PMC10669128 DOI: 10.3390/biom13111624] [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: 10/02/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Visceral sarcomas are a rare malignant subgroup of soft tissue sarcomas (STSs). STSs, accounting for 1% of all adult tumors, are derived from mesenchymal tissues and exhibit a wide heterogeneity. Their rarity and the high number of histotypes hinder the understanding of tumor development mechanisms and negatively influence clinical outcomes and treatment approaches. Although some STSs (~20%) have identifiable genetic markers, as specific mutations or translocations, most are characterized by complex genomic profiles. Thus, identification of new therapeutic targets and development of personalized therapies are urgent clinical needs. Although cell lines are useful for preclinical investigations, more reliable preclinical models are required to develop and test new potential therapies. Here, we provide an overview of the available in vitro and in vivo models of visceral sarcomas, whose gene signatures are still not well characterized, to highlight current challenges and provide insights for future studies.
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Affiliation(s)
- Alice Costa
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Livia Gozzellino
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Margherita Nannini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
- Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Annalisa Astolfi
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Maria Abbondanza Pantaleo
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
- Division of Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Gianandrea Pasquinelli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
- Division of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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157
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Wu J, Zhang Y, Yao G, Tuersunmaimaiti A, Azhati Y, Mamuti A, Wen H, Tuxun T. Survival nomograms for patients with retroperitoneal soft tissue sarcoma based on the SEER database and an external cohort. J Cancer Res Clin Oncol 2023; 149:15013-15026. [PMID: 37610674 DOI: 10.1007/s00432-023-05278-w] [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: 06/04/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Retroperitoneal soft tissue sarcoma (RPS) is a quite rare disease,and new nomograms need to be constructed to predict the overall survival (OS) and cancer specific survival (CSS) of RPS patients. METHODS The clinical data of patients with RPS were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and authors' hospital. The LASSO method and COX proportional hazard regression were used to screen independent risk factors which were used to develop nomograms. Nomograms was evaluated in terms of discrimination by consistency index (C-index) and calibration curve. Decision curve analysis (DCA) and integrated discrimination index (IDI) were performed to assess net benefit and the improvement of model, respectively. Kaplan-Meier method and log-rank test were applied to compare the survival difference between groups. RESULTS A total of 1164 cases were enrolled which were divided into training cohort (n = 814) and internal validation cohort (n = 350) at a 7:3 ratio. The discrimination of nomograms were good with C-index of 0.728 (95%CI = 0.704-0.752, R2 = 0.270), 0.754 (95%CI = 0.729-0.779, R2 = 0.281) for OS and CSS, respectively. Calibration curve showed good predictive accuracy of nomograms both in internal and external validation cohort, and IDI indicated that nomograms perform well than AJCC stage. Kaplan Meier curve and log-rank test uncovered statistically significance survival difference between high- and low-risk groups with P < 0.001 in terms of OS and CSS. CONCLUSION Novel nomograms predicting the OS and CSS of RPS patients perform well in discrimination, calibration, clinical benefit and IDI. These nomograms may facilitate risk stratification and making clinical decision.
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Affiliation(s)
- Jing Wu
- Department of Liver & Laparoscopic Surgery, Center of Digestive and Vascular Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uyghur Autonomous Region, No.137, Liyushan Rd, Xinshi District, Urumqi, 830054, China
- State Key Laboratory of Pathogenesis, Prevention, Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, 830054, China
| | - Yunfei Zhang
- Department of Liver & Laparoscopic Surgery, Center of Digestive and Vascular Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uyghur Autonomous Region, No.137, Liyushan Rd, Xinshi District, Urumqi, 830054, China
| | - Gang Yao
- Department of Liver & Laparoscopic Surgery, Center of Digestive and Vascular Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uyghur Autonomous Region, No.137, Liyushan Rd, Xinshi District, Urumqi, 830054, China
| | - Abudusalamu Tuersunmaimaiti
- Department of Liver & Laparoscopic Surgery, Center of Digestive and Vascular Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uyghur Autonomous Region, No.137, Liyushan Rd, Xinshi District, Urumqi, 830054, China
| | - Yilizhati Azhati
- Department of Liver & Laparoscopic Surgery, Center of Digestive and Vascular Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uyghur Autonomous Region, No.137, Liyushan Rd, Xinshi District, Urumqi, 830054, China
| | - Alimujiang Mamuti
- Department of Liver & Laparoscopic Surgery, Center of Digestive and Vascular Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uyghur Autonomous Region, No.137, Liyushan Rd, Xinshi District, Urumqi, 830054, China
| | - Hao Wen
- Department of Liver & Laparoscopic Surgery, Center of Digestive and Vascular Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uyghur Autonomous Region, No.137, Liyushan Rd, Xinshi District, Urumqi, 830054, China.
- State Key Laboratory of Pathogenesis, Prevention, Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, 830054, China.
| | - Tuerhongjiang Tuxun
- Department of Liver & Laparoscopic Surgery, Center of Digestive and Vascular Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uyghur Autonomous Region, No.137, Liyushan Rd, Xinshi District, Urumqi, 830054, China.
- State Key Laboratory of Pathogenesis, Prevention, Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, 830054, China.
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158
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Gao Y, Niu Y, Zhang G. Localized giant cell tumor of tendon sheath in the joint capsule: A case report. Asian J Surg 2023; 46:4911-4912. [PMID: 37328384 DOI: 10.1016/j.asjsur.2023.05.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 05/31/2023] [Indexed: 06/18/2023] Open
Affiliation(s)
- Yafei Gao
- Inner Mongolia Medical University, Department of Orthopedics, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010050, China
| | - Yaqing Niu
- Inner Mongolia Medical University, Department of Orthopedics, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010050, China.
| | - Guoliang Zhang
- Inner Mongolia Medical University, Department of Orthopedics, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, 010050, China
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159
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Runkel A, Braig D, Bogner B, Schmid A, Lausch U, Boneberg A, Brugger Z, Eisenhardt A, Kiefer J, Pauli T, Boerries M, Fuellgraf H, Kurowski K, Bronsert P, Scholber J, Grosu AL, Rovedo P, Bamberg F, Eisenhardt SU, Jung M. Non-invasive monitoring of neoadjuvant radiation therapy response in soft tissue sarcomas by multiparametric MRI and quantification of circulating tumor DNA-A study protocol. PLoS One 2023; 18:e0285580. [PMID: 37910565 PMCID: PMC10619790 DOI: 10.1371/journal.pone.0285580] [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: 11/18/2022] [Accepted: 04/03/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Wide resection remains the cornerstone of localized soft-tissue sarcomas (STS) treatment. Neoadjuvant radiation therapy (NRT) may decrease the risk of local recurrences; however, its effectiveness for different histological STS subtypes has not been systematically investigated. The proposed prospective study evaluates the NRT response in STS using liquid biopsies and the correlation of multiparametric magnetic resonance imaging (mpMRI) with histopathology and immunohistochemistry. METHODS Patients with localized high-grade STS, who qualify for NRT, are included in this study. LIQUID BIOPSIES Quantification of circulating tumor DNA (ctDNA) in patient blood samples is performed by targeted next-generation sequencing. Soft-tissue sarcoma subtype-specific panel sequencing in combination with patient-specific exome sequencing allows the detection of individual structural variants and point mutations. Circulating free DNA is isolated from peritherapeutically collected patient plasma samples and ctDNA quantified therein. Identification of breakpoints is carried out using FACTERA. Bioinformatic analysis is performed using samtools, picard, fgbio, and the MIRACUM Pipeline. MPMRI Combination of conventional MRI sequences with diffusion-weighted imaging, intravoxel-incoherent motion, and dynamic contrast enhancement. Multiparametric MRI is performed before, during, and after NRT. We aim to correlate mpMRI data with the resected specimen's macroscopical, histological, and immunohistochemical findings. RESULTS Preliminary data support the notion that quantification of ctDNA in combination with tumor mass characterization through co-registration of mpMRI and histopathology can predict NRT response of STS. CLINICAL RELEVANCE The methods presented in this prospective study are necessary to assess therapy response in heterogeneous tumors and lay the foundation of future patient- and tumor-specific therapy concepts. These methods can be applied to various tumor entities. Thus, the participation and support of a wider group of oncologic surgeons are needed to validate these findings on a larger patient cohort.
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Affiliation(s)
- Alexander Runkel
- Faculty of Medicine, Department of Plastic and Hand Surgery, Medical Center—University of Freiburg, Freiburg, Germany
- Faculty of Medicine, Berta-Ottenstein-Programme, University of Freiburg, Freiburg, Germany
| | - David Braig
- Faculty of Medicine, Department of Plastic and Hand Surgery, Medical Center—University of Freiburg, Freiburg, Germany
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Balazs Bogner
- Faculty of Medicine, Department of Radiology, Medical Center—University of Freiburg, Freiburg, Germany
| | - Adrian Schmid
- Faculty of Medicine, Department of Plastic and Hand Surgery, Medical Center—University of Freiburg, Freiburg, Germany
| | - Ute Lausch
- Faculty of Medicine, Department of Plastic and Hand Surgery, Medical Center—University of Freiburg, Freiburg, Germany
| | - Anika Boneberg
- Faculty of Medicine, Department of Plastic and Hand Surgery, Medical Center—University of Freiburg, Freiburg, Germany
| | - Zacharias Brugger
- Faculty of Medicine, Department of Medicine I, Medical Center—University of Freiburg, Freiburg, Germany
| | - Anja Eisenhardt
- Faculty of Medicine, Department of Plastic and Hand Surgery, Medical Center—University of Freiburg, Freiburg, Germany
| | - Jurij Kiefer
- Faculty of Medicine, Department of Plastic and Hand Surgery, Medical Center—University of Freiburg, Freiburg, Germany
| | - Thomas Pauli
- Faculty of Medicine, Institute of Medical Bioinformatics, Medical Center—University of Freiburg, Freiburg, Germany
| | - Melanie Boerries
- Faculty of Medicine, Institute of Medical Bioinformatics, Medical Center—University of Freiburg, Freiburg, Germany
| | - Hannah Fuellgraf
- Faculty of Medicine, Institute of Surgical Pathology, Medical Center—University of Freiburg, Freiburg, Germany
| | - Konrad Kurowski
- Faculty of Medicine, Institute of Surgical Pathology, Medical Center—University of Freiburg, Freiburg, Germany
| | - Peter Bronsert
- Faculty of Medicine, Institute of Surgical Pathology, Medical Center—University of Freiburg, Freiburg, Germany
- Tumorbank Comprehensive Cancer Center Freiburg, Medical Center—University of Freiburg, Freiburg, Germany
- Core Facility for Histopathology and Digital Pathology, Medical Center—University of Freiburg, Freiburg, Germany
| | - Jutta Scholber
- Faculty of Medicine, Department of Radiation Oncology, Medical Center—University of Freiburg, Freiburg, Germany
| | - Anca-Ligia Grosu
- Faculty of Medicine, Department of Radiation Oncology, Medical Center—University of Freiburg, Freiburg, Germany
| | - Philipp Rovedo
- Faculty of Medicine, Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Freiburg, Germany
| | - Fabian Bamberg
- Faculty of Medicine, Department of Radiology, Medical Center—University of Freiburg, Freiburg, Germany
| | - Steffen Ulrich Eisenhardt
- Faculty of Medicine, Department of Plastic and Hand Surgery, Medical Center—University of Freiburg, Freiburg, Germany
| | - Matthias Jung
- Faculty of Medicine, Berta-Ottenstein-Programme, University of Freiburg, Freiburg, Germany
- Faculty of Medicine, Department of Radiology, Medical Center—University of Freiburg, Freiburg, Germany
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160
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Buja A, Rugge M, Tropea S, Cozzolino C, Formaro CM, Grotto G, Zorzi M, Vecchiato A, Del Fiore P, Brunello A, Sbaraglia M, Ferroni E, Rossi CR, Dei Tos AP, Mocellin S. Sex Differences in Soft Tissue Sarcoma: Incidence, Clinicopathological Profile, Survival, and Costs. J Womens Health (Larchmt) 2023; 32:1257-1264. [PMID: 37819711 PMCID: PMC10621658 DOI: 10.1089/jwh.2023.0019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
Background: There are evident sex differences in the incidence of and mortality rates for several tumors. Soft tissue sarcomas (STSs) account for no more than 1% of all malignancies in adults. This study aimed to provide a comprehensive overview of the sex differences in the epidemiology of STSs and the related costs. Methods: This retrospective population-based study draws on epidemiological data regarding cases of STS collected by the cancer registry of the Italian Veneto region for the years 1990-2018. A joinpoint regression analysis was performed to identify significant changes in the trends of the standardized incidence rates in males and females. Bivariate and survival analyses were conducted to assess differences in clinicopathological characteristics and short-term mortality by sex. Direct health care costs incurred over 2 years after a diagnosis of STS were calculated, stratified by sex. Results: The incidence rates of STS at any age were higher for males; only among males the incidence rates showed a tendency to slightly increase. No significant sex differences came to light in short-term mortality or clinicopathological profile, except for the cancer site. Health care costs in the 2 years after a diagnosis of STS were not sex related. Conclusion: The STS incidence was found to be higher for males and showed a rising trend over the last three decades only for males. These findings could result from the occupational exposure to environmental mutagens mainly involving men. Sex did not affect the survival or the clinicopathological STS profile.
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Affiliation(s)
- Alessandra Buja
- Laboratory of Healthcare Services and Health Promotion Evaluation, Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padua, Padua, Italy
| | - Massimo Rugge
- Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Veneto Tumor Registry, Azienda Zero, Padua, Italy
| | - Saveria Tropea
- Soft-Tissue, Peritoneum, and Melanoma Surgical Oncology Unit and Veneto Institute of Oncology (IOV)–IRCCS, Padua, Italy
| | - Claudia Cozzolino
- Soft-Tissue, Peritoneum, and Melanoma Surgical Oncology Unit and Veneto Institute of Oncology (IOV)–IRCCS, Padua, Italy
| | - Carlo Maria Formaro
- Laboratory of Healthcare Services and Health Promotion Evaluation, Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padua, Padua, Italy
| | - Giulia Grotto
- Laboratory of Healthcare Services and Health Promotion Evaluation, Hygiene and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, and Public Health, University of Padua, Padua, Italy
| | - Manuel Zorzi
- Veneto Tumor Registry, Azienda Zero, Padua, Italy
| | - Antonella Vecchiato
- Soft-Tissue, Peritoneum, and Melanoma Surgical Oncology Unit and Veneto Institute of Oncology (IOV)–IRCCS, Padua, Italy
| | - Paolo Del Fiore
- Soft-Tissue, Peritoneum, and Melanoma Surgical Oncology Unit and Veneto Institute of Oncology (IOV)–IRCCS, Padua, Italy
| | - Antonella Brunello
- Medical Oncology Unit 1, Veneto Institute of Oncology (IOV)–IRCCS, Padua, Italy
| | - Marta Sbaraglia
- Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Department of Pathology, Azienda Ospedale Università Padova, Padua, Italy
| | - Eliana Ferroni
- Servizio Epidemiologico Regionale, Azienda Zero, Padua, Italy
| | - Carlo Riccardo Rossi
- Department of Surgery, Oncology, and Gastroenterology (DISCOG), University of Padua, Padua, Italy
| | - Angelo Paolo Dei Tos
- Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Department of Pathology, Azienda Ospedale Università Padova, Padua, Italy
| | - Simone Mocellin
- Soft-Tissue, Peritoneum, and Melanoma Surgical Oncology Unit and Veneto Institute of Oncology (IOV)–IRCCS, Padua, Italy
- Department of Surgery, Oncology, and Gastroenterology (DISCOG), University of Padua, Padua, Italy
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Kassi ABF, Yenon KS, Kassi FMH, Adjeme AJ, Diarra KM, Bombet-Kouame C, Kouassi M. Giant dedifferentiated liposarcoma of the gastrocolic ligament: A case report. World J Gastrointest Surg 2023; 15:2376-2381. [PMID: 37969706 PMCID: PMC10642459 DOI: 10.4240/wjgs.v15.i10.2376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Dedifferentiated liposarcoma (DDLS) has a worse prognosis and occurs most commonly in the retroperitoneal region and rarely in the intraperitoneal region. Histological diagnosis was revolutionized by the combined contributions of histo-immuno-chemistry and molecular biology. Aside from surgery, there is no consensus on the optimal treatment for this chemoresistant cancer. CASE SUMMARY A thirty-year-old black female presented with a large painful abdominal mass occupying nearly the entire abdomen and progressive weight loss was admitted for surgery. Abdominal computed tomography showed a large heterogeneous mass of the mesentery that was sized 18 cm × 16 cm in size and had heterogeneous contrast enhancement. During laparotomy, en bloc excision of the large and multilobulated gastrocolic ligament mass was performed. The initial postoperative histopathological diagnosis was undifferentiated sarcoma. Finally, the results of immunohistochemistry and molecular biology allowed us to confirm the diagnosis of DDLS. The tumour followed an aggressive evolution with diffuse metastasis, causing the death of the patient less than 5 mo after the operation. CONCLUSION Dedifferentiated liposarcomas are rare tumours that typically originate in the retroperitoneum but may arise in unexpected locations.
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Affiliation(s)
- Assamoi Brou Fulgence Kassi
- Surgery and Surgical Specialities, Medical Sciences Training and Research Unit, Abidjan Felix Houphouet-Boigny University, Abidjan 01 BP V 34, Cote d'Ivoire
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Kacou Sebastien Yenon
- Surgery and Surgical Specialities, Medical Sciences Training and Research Unit, Abidjan Felix Houphouet-Boigny University, Abidjan 01 BP V 34, Cote d'Ivoire
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Fian Marc Herve Kassi
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Adja Jacob Adjeme
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Khader Morel Diarra
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Cynthia Bombet-Kouame
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
| | - Marcellin Kouassi
- Surgery and Surgical Specialities, Digestive Surgery Unit, University Hospital of Cocody, Abidjan 01 BP V13, Cote d'Ivoire
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162
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Zhang L, Wu J. Multimodal imaging features of retroperitoneal anastomosing hemangioma: a case report and literature review. Front Oncol 2023; 13:1269631. [PMID: 37954079 PMCID: PMC10634416 DOI: 10.3389/fonc.2023.1269631] [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: 07/30/2023] [Accepted: 10/02/2023] [Indexed: 11/14/2023] Open
Abstract
Background Anastomotic hemangioma is a rare subtype of capillary hemangioma primarily found in the genitourinary tract. We present a case of a patient with an anastomotic hemangioma located in the retroperitoneal space; then, we explore and summarize the imaging features from previously reported cases for accurate diagnosis. Case presentation A 57-year-old woman complained of left lower back pain. Contrast-enhanced ultrasound revealed a hypoechoic mass with "slow-in and slow-out" enhancement. Abdominal CT scan displayed a well-defined, round soft tissue mass in the right retroperitoneal region with obvious enhancement. MRI indicated low signal on T1-weighted imaging, high signal on T2-weighted imaging and diffusion-weighted imaging, and progressive enhancement after enhancement. Surgical removal of the tumor was performed. Histopathological examination exhibited a distinct tumor border with interconnected blood vessels and a cavity lined by a single layer of cubic endothelial cells. Immunohistochemistry confirmed the presence of CD31[+] and CD34[+]. The final pathological diagnosis was anastomotic hemangioma. No recurrence was observed during a 40-month follow-up. Conclusion Retroperitoneal anastomotic hemangioma is a rare and benign neoplasm that may be misdiagnosed as ectopic pheochromocytoma or angiosarcoma. This case report presents and analyzes the imaging characteristics of a series of retroperitoneal anastomotic hemangiomas, which can be valuable for future diagnoses and help prevent unnecessary surgeries.
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Affiliation(s)
- Liqing Zhang
- Department of Radiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jian Wu
- Department of Pathology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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163
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Jiang Y, Chen K, Yu M, Qin J, Wang J. Uterine giant cell tumor of soft tissue: A case report. Medicine (Baltimore) 2023; 102:e35414. [PMID: 37861517 PMCID: PMC10589528 DOI: 10.1097/md.0000000000035414] [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: 06/27/2023] [Accepted: 09/06/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Giant cell tumor of soft tissue (GCT-ST) is a rare primary soft tissue tumor. GCT-ST mainly occurs in the trunk and extremities. There is no standard treatment for GCT-ST. This paper reports a rare case of primary uterine GCT-ST. CASE PRESENTATION A 48-year-old female patient underwent a transabdominal subhysterectomy for uterine leiomyoma. Postoperative pathological examination showed GCT-ST with unclear tissue boundary (10.0 × 6.0 × 5.0 cm). A small amount of GCT-ST tissue could be seen on the local edge of the leiomyoma. Residual tumor tissue was found around the uterine cavity. The patient reported persistent lower abdominal distension pain 3 months after the operation. Pelvic and abdominal imaging showed a huge tumor and multiple pelvic and abdominal organ metastasis. No pulmonary metastasis was found. Exploratory surgery revealed widespread metastases in the abdominal and peritoneal cavities, involving both ovaries, right tubal serous membrane, appendix serous membrane, bladder, pelvic peritoneum, and abdominal wall incision. After surgery, the patient had 6 cycles of docetaxel and carboplatin but stopped treatments due to economic reasons. The patient died 3 months later because of multiple organs failure. CONCLUSION GCT-ST is generally benign but has unpredictable behavior. A massive recurrence with wide invasion is possible after subtotal resection.
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Affiliation(s)
| | | | | | - Juan Qin
- The Maternal and Child Health Care Hospital of Guizhou Medical University, China
| | - Juntao Wang
- The Maternal and Child Health Care Hospital of Guizhou Medical University, China
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164
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Tang X, Hu X, Wen Y, Min L. Progressive insights into fibrosarcoma diagnosis and treatment: leveraging fusion genes for advancements. Front Cell Dev Biol 2023; 11:1284428. [PMID: 37920823 PMCID: PMC10618559 DOI: 10.3389/fcell.2023.1284428] [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: 08/28/2023] [Accepted: 10/05/2023] [Indexed: 11/04/2023] Open
Abstract
Fibrosarcoma, originating from fibroblast cells, represents a malignant neoplasm that can manifest across all genders and age groups. Fusion genes are notably prevalent within the landscape of human cancers, particularly within the subtypes of fibrosarcoma, where they exert substantial driving forces in tumorigenesis. Many fusion genes underlie the pathogenic mechanisms triggering the onset of this disease. Moreover, a close association emerges between the spectrum of fusion gene types and the phenotypic expression of fibrosarcoma, endowing fusion genes not only as promising diagnostic indicators for fibrosarcoma but also as pivotal foundations for its subcategorization. Concurrently, an increasing number of chimeric proteins encoded by fusion genes have been substantiated as specific targets for treating fibrosarcoma, consequently significantly enhancing patient prognoses. This review comprehensively delineates the mechanisms behind fusion gene formation in fibrosarcoma, the lineage of fusion genes, methodologies employed in detecting fusion genes within fibrosarcoma, and the prospects of targeted therapeutic interventions driven by fusion genes within the fibrosarcoma domain.
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Affiliation(s)
- Xiaodi Tang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, China
| | - Xin Hu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, China
| | - Yang Wen
- Department of Orthopedics, Zigong Fourth People’s Hospital, Zigong, China
| | - Li Min
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province, Chengdu, Sichuan, China
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165
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Eldaabossi S, Al-Ghoneimy Y, Antar A, Lotfy E, Aljawad H, Abish YG, Helyl M, Oraby H, Soliman H, Abdullatif B, Nour SO, Lotfi A. Partial sternectomy with reconstruction of a giant cell tumor of the sternum, a case report, Saudi, Arabia. J Cardiothorac Surg 2023; 18:296. [PMID: 37848912 PMCID: PMC10580503 DOI: 10.1186/s13019-023-02404-0] [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: 01/30/2023] [Accepted: 09/30/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Giant cell tumor (GCT) is a relatively common and locally aggressive benign bone tumor that rarely affects the sternum. CASE PRESENTATION We report a case of giant cell tumor of the sternum in a 28-year-old Saudi with painful swelling at the lower part of the sternum. Subtotal sternectomy and reconstruction with a neosternum using two layers of proline mesh, a methyl methacrylate prosthesis, and bilateral pectoralis muscle advancement flaps were performed. CONCLUSIONS Giant cell tumor of the sternum is a rare diagnosis. Surgical resection with negative margins is the ideal management. To avoid defects or instability of the chest wall, reconstruction of the chest wall with neosternum should be considered.
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Affiliation(s)
- Safwat Eldaabossi
- Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia.
- Department of Chest Diseases, Al-Azhar Faculty of Medicine, Cairo, Egypt.
| | | | - Ahmad Antar
- Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia
| | - Elsaid Lotfy
- Radiology Department, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia
| | - Hameed Aljawad
- Pathology and Laboratory Medicine, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia
| | - Yasser G Abish
- Pathology and Laboratory Medicine, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia
- Al-Azhar Faculty of Medicine, Cairo, Egypt
| | | | | | - Hesham Soliman
- Anesthesia Department, Almoosa Specialist Hospital, Al Ahsa, Saudi Arabia
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166
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Košir U, van de Wal D, Husson O, Zablith N, Turcotte RE. Patient-physician agreement on function and pain is associated with long-term outcomes in sarcoma: findings from a longitudinal study. J Cancer Surviv 2023:10.1007/s11764-023-01473-3. [PMID: 37847463 DOI: 10.1007/s11764-023-01473-3] [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: 06/19/2023] [Accepted: 09/21/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE We aimed to describe the level of agreement between patients and physicians on the ratings of daily functioning and pain in a cohort of sarcoma patients and assess how (dis)agreement and its change over time predicted patient-reported outcomes in survivorship. METHOD We performed secondary analysis of longitudinal data from a sarcoma-specialty clinic in Montreal, Canada. Demographics, clinical characteristics and patient-physician agreement were summarized descriptively. Linear mixed models were used to assess the effects of time, baseline agreement, change in agreement over time, interaction of time and change in agreement and 12-month daily functioning, quality of life, and fatigue. RESULTS Data were available for 806 patients (57.7% male, x̄ = 53.3 years) who completed at least one questionnaire. Patient-physician disagreement was common on the level of function (43.4%) and pain (45.7%). Baseline physician-patient agreement was associated with better 12-month outcomes. Improvement in agreement on function over time was significantly associated with daily functioning (F(2, 212) = 3.18, p = 0.043) and quality of life (F(2, 212) = 3.17, p < 0.044). The pattern was similar though less pronounced for the agreement on pain. CONCLUSIONS Our study offers novel insights into the importance of patient-physician agreement and communication's role in long-term patient-reported outcomes in sarcoma. IMPLICATIONS FOR CANCER SURVIVORS The results emphasize the importance of mutual understanding of symptoms and patients' needs and suggest that further consultation in cases of discordance of ratings and opinions might be beneficial for optimal survivorship.
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Affiliation(s)
- Urška Košir
- Division of Orthopedic Surgery, McGill University Health Centre (MUHC), Montreal, QC, Canada.
- Department of Experimental Psychology, University of Oxford, Oxford, UK.
| | - Deborah van de Wal
- Medical Oncology Department, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Olga Husson
- Medical Oncology Department, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Nadine Zablith
- Division of Orthopedic Surgery, McGill University Health Centre (MUHC), Montreal, QC, Canada
| | - Robert E Turcotte
- Division of Orthopedic Surgery, McGill University Health Centre (MUHC), Montreal, QC, Canada
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167
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d’Abadie P, Gheysens O, Lhommel R, Jamar F, Kirchgesner T, Mazzeo F, Coubeau L, Yildiz H, De Roo AK, Schubert T. Diagnostic Superiority of Dual-Time Point [ 18F]FDG PET/CT to Differentiate Malignant from Benign Soft Tissue Tumors. Diagnostics (Basel) 2023; 13:3202. [PMID: 37892023 PMCID: PMC10606132 DOI: 10.3390/diagnostics13203202] [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: 09/12/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
[18F]FDG PET/CT is used in the workup of indeterminate soft tissue tumors (STTs) but lacks accuracy in the detection of malignant STTs. The aim of this study is to evaluate whether dual-time point [18F]FDG PET/CT imaging (DTPI) can be useful in this indication. In this prospective study, [18F]FDG PET/CT imaging was performed 1 h (t1) and 3 h (t2) after injection. Tumor uptake (SUVmax) was calculated at each time point to define a retention index (RI) corresponding to the variation between t1 and t2 (%). Sixty-eight patients were included, representing 20 benign and 48 malignant tumors (including 40 sarcomas). The RI was significantly higher in malignant STTs than in benign STTs (median: +21.8% vs. -2%, p < 0.001). An RI of >14.3% predicted STT malignancy with a specificity (Sp) of 90% and a sensitivity (Se) of 69%. An SUVmaxt1 of >4.5 was less accurate with an Sp of 80% and an Se of 60%. In a subgroup of tumors with at least mild [18F]FDG uptake (SUVmax ≥ 3; n = 46), the RI significantly outperformed the diagnostic accuracy of SUVmax (AUC: 0.88 vs. 0.68, p = 0.01). DTPI identifies malignant STT tumors with high specificity and outperforms the diagnostic accuracy of standard PET/CT.
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Affiliation(s)
- Philippe d’Abadie
- Department of Nuclear Medicine, Cliniques Universitaires Saint Luc-Institut Roi Albert II, Université Catholique de Louvain, 1200 Brussels, Belgium; (O.G.); (R.L.); (F.J.)
| | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint Luc-Institut Roi Albert II, Université Catholique de Louvain, 1200 Brussels, Belgium; (O.G.); (R.L.); (F.J.)
| | - Renaud Lhommel
- Department of Nuclear Medicine, Cliniques Universitaires Saint Luc-Institut Roi Albert II, Université Catholique de Louvain, 1200 Brussels, Belgium; (O.G.); (R.L.); (F.J.)
| | - François Jamar
- Department of Nuclear Medicine, Cliniques Universitaires Saint Luc-Institut Roi Albert II, Université Catholique de Louvain, 1200 Brussels, Belgium; (O.G.); (R.L.); (F.J.)
| | - Thomas Kirchgesner
- Department of Radiology, Cliniques Universitaires Saint Luc-Institut Roi Albert II, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Filomena Mazzeo
- Department of Clinical Oncology, Cliniques Universitaires Saint Luc-Institut Roi Albert II, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Laurent Coubeau
- Department of Abdominal Surgery, Cliniques Universitaires Saint Luc-Institut Roi Albert II, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Halil Yildiz
- Department of Internal Medicine, Cliniques Universitaires Saint Luc-Institut Roi Albert II, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - An-Katrien De Roo
- Department of Pathology, Cliniques Universitaires Saint Luc-Institut Roi Albert II, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Thomas Schubert
- Department of Orthopedic Surgery, Cliniques Universitaires Saint Luc-Institut Roi Albert II, Université Catholique de Louvain, 1200 Brussels, Belgium;
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168
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Palmerini E, Frega G, Gambarotti M, Frisoni T, Cesari M, Bazzocchi A, Miceli M, Donati DM, Fanti S, Nanni C, Benini S, Longhi A, Paioli A, Marrari A, Hakim R, Righi A, Ibrahim T. NTRK rearranged sarcoma of the bone. Role for larotrectinib in the neoadjuvant setting of an ultra-rare tumor: a case report. Front Oncol 2023; 13:1252359. [PMID: 37876963 PMCID: PMC10591071 DOI: 10.3389/fonc.2023.1252359] [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: 07/03/2023] [Accepted: 09/04/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Neurotrophic tyrosine receptor kinase (NTRK) gene-fusion targeted molecules revolutionized the paradigm of treatment of a limited subgroup of cancers of various histologies. Entrectinib and larotrectinib obtained unprecedented response rates in patients with cancer harboring NTRK rearrangements. This evidence recently led to the agnostic approval of these drugs, and evidence (confirmation) of their activity in a broader disease setting is emerging. Here, we report the case of a patient affected by EML4-NTRK3 rearranged undifferentiated spindle cell bone sarcoma treated with larotrectinib, and we argue (discuss about) the incidence and clinical presentation of NTRK gene-fusion positive bone sarcomas, the potential use of upfront treatment with NTRK inhibitors in neoadjuvant setting, and the role of a multidisciplinary tumor board. Despite the rarity of these rearrangements in patients with primitive bone sarcomas, the therapy with NTRK inhibitors represents a highly effective strategy to be pursued in selected cases even in neoadjuvant settings. The management of these very rare cancers should always be discussed in a multidisciplinary board of reference centers.
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Affiliation(s)
- Emanuela Palmerini
- Osteoncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giorgio Frega
- Osteoncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Gambarotti
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Tommaso Frisoni
- Third Orthopaedic Clinic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marilena Cesari
- Osteoncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marco Miceli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Davide Maria Donati
- Third Orthopaedic Clinic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Stefano Fanti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Di Sant’Orsola, Bologna, Italy
| | - Cristina Nanni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Di Sant’Orsola, Bologna, Italy
| | - Stefania Benini
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alessandra Longhi
- Osteoncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Anna Paioli
- Osteoncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Andrea Marrari
- Osteoncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Rossella Hakim
- Osteoncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alberto Righi
- Department of Pathology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Toni Ibrahim
- Osteoncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Elyes M, Heesen P, Schelling G, Bode-Lesniewska B, Studer G, Fuchs B. Enhancing Healthcare for Sarcoma Patients: Lessons from a Diagnostic Pathway Efficiency Analysis. Cancers (Basel) 2023; 15:4892. [PMID: 37835586 PMCID: PMC10571532 DOI: 10.3390/cancers15194892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
Sarcomas, rare and with lower survival rates than common tumors, offer insights into healthcare efficiency via the analysis of the total interval of the diagnostic pathway, combining the patient interval (time between the first symptom and visit with a physician) and diagnostic interval (time between first physician visit and histological diagnosis). Switzerland's healthcare system, Europe's costliest, lacks research on treating rare conditions, like mesenchymal tumors. This study examines the total interval of the diagnostic pathway for optimization strategies. Analyzing a dataset of 1028 patients presented from 2018 to 2021 to the Swiss Sarcoma Board (MDT/SB-SSN), this retrospective analysis delves into bone sarcoma (BS), soft-tissue sarcoma (STS), and their benign counterparts. Demographic and treatment data were extracted from medical records. The patient interval accounted for the largest proportion of the total interval and secondary care interval for the largest proportion of the diagnostic interval. Age, grade, and localization could be elicited as influencing factors of the length of different components of the total interval. An increasing age and tumor size, as well as the axial localization, could be elicited as factors increasing the probability of sarcoma. The patient and secondary care interval (SCI) offer the greatest potential for optimization, with SCI being the bottleneck of the diagnostic interval. New organizational structures for care work-ups are needed, such as integrated practice units (IPU) as integral part of value-based healthcare (VBHC).
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Affiliation(s)
- Maria Elyes
- University Teaching Hospital LUKS, Lucerne, Sarcoma Service, University of Lucerne, 6000 Lucerne, Switzerland
| | - Philip Heesen
- University Hospital USZ, Sarcoma Servuce, University of Zurich, 8000 Zurich, Switzerland
| | - Georg Schelling
- University Teaching Hospital LUKS, Lucerne, Sarcoma Service, University of Lucerne, 6000 Lucerne, Switzerland
| | | | - Gabriela Studer
- University Teaching Hospital LUKS, Lucerne, Sarcoma Service, University of Lucerne, 6000 Lucerne, Switzerland
| | - Bruno Fuchs
- University Teaching Hospital LUKS, Lucerne, Sarcoma Service, University of Lucerne, 6000 Lucerne, Switzerland
- University Hospital USZ, Sarcoma Servuce, University of Zurich, 8000 Zurich, Switzerland
- Kantonsspital Winterthur, Sarcoma Service, 8400 Winterthur, Switzerland
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170
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Mihalceanu S, Schäfer S, Mentzel T, Toberer F. [Multiple, eruptive epithelioid hemangiomas of the scalp]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:793-798. [PMID: 37493716 PMCID: PMC10516796 DOI: 10.1007/s00105-023-05193-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/27/2023]
Abstract
Epithelioid hemangioma is a benign vascular neoplasm with a characteristic histological and immunohistochemical pattern, characterized by a lymphocytic inflammatory infiltrate with admixed eosinophils and FOS‑B expression. The correct diagnosis is of particular relevance, since malignant vascular tumors with differentiated epithelioid cells can also be considered in the differential diagnosis. We present a patient with multiple epithelioid hemangiomas of the scalp accompanied by severe pain and itching. The long history of multiple therapeutic attempts illustrates the limited success of currently available treatment options.
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Affiliation(s)
- Silvia Mihalceanu
- Universitäts-Hautklinik Heidelberg, Ruprecht-Karls Universität Heidelberg, Heidelberg, Deutschland
| | - Sarah Schäfer
- Universitäts-Hautklinik Heidelberg, Ruprecht-Karls Universität Heidelberg, Heidelberg, Deutschland
| | - Thomas Mentzel
- MVZ Dermatopathologie Friedrichshafen/Bodensee, Friedrichshafen, Deutschland
| | - Ferdinand Toberer
- Universitäts-Hautklinik Heidelberg, Ruprecht-Karls Universität Heidelberg, Heidelberg, Deutschland
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171
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Jadhav K, Venkateswaran R, Landge R, Kadam A, Rashid R. A Para-Scrotal Pleomorphic Liposarcoma Mimicking As Another Scrotum (Pseudo-Scrotum): A Case Report. Cureus 2023; 15:e46569. [PMID: 37937002 PMCID: PMC10626208 DOI: 10.7759/cureus.46569] [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: 10/05/2023] [Indexed: 11/09/2023] Open
Abstract
Liposarcomas are a subtype of soft tissue sarcomas arising from lipoblasts, a mesenchymal cell lineage that commonly arises from deep tissues of the body. Though these are the most common subtypes, their early diagnosis still remains a challenge due to their varied presentation as a soft benign appearing growth. The pleomorphic variant has complex management due to its high recurrence rate and resistance to chemoradiation. Scrotal liposarcomas have been reported. But in the present case, a 69-year-old male who presented with a pedunculated swelling in the left groin mimicking a left hemi-scrotal swelling. It was a left para-scrotal pleomorphic liposarcoma which was totally extra-scrotal, and not related to the spermatic cord or testes. So, this is a rare case with a review of the literature presented here.
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Affiliation(s)
- Kavita Jadhav
- General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND
| | | | - Ravi Landge
- General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND
| | - Akshay Kadam
- General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND
| | - Rihan Rashid
- General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND
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172
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Machado PAB, Bartolomeu GFP, Handeri AM, Wainstein AJA, Drummond-Lage AP. Assessment of Medical Students' Knowledge of Imaging Methods for Bone Sarcomas. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1571-1576. [PMID: 37185942 DOI: 10.1007/s13187-023-02301-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Abstract
Cancer is a leading cause of death in Brazil and worldwide. However, Brazilian medical education fails to include oncology as an essential topic. This creates a gap between the health status of the population and medical education. Bone sarcomas fall into both the group of malignant neoplasms and rare diseases and are thus doubly influenced by misinformation. To assess medical students' knowledge of imaging diagnostic methods for bone sarcomas. A cross-sectional, quantitative study was undertaken by obtaining the responses of medical students to a questionnaire containing radiographic images and questions about the radiological aspects of bone sarcomas. The categorical variables were compared using the chi-square test. The level of significance was 5% for all the tests. SPSS software version 25.0 was used for the analysis. A total of 325 responses were collected, with 72% of the participants having no interest in oncology and 55.6-63.9% not knowing how to diagnose a periosteal reaction on bone radiography. Only 11.1-17.1% of the students correctly interpreted the radiographic image of osteosarcoma. Medical students fail to correctly interpret images of bone sarcomas. It is important to promote oncology undergraduate education in general and to include the approach to bone sarcomas in this context.
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Affiliation(s)
- Pedro Alcântara Botelho Machado
- Department of Post-Graduation, Faculty of Medical Sciences of Minas Gerais, Alameda Ezequiel Dias 275/3º - Centro, Belo Horizonte, MG, Brazil
| | | | | | | | - Ana Paula Drummond-Lage
- Department of Post-Graduation, Faculty of Medical Sciences of Minas Gerais, Alameda Ezequiel Dias 275/3º - Centro, Belo Horizonte, MG, Brazil.
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173
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Xu B, Pan Q, Pan H, Li H, Li X, Chen J, Pang D, Zhang B, Weng D, Peng R, Fang M, Zhang X. Anlotinib as a maintenance treatment for advanced soft tissue sarcoma after first-line chemotherapy (ALTER-S006): a multicentre, open-label, single-arm, phase 2 trial. EClinicalMedicine 2023; 64:102240. [PMID: 37767191 PMCID: PMC10520347 DOI: 10.1016/j.eclinm.2023.102240] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Background No standard maintenance treatment has been obtained to prolong the response duration of soft tissue sarcoma (STS) after first-line chemotherapy. In this study, we aimed to evaluate the efficacy and safety of anlotinib as a maintenance treatment after chemotherapy in STS. Methods In this multicentre, open-label, single-arm phase 2 trial, patients with advanced STS who achieved partial response or stable disease after first-line anthracycline-based chemotherapy were enrolled between April 2019 and January 2022. All patients received anlotinib as a maintenance treatment. The primary endpoint was progression-free survival (PFS) of anlotinib maintenance treatment. Other endpoints included overall survival (OS), objective response rate (ORR), disease control rate (DCR) and safety. This study is registered with ClinicalTrials.gov, NCT03890068. Findings At the data cut-off date (August 8, 2022), 49 patients were enrolled, including 17 with liposarcoma (35%) and 15 with leiomyosarcoma (31%). After a median follow-up of 17.1 months (IQR 9.0-27.2), the median PFS from the beginning of maintenance treatment was 9.1 months (95% CI 5.7-12.5), and the median OS was not reached, and the 1-year OS rate for anlotinib maintenance treatment was 98.0%. The best ORR and DCR were 16% (8/49, 95% CI 7-30) and 94% (46/49, 95% CI 83-99), respectively. Most of the treatment-related adverse events were grade 1-2. Of the grade 3-4 adverse events, the most common were hypertension (10%) and hand-foot syndrome reaction (6%). Interpretation Postchemotherapy maintenance treatment with anlotinib exhibits promising efficacy and tolerable toxicity in patients with advanced STS. Funding Chia Tai Tianqing Pharmaceutical Group Co., Ltd., the National Key Research and Development Program of China, and the National Natural Science Foundation of China.
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Affiliation(s)
- Bushu Xu
- Melanoma and Sarcoma Medical Oncology Unit, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Qiuzhong Pan
- Melanoma and Sarcoma Medical Oncology Unit, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Hua Pan
- Melanoma and Sarcoma Medical Oncology Unit, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Haomiao Li
- Department of Bone Oncology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Xianan Li
- Department of Orthopedics, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Jing Chen
- Department of Medical Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Danmei Pang
- Department of Medical Oncology, The First People's Hospital of Foshan, Foshan, China
| | - Baoqing Zhang
- Department of Orthopedics, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Desheng Weng
- Melanoma and Sarcoma Medical Oncology Unit, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ruiqing Peng
- Melanoma and Sarcoma Medical Oncology Unit, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Meiyu Fang
- Department of Rare and Head and Neck Oncology, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Xing Zhang
- Melanoma and Sarcoma Medical Oncology Unit, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
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174
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Edsjö A, Holmquist L, Geoerger B, Nowak F, Gomon G, Alix-Panabières C, Ploeger C, Lassen U, Le Tourneau C, Lehtiö J, Ott PA, von Deimling A, Fröhling S, Voest E, Klauschen F, Dienstmann R, Alshibany A, Siu LL, Stenzinger A. Precision cancer medicine: Concepts, current practice, and future developments. J Intern Med 2023; 294:455-481. [PMID: 37641393 DOI: 10.1111/joim.13709] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Precision cancer medicine is a multidisciplinary team effort that requires involvement and commitment of many stakeholders including the society at large. Building on the success of significant advances in precision therapy for oncological patients over the last two decades, future developments will be significantly shaped by improvements in scalable molecular diagnostics in which increasingly complex multilayered datasets require transformation into clinically useful information guiding patient management at fast turnaround times. Adaptive profiling strategies involving tissue- and liquid-based testing that account for the immense plasticity of cancer during the patient's journey and also include early detection approaches are already finding their way into clinical routine and will become paramount. A second major driver is the development of smart clinical trials and trial concepts which, complemented by real-world evidence, rapidly broaden the spectrum of therapeutic options. Tight coordination with regulatory agencies and health technology assessment bodies is crucial in this context. Multicentric networks operating nationally and internationally are key in implementing precision oncology in clinical practice and support developing and improving the ecosystem and framework needed to turn invocation into benefits for patients. The review provides an overview of the diagnostic tools, innovative clinical studies, and collaborative efforts needed to realize precision cancer medicine.
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Affiliation(s)
- Anders Edsjö
- Department of Clinical Genetics, Pathology and Molecular Diagnostics, Office for Medical Services, Region Skåne, Lund, Sweden
- Division of Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Genomic Medicine Sweden (GMS), Kristianstad, Sweden
| | - Louise Holmquist
- Department of Clinical Genetics, Pathology and Molecular Diagnostics, Office for Medical Services, Region Skåne, Lund, Sweden
- Genomic Medicine Sweden (GMS), Kristianstad, Sweden
| | - Birgit Geoerger
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
- INSERM U1015, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | | | - Georgy Gomon
- Department of Molecular Oncology and Immunology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Catherine Alix-Panabières
- Laboratory of Rare Human Circulating Cells, University Medical Center of Montpellier, Montpellier, France
- CREEC, MIVEGEC, University of Montpellier, Montpellier, France
| | - Carolin Ploeger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Centers for Personalized Medicine (ZPM), Heidelberg, Germany
| | - Ulrik Lassen
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, France
- INSERM U900 Research Unit, Saint-Cloud, France
- Faculty of Medicine, Paris-Saclay University, Paris, France
| | - Janne Lehtiö
- Department of Oncology Pathology, Karolinska Institutet, Science for Life Laboratory, Stockholm, Sweden
| | - Patrick A Ott
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA
| | - Andreas von Deimling
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Fröhling
- Division of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Emile Voest
- Department of Molecular Oncology and Immunology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Frederick Klauschen
- Institute of Pathology, Charite - Universitätsmedizin Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- BIFOLD - Berlin Institute for the Foundations of Learning and Data, Berlin, Germany
- Institute of Pathology, Ludwig-Maximilians-University, Munich, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Munich Partner Site, Heidelberg, Germany
| | | | | | - Lillian L Siu
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Albrecht Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Centers for Personalized Medicine (ZPM), Heidelberg, Germany
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175
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Lv C, Xue X, Huang M, Yang Z, Chen X, Koo CW. The dynamic contrast enhanced-magnetic resonance imaging and diffusion-weighted imaging features of alveolar soft part sarcoma. Quant Imaging Med Surg 2023; 13:7269-7280. [PMID: 37869277 PMCID: PMC10585583 DOI: 10.21037/qims-23-743] [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: 05/25/2023] [Accepted: 08/25/2023] [Indexed: 10/24/2023]
Abstract
Background Alveolar soft part sarcoma (ASPS) is a rare type of soft tissue sarcoma that predominantly affects adolescents and young adults. Early diagnosis of ASPS is crucial for optimal therapeutic planning and improving prognosis, but its diagnostic features are not well delineated. This study aimed to retrospectively analyze the imaging features of ASPS with an emphasis on the dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) findings to identify imaging findings that might suggest the diagnosis to radiologists. Methods The imaging features of 34 patients with pathologically proven limb ASPS were retrospectively analyzed. A total of 23 underwent DCE-MRI, and 12 underwent DWI. Results Among the 34 cases of ASPS, 31 tumors were in the lower extremities, and 3 were in the upper extremities. The maximum tumor diameters ranged from 3.0 to 19.4 cm (mean, 8.7±3.96 cm). A total of 28 cases had well-defined borders. The masses demonstrated heterogeneous high signal intensity on T2-weighted imaging (T2WI) and the fat-suppressed (FS) T2WI sequence and slight hyperintensity on T1-weighted imaging (T1WI). A total of 25 lesions had thin hypointense bands on T1WI and T2WI. Intra- and peri-tumoral tubular areas of flow void were exhibited on both T1WI and T2WI in all cases. A total of 12 cases showed a high signal on DWI, and the mean apparent diffusion coefficient (ADC) value was (0.86±0.07)×10-3 mm2/s [range, (0.6-1.4)×10-3 mm2/s]. Persistent remarkable enhancement of the lesion was displayed on contrast-enhanced scans. The time-intensity curves (TICs) of 23 masses showed early arterial enhancement and slow washout of contrast. Conclusions ASPS most commonly presents in the lower extremities of adolescents or young adults. Hyperintense T1WI, T2WI, and DWI signals, low ADC, flow voids, early arterial enhancement are frequent MRI features.
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Affiliation(s)
- Changlei Lv
- Department of Radiology, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xiaolei Xue
- Department of Ultrasound, Shandong Provincial Third Hospital, Shandong University, Jinan, China
| | - Minggang Huang
- Department of Radiology, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Zhen Yang
- Department of Radiology, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Xiaolong Chen
- Department of Radiology, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Chi Wan Koo
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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176
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Zhang Z, Peng LJ, Tong YJ. Cellular angiolipoma: a case report and review of the literature. J Int Med Res 2023; 51:3000605231206290. [PMID: 37824729 PMCID: PMC10571695 DOI: 10.1177/03000605231206290] [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: 07/13/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
Cellular angiolipoma is a rare subtype of angiolipoma, with vascular density approaching 95%. This case report describes a 55-year-old female that presented for treatment of a mass in her left breast that had been tender to slightly painful on palpation for nearly 2 years The patient underwent surgical excision of the mass, which was pathologically confirmed as a cellular angiolipoma. As of the 3-year follow-up, the patient reported no recurrence of the lesion. It is important to report this case and refresh knowledge of this and similar lesions to raise awareness of this diagnosis and treatment and improve future management of cellular angiolipoma cases.
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Affiliation(s)
- Zhen Zhang
- Department of Breast Surgery, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China
| | - Li-Jun Peng
- Department of Pathology, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China
| | - Yu-Jun Tong
- Department of Breast Surgery, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China
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177
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Jot K, Nayyar V, Surya V, Mishra D, Sowmya SV, Augustine D, Indu M, Haragannavar VC. A multicentric case study of fibroblastic and myofibroblastic oral spindle cell lesions. J Oral Maxillofac Pathol 2023; 27:629-641. [PMID: 38304501 PMCID: PMC10829460 DOI: 10.4103/jomfp.jomfp_282_23] [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: 06/26/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 02/03/2024] Open
Abstract
Context Spindle cell lesions comprise a vast plethora of benign and malignant lesions with similar clinical and radiographic features. Their overlapping histopathologic features ensure a diagnostic dilemma. Aim The current multicentric study aims to delineate fibroblastic and myofibroblastic oral spindle cell lesions based on cytomorphology and comprehensive immunohistochemical analysis. Settings and Design The experimental study was conducted at MS Ramaiah University of Applied Sciences, Bangalore, and All India Institute of Applied Sciences, Delhi. Methods and Material A comprehensive histological scoring criteria and panel of immunohistochemical makers (STAT6, CD31, CD34, S100, SMA, vimentin, pan-CK, HHF-35, Ki67, ALK, desmin, HMB-45, SATB2, ERG, EMA and CD99) were employed concurrently for the first time for fibroblastic and myofibroblastic oral spindle cell lesions. The data obtained was tabulated and studied. Statistical Analysis Used NA. Results: Using cytological scoring criteria and panel of immunohistochemical makers, the cases analysed and characterized were desmoplastic fibroma, fibrosarcoma, leiomyosarcoma, nodular fasciitis, neurofibroma and epithelioid inflammatory myofibroblastic sarcoma (EIMS). Conclusions The diagnostic strategies need to be upgraded for the diagnosis of spindle cell lesions. Emphasis must be placed on cytomorphology, an immunohistochemistry (IHC) panel of markers is imperative for the accurate diagnosis of fibroblastic and myofibroblastic oral spindle cell lesions.
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Affiliation(s)
- Kiran Jot
- Department of Oral Pathology and Microbiology, Fifth Floor, Centre for Dental Education and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Vivek Nayyar
- Department of Oral Pathology and Microbiology, Fifth Floor, Centre for Dental Education and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Varun Surya
- Department of Oral Pathology and Microbiology, Fifth Floor, Centre for Dental Education and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Deepika Mishra
- Department of Oral Pathology and Microbiology, Fifth Floor, Centre for Dental Education and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - SV Sowmya
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, MSR Nagar, Bengaluru, Karnataka, India
| | - Dominic Augustine
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, MSR Nagar, Bengaluru, Karnataka, India
| | - M Indu
- Department of Oral Pathology, Government Dental College, Kottayam, Kerala, India
| | - Vanishri C. Haragannavar
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Ramaiah University of Applied Sciences, MSR Nagar, Bengaluru, Karnataka, India
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178
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Zheng X, Wu G, Fu Y, Fan R. Synchronous occurrence of small cell lung cancer and primary rectal dedifferentiated liposarcoma with osteosarcomatous differentiation: A rare case report. Medicine (Baltimore) 2023; 102:e35465. [PMID: 37773783 PMCID: PMC10545380 DOI: 10.1097/md.0000000000035465] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/13/2023] [Indexed: 10/01/2023] Open
Abstract
RATIONALE Rectal dedifferentiated liposarcoma (DDL) and DDL with osteosarcomatous differentiation both are extremely unwonted. In addition, there are no reports of simultaneous DDL with osteosarcoma differentiation with small cell lung cancer (SCLC) to date. Therefore, it is imperative to alert clinicians and pathologists to this extremely rare and instructive synchronous tumor. PATIENT CONCERNS The patient was a 63-year-old male who presented with intermittent hematochezia and a swelling in the anus. Irregular masses were found on computed tomography (CT) examinations of the chest and abdomen respectively. DIAGNOSIS The final diagnosis of synchronous occurrence of SCLC and primary rectal DDL with osteosarcomatous differentiation was established by radiological, histological, immunohistochemical and molecular findings. INTERVENTIONS The patient underwent a puncture biopsy of the right lung mass and a complete resection of the rectal mass. OUTCOMES The patient abandoned treatment, and multiple SCLC metastases appeared multiple metastasis 8 months after the operation. In the end, he expired suddenly due to severe cerebral hemorrhage caused by brain SCLC metastasis. LESSONS DDL with osteosarcoma differentiation is infrequent, and its accurate diagnosis is based on morphology, immunohistochemistry and the necessary molecular tests. In rare cases, DDL occurs concurrently with other malignancies and and will be a challenge for pathologists and clinicians at this time. Accordingly, a comprehensive examination to identify possible synchronous tumors is very important in clinical practice.
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Affiliation(s)
- Xiangyu Zheng
- Department of Pathology, Henan University attached Nanyang first people Hospital, Nanyang, Henan Province, China
| | - Guangfeng Wu
- Department of Pathology, Henan University attached Nanyang first people Hospital, Nanyang, Henan Province, China
| | - Yongxian Fu
- Department of Pathology, Henan University attached Nanyang first people Hospital, Nanyang, Henan Province, China
| | - Rui Fan
- Department of Pathology, Henan University attached Nanyang first people Hospital, Nanyang, Henan Province, China
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Campoverde L, Camacho F, Alessandrino F, Evans MG, Elliot A, Rosenberg A, Trent J. Case report: The activity of multi-kinase VEGF inhibitor, Pazopanib, in metastatic undifferentiated round cell sarcomas harboring EWSR1::CREM fusion: clinicopathological series of two cases and literature review. Front Oncol 2023; 13:1215003. [PMID: 37829338 PMCID: PMC10565213 DOI: 10.3389/fonc.2023.1215003] [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: 05/01/2023] [Accepted: 08/14/2023] [Indexed: 10/14/2023] Open
Abstract
Soft tissue sarcomas harboring EWSR1::CREM fusion are rare and challenging to treat. Pazopanib, a multi-tyrosine kinase inhibitor, is FDA-approved for advanced soft tissue sarcomas, but predictive biomarkers for its efficacy remain unidentified. We conducted a study on > 240,000 neoplasms submitted to Caris Life Sciences (Phoenix, AZ) to detect rearrangements using whole transcriptome sequencing. Two sarcoma-experienced, board-certified pathologists performed histological reviews, and treatment/outcome information was collected. Among the identified cases (n = 18), we observed a diverse range of sarcoma and other cancers, including an intracranial myxoid mesenchymal tumor, mesothelioma, hyalinizing clear cell carcinomas of the head and neck, clear cell sarcomas, and undifferentiated round cell sarcomas, as well as histologically malignant tumors with epithelioid morphology. Notably, two undifferentiated, metastatic, abdominal round cell sarcoma cases treated with pazopanib demonstrated significant sustained partial response and clinical benefit. To explore the genetic factors associated with the efficacy of pazopanib in these cases, next-generation sequencing and fluorescence in situ hybridization were analyzed for alterations in the tumors. The genomic analysis provided compelling evidence confirming the presence of EWSR1::CREM fusion in both cases, with no other pathogenic gene variants or copy number alterations detected. These cases demonstrate the potential of Pazopanib as a promising therapeutic option for patients with EWSR1::CREM fusion-positive soft tissue sarcomas, including metastatic undifferentiated round cell sarcomas. The sustained clinical benefit and partial responses observed in these cases warrant further research to validate these findings and explore the wider utility of Pazopanib in this rare and challenging subset of soft tissue sarcomas. Case studies: Case 1: A 49-year-old man presented with abdominal pain, weight loss, and chronic cough. A computed tomography (CT) of the chest, abdomen, and pelvis showed multiple lung nodules and masses and a right rectus mass that was biopsied and revealed an undifferentiated round cell sarcoma with a rare fusion EWSR1-CREM. No additional pathogenic gene variants or copy number alterations were detected. He received neoadjuvant chemotherapy with three cycles of Vincristine, Adriamycin, and Ifosfamide (VAI) and seven cycles of Vincristine/Irinotecan and Temodar (VIT). After cycle 7 of VIT, he had surgical resection of the abdominal mass and received radiation for lung metastasis. He completed 13 cycles of VIT after which he presented with progression of disease and switched to monotherapy with Pazopanib. At the time of this analysis he had stable disease for 28 months. Case 2: A 75-year-old woman presented with pelvic pain and new onset constipation. CT abdomen showed a large pelvic mass and intraperitoneal tumor spread. Exploratory laparotomy revealed a ruptured pelvic mass and a small bowel tumor. Both tumors were proved to be high-grade, poorly differentiated sarcoma. Genomic analysis demonstrated an EWSR1::CREM fusion but no other pathogenic gene variants or copy number alterations. She was treated initially for a primitive neuroectodermal tumor (PNET) with four cycles of Vincristine/Adriamycin/Cytoxan/Olaratumab but declined additional chemotherapy after progression. Two years later, she presented with recurrent abdominal mass and received one cycle of Temodar/Irinotecan, then she began Pozapanib and underwent palliative radiation to the entire pelvis. She has been on Pazopanib for 23 months with stable disease.
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Affiliation(s)
- Leticia Campoverde
- University of Miami, Miami, FL, United States
- Jackson Memorial Hospital, Miami, FL, United States
| | - Felipe Camacho
- University of Miami, Miami, FL, United States
- Jackson Memorial Hospital, Miami, FL, United States
| | - Francesco Alessandrino
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
| | | | | | - Andrew Rosenberg
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
| | - Jonathan Trent
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, United States
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180
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Zhang R, Liu J, Liu L, Lin Y, Zhang Q. Delayed diagnosis of pediatric intra-articular epithelioid sarcoma: a case report and literature review. BMC Pediatr 2023; 23:488. [PMID: 37752442 PMCID: PMC10521400 DOI: 10.1186/s12887-023-04305-6] [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: 06/29/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Epithelioid sarcoma (ES) is a rare form of mesenchymal malignancy that rarely occurs in children. Only seven cases of intra-articular epithelioid sarcoma have been reported in the medical literature. CASE PRESENTATION In this report, we presented the case of a 13-year-old girl with a delayed diagnosis of ES in the left knee. Her initial diagnosis was mistaken for Pigmented Villonodular Synovitis (PVNS) but ruled out later by the first biopsy. However, the lesion rapidly regrew again after arthroscopy, raising suspicions of malignancy. A comprehensive histochemistry examination was conducted again, leading to the diagnosis of INI-1 negative epithelioid sarcoma. Unfortunately, the girl passed away seven months later due to early metastasis of the tumor. CONCLUSION Careful consideration should be given to the differential diagnosis of pediatric patients presenting with monoarthritis. This report highlights the importance of early and accurate diagnosis and underscores the necessity for effective treatments for epithelioid sarcoma. Surgical resection or radical surgery is recommended, while novel treatment strategies targeting EZH2 show promise.
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Affiliation(s)
- Ranran Zhang
- Department of Pediatric Nephrology, Rheumatology and Immunity, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jia Liu
- Department of Pediatric Nephrology, Rheumatology and Immunity, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lin Liu
- Department of Pediatric Nephrology, Rheumatology and Immunity, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yi Lin
- Department of Pediatric Nephrology, Rheumatology and Immunity, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qiuye Zhang
- Department of Pediatric Nephrology, Rheumatology and Immunity, The Affiliated Hospital of Qingdao University, Qingdao, China.
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Kim E, Kim MS, Paik EK, Chang UK, Kong CB. Treatment outcomes of stereotactic body radiation therapy for primary and metastatic sarcoma of the spine. Radiat Oncol 2023; 18:156. [PMID: 37736735 PMCID: PMC10514933 DOI: 10.1186/s13014-023-02346-w] [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: 06/07/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023] Open
Abstract
PURPOSE This study evaluated the treatment outcomes of spine stereotactic body radiation therapy (SBRT) in sarcoma patients. MATERIALS AND METHODS A total of 44 sarcoma patients and 75 spinal lesions (6 primary tumors, 69 metastatic tumors) treated with SBRT were retrospectively reviewed between 2006 and 2017. The median radiation dose was 33 Gy (range, 18-45 Gy) in 3 fractions (range, 1-5) prescribed to the 75% isodose line. RESULTS The median follow-up duration was 18.2 months. The 1-year local control was 76.4%, and patients treated with single vertebral body were identified as a favorable prognostic factor on multivariate analyses. Progression-free survival at 1 year was 31.9%, with the interval between initial diagnosis and SBRT and extent of disease at the time of treatment being significant prognostic factors. The 1-year overall survival was 80.5%, and PTV and visceral metastases were independently associated with inferior overall survival. CONCLUSION SBRT for spinal sarcoma is effective in achieving local control, particularly when treating a single vertebral level with a limited extent of disease involvement, resulting in an excellent control rate. The extent of disease at the time of SBRT is significantly correlated with survival outcomes and should be considered when treating spine sarcoma.
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Affiliation(s)
- Eunji Kim
- Department of Radiation Oncology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Mi-Sook Kim
- Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Eun Kyung Paik
- Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Ung-Kyu Chang
- Department of Neurosurgery, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Chang-Bae Kong
- Department of Orthopedic Surgery, Korea Institute of Radiological and Medical Sciences, 75, Nowon-ro, Nowon-gu, Seoul, 01812, Republic of Korea.
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Michcik A, Bień M, Wojciechowska B, Polcyn A, Garbacewicz Ł, Kowalski J, Drogoszewska B. Difficulties in diagnosing angiomatoid fibrous histiocytoma of the head and neck region: A case report. World J Clin Cases 2023; 11:6252-6261. [PMID: 37731558 PMCID: PMC10507541 DOI: 10.12998/wjcc.v11.i26.6252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Angiomatoid fibrous histiocytoma (AFH) is a rare, slow-growing soft tissue tumor. It appears mostly on the limbs and trunk in children and young adults. The biology of AFH remains unclear because of the small number of reported cases. Diagnostic testing does not provide definitive results. It has two clinical forms, that differ in terms of gene expression and clinical prognosis. It is important to inform the laboratory which specific gene testing is necessary. Here, we describe a case of rare AFH in the submandibular region using a full genetic panel. CASE SUMMARY A 13-year-old boy who had been misdiagnosed in the past 6 mo by his dentist visited our clinic because of a lesion in the submandibular area on the right side. The lesion was homogeneous and painless upon palpation. No skin discoloration was observed. Due to the non-specific radiological picture computed tomography (CT), magnetic resonance imaging (MRI), cone-beam CT (CBCT), and ultrasound-guided biopsy were performed. A venous malformation was suspected on the MRI. None of the tests provided a definitive diagnosis. Owing to the non-specific radiological findings, the patient qualified for surgical treatment. The surgical procedure included an excisional biopsy. The diagnostic testing was extended using gene rearrangements. The most distinctive gene translocation in diagnosing AFH is within the EWS RNA-binding protein 1 (EWSR1)-CREB-binding protein. However, in this case, the diagnosis was confirmed by a rearrangement within the EWSR1 gene testing. CONCLUSION AFH in the submandibular location is rare, and surgical treatment with genetic evaluation defines AFH type that affects subsequent procedures.
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Affiliation(s)
- Adam Michcik
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Marta Bień
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Barbara Wojciechowska
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Adam Polcyn
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Łukasz Garbacewicz
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Jacek Kowalski
- Department of Pathomorphology, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Barbara Drogoszewska
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
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183
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Coppola E, Giardino G, Abate M, Tambaro FP, Bifano D, Toriello E, De Rosa A, Cillo F, Pignata C, Cirillo E. Rare solid tumors in a patient with Wiskott-Aldrich syndrome after hematopoietic stem cell transplantation: case report and review of literature. Front Immunol 2023; 14:1229674. [PMID: 37781361 PMCID: PMC10533990 DOI: 10.3389/fimmu.2023.1229674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/23/2023] [Indexed: 10/03/2023] Open
Abstract
Background and aims Wiskott-Aldrich syndrome (WAS) is an X-linked recessive primary immunodeficiency disorder characterized by severe eczema, recurrent infections, and micro-thrombocytopenia. Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative therapeutic option for patients with classic form. The risk of developing post-transplant tumors appears to be higher in patients with WAS than in other inborn errors of immunity (IEIs), but the actual incidence is not well defined, due to the scarcity of published data. Methods Herein, we describe a 10-year-old patient diagnosed with WAS, treated with HSCT in the first year of life, who subsequently developed two rare solid tumors, kaposiform hemangioendothelioma and desmoid tumor. A review of the literature on post-HSCT tumors in WAS patients has been performed. Results The patient received diagnosis of classic WAS at the age of 2 months (Zhu score = 3), confirmed by WAS gene sequencing, which detected the nonsense hemizygous c.37C>T (Arg13X) mutation. At 9 months, patient underwent HSCT from a matched unrelated donor with an adequate immune reconstitution, characterized by normal lymphocyte subpopulations and mitogen proliferation tests. Platelet count significantly increased, even though platelet count never reached reference values. A mixed chimerism was also detected, with a residual WASP- population on monocytes (27.3%). The patient developed a kaposiform hemangioendothelioma at the age of 5. A second abdominal tumor was identified, histologically classified as a desmoid tumor when he reached the age of 10 years. Both hematopoietic and solid tumors were identified in long-term WAS survivors after HSCT. Conclusion Here, we describe the case of a patient with WAS who developed two rare solid tumors after HSCT. An active surveillance program for the risk of tumors is necessary in the long-term follow-up of post-HSCT WAS patients.
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Affiliation(s)
- Emma Coppola
- Department of Translational Medical Sciences, Pediatrics Section, Federico II University of Naples, Naples, Italy
| | - Giuliana Giardino
- Department of Translational Medical Sciences, Pediatrics Section, Federico II University of Naples, Naples, Italy
| | - Massimo Abate
- Pediatric Oncology Department, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Francesco Paolo Tambaro
- Division of Stem Cell Transplantation and Cell Therapy, Pediatric Oncology Department, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Delfina Bifano
- Department of Pathology, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Elisabetta Toriello
- Department of Translational Medical Sciences, Pediatrics Section, Federico II University of Naples, Naples, Italy
| | - Antonio De Rosa
- Department of Translational Medical Sciences, Pediatrics Section, Federico II University of Naples, Naples, Italy
| | - Francesca Cillo
- Department of Translational Medical Sciences, Pediatrics Section, Federico II University of Naples, Naples, Italy
| | - Claudio Pignata
- Department of Translational Medical Sciences, Pediatrics Section, Federico II University of Naples, Naples, Italy
| | - Emilia Cirillo
- Department of Translational Medical Sciences, Pediatrics Section, Federico II University of Naples, Naples, Italy
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Dupuy M, Lamoureux F, Mullard M, Postec A, Regnier L, Baud’huin M, Georges S, Brounais-Le Royer B, Ory B, Rédini F, Verrecchia F. Ewing sarcoma from molecular biology to the clinic. Front Cell Dev Biol 2023; 11:1248753. [PMID: 37752913 PMCID: PMC10518617 DOI: 10.3389/fcell.2023.1248753] [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: 06/27/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023] Open
Abstract
In Europe, with an incidence of 7.5 cases per million, Ewing sarcoma (ES) is the second most common primary malignant bone tumor in children, adolescents and young adults, after osteosarcoma. Since the 1980s, conventional treatment has been based on the use of neoadjuvant and adjuvant chemotherapeutic agents combined with surgical resection of the tumor when possible. These treatments have increased the patient survival rate to 70% for localized forms, which drops drastically to less than 30% when patients are resistant to chemotherapy or when pulmonary metastases are present at diagnosis. However, the lack of improvement in these survival rates over the last decades points to the urgent need for new therapies. Genetically, ES is characterized by a chromosomal translocation between a member of the FET family and a member of the ETS family. In 85% of cases, the chromosomal translocation found is (11; 22) (q24; q12), between the EWS RNA-binding protein and the FLI1 transcription factor, leading to the EWS-FLI1 fusion protein. This chimeric protein acts as an oncogenic factor playing a crucial role in the development of ES. This review provides a non-exhaustive overview of ES from a clinical and biological point of view, describing its main clinical, cellular and molecular aspects.
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Affiliation(s)
- Maryne Dupuy
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, CRCI2NA, Université d'Angers, Nantes, France
| | | | | | | | | | | | | | | | | | | | - Franck Verrecchia
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, CRCI2NA, Université d'Angers, Nantes, France
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185
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Klingbeil KD, Tang JP, Graham DS, Lofftus SY, Jaiswal AK, Lin TL, Frias C, Chen LY, Nakasaki M, Dry SM, Crompton JG, Eilber FC, Rao DS, Kalbasi A, Kadera BE. IGF2BP3 as a Prognostic Biomarker in Well-Differentiated/Dedifferentiated Liposarcoma. Cancers (Basel) 2023; 15:4489. [PMID: 37760460 PMCID: PMC10526143 DOI: 10.3390/cancers15184489] [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: 07/29/2023] [Revised: 08/30/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Although IGF2BP3 has been implicated in tumorigenesis and poor outcomes in multiple cancers, its role in soft-tissue sarcoma (STS) remains unknown. Preliminary data have suggested an association with IGF2BP3 expression among patients with well-differentiated/dedifferentiated liposarcoma (WD/DD LPS), a disease where molecular risk stratification is lacking. METHODS We examined the survival associations of IGF2BP3 via univariate and multivariate Cox regression in three unique datasets: (1) the Cancer Genome Atlas (TCGA), (2) an in-house gene microarray, and (3) an in-house tissue microarray (TMA). A fourth dataset, representing an independent in-house TMA, was used for validation. RESULTS Within the TCGA dataset, IGF2BP3 expression was a poor prognostic factor uniquely in DD LPS (OS 1.6 vs. 5.0 years, p = 0.009). Within the microarray dataset, IGF2BP3 expression in WD/DD LPS was associated with worse survival (OS 7.7 vs. 21.5 years, p = 0.02). IGF2BP3 protein expression also portended worse survival in WD/DD LPS (OS 3.7 vs. 13.8 years, p < 0.001), which was confirmed in our validation cohort (OS 2.7 vs. 14.9 years, p < 0.001). In the multivariate model, IGF2BP3 was an independent risk factor for OS, (HR 2.55, p = 0.034). CONCLUSION IGF2BP3 is highly expressed in a subset of WD/DD LPS. Across independent datasets, IGF2BP3 is also a biomarker of disease progression and worse survival.
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Affiliation(s)
- Kyle D. Klingbeil
- Department of Surgery, Division of Surgical Oncology, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90049, USA (C.F.)
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Molecular, Cellular, and Integrative Physiology Interdepartmental PhD Program, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Jack Pengfei Tang
- University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Danielle S. Graham
- Department of Surgery, Division of Surgical Oncology, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90049, USA (C.F.)
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Serena Y. Lofftus
- Department of Surgery, Division of Surgical Oncology, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90049, USA (C.F.)
| | - Amit Kumar Jaiswal
- Department of Pathology & Laboratory Medicine, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Tasha L. Lin
- Department of Medicine, Division of Hematology and Oncology, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Chris Frias
- Department of Surgery, Division of Surgical Oncology, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90049, USA (C.F.)
| | - Lucia Y. Chen
- Department of Medicine, Statistics Core, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Manando Nakasaki
- Department of Pathology & Laboratory Medicine, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Sarah M. Dry
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Department of Pathology & Laboratory Medicine, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA
| | - Joseph G. Crompton
- Department of Surgery, Division of Surgical Oncology, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90049, USA (C.F.)
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Fritz C. Eilber
- Department of Surgery, Division of Surgical Oncology, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90049, USA (C.F.)
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Dinesh S. Rao
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
- Department of Pathology & Laboratory Medicine, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA
- Broad Stem Cell Research Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Anusha Kalbasi
- Department of Radiation Oncology, Stanford Cancer Institute, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Brian E. Kadera
- Department of Surgery, Division of Surgical Oncology, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA 90049, USA (C.F.)
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
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Ndjapa-Ndamkou C, Ngwenya S, Mamontov D, Mbodi L, Govender L, Luvhengo T, Chauke L. Diagnosis and management of a pelvic solitary fibrous tumor in a postmenopausal woman - a case report. Case Rep Womens Health 2023; 39:e00534. [PMID: 37608822 PMCID: PMC10440545 DOI: 10.1016/j.crwh.2023.e00534] [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: 05/25/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
Background Solitary fibrous tumors, previously known as hemangiopericytomas, originate from mesenchymal tissue and can occur at many body sites, such as the thorax, head and neck, retroperitoneal space and abdomen. These tumors are generally rare and pelvic location is extremely uncommon. Consequently, pelvic solitary tumors could be mistaken for ovarian cancer in menopausal women. This report presents a case of pelvic solitary tumor to highlight the importance of considering this diagnosis in a postmenopausal woman presenting with a solid pelvic mass, normal tumor markers and no ascites. Case A 54-year-old woman presented with amenorrhea, abdominal pain, constipation, nausea, vomiting, and frequency of urination. On examination she had a pelvic mass of approximately 20-24 weeks in size. Ultrasound and computed tomography imaging showed a well-defined, round, centrally hypodense, irregular thick and peripheral, enhancing solid mass originating from the left ovary. Carcinoembryonic antigen, carbohydrate antigen-125, and carcinoembryonic antigen 19-9 were all normal. Intraoperatively the tumor was attached to the peritoneum and mesentery. Part of the large bowel, including the sigmoid colon, were attached to it. The exact origin of the tumor could not be ascertained during surgery. The tumor was successfully excised, and specimen sent for histology and immunochemistry analysis. The definitive diagnosis was confirmed with immunochemistry. The patient had an uneventful postsurgical course and was discharged on day 4 after surgery for routine gynecological follow-up. Conclusion Solitary fibrous tumor is very rare; however, the diagnosis should be considered in a postmenopausal woman with solid pelvic mass, normal tumor markers and no ascites.
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Affiliation(s)
- Constant Ndjapa-Ndamkou
- Department of Obstetrics & Gynaecology, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital, Gauteng Department of Health, Johannesburg, South Africa
| | - Sharol Ngwenya
- Department of Anatomical Pathology, Faculty of Health Sciences, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa
| | - Dimitrije Mamontov
- Department of Anatomical Pathology, Faculty of Health Sciences, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa
| | - Langanani Mbodi
- Department of Obstetrics & Gynaecology, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital, Gauteng Department of Health, Johannesburg, South Africa
| | - Logie Govender
- Department of Obstetrics & Gynaecology, Queen Nandi Regional Hospital, Empangeni, University of KwaZulu-Natal, KZN, South Africa
| | - Thifhelimbilu Luvhengo
- Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johnnesburg Academic Hospital, Gauteng Department of Health, Johannesburg, South Africa
| | - Lawrence Chauke
- Department of Obstetrics & Gynaecology, Faculty of Health Sciences, University of the Witwatersrand and Charlotte Maxeke Johannesburg Academic Hospital, Gauteng Department of Health, Johannesburg, South Africa
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Buchalet C, Durdux C. Role of radiotherapy in the management of rare solid thoracic tumors of the adults. Cancer Radiother 2023; 27:614-621. [PMID: 37558606 DOI: 10.1016/j.canrad.2023.06.025] [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: 05/30/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 08/11/2023]
Abstract
Thoracic tumors include more than one hundred histopathological subtypes. Rare thoracic malignancies can be defined as representing less than 1% of all thoracic tumors. The European Rare Cancer Surveillance Project (RARECARE) identified rarity as an incidence less than 6 for 100,000 people, with significant difference of prevalence between them. Modalities of treatment for these pathologies include surgery, radiotherapy, and systemic therapies. In this article, we aim to discuss role and techniques of radiotherapy in management of rare solid thoracic tumors in adults, focusing on different anatomical locations such as lung parenchyma, mediastinum, vessels, chest wall and pleural cavity.
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Affiliation(s)
- C Buchalet
- Département d'oncologie radiothérapie, Institut du Cancer de Montpellier, 208, avenue des Apothicaires, 34000 Montpellier, France.
| | - C Durdux
- Département d'oncologie radiothérapie, Hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France
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188
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Saifi I, Kashikar SV, Parihar P, Saifi AI, Ansari KK. Magnetic Resonance Imaging (MRI) Findings in a Case of Pigmented Villonodular Synovitis of the Knee. Cureus 2023; 15:e45806. [PMID: 37876406 PMCID: PMC10591204 DOI: 10.7759/cureus.45806] [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: 08/23/2023] [Accepted: 09/22/2023] [Indexed: 10/26/2023] Open
Abstract
Pigmented villonodular synovitis (PVNS) is a rare benign condition of tenosynovial proliferation that mostly affects the knee joint. In this case report, we present a 39-year-old female with a ten-year history of gradual progression in the size of painful soft tissue swelling in her left knee. Our case report emphasizes the MRI's ability to provide detailed information on tendon sheath and synovium involvement, as well as extensive extra-articular involvement and hemosiderin deposition.
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Affiliation(s)
- Iram Saifi
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shivali V Kashikar
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratap Parihar
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Azeem I Saifi
- Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Khizer K Ansari
- Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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189
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Gonçalves S, Soares C, Ribeiro R, Sousa S. Unveiling the Mystery: A Case Report on Oropharyngeal Synovial Sarcoma. Cureus 2023; 15:e44703. [PMID: 37809216 PMCID: PMC10552340 DOI: 10.7759/cureus.44703] [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: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Synovial sarcoma, originating from mesenchymal cells, represents a rare and aggressive sarcoma subtype. This case report describes a rare occurrence of synovial sarcoma in the soft palate, with only a few cases described in the literature. A 38-year-old male presented with a painless mass on the soft palate, which raised suspicion of an abscess and emphasized the importance of considering malignancy in persistent or progressive soft tissue masses, even in atypical anatomical locations. The diagnostic workup, including imaging modalities such as maxillofacial computed tomography (CT) scan, magnetic resonance imaging (MRI), and positron emission tomography-fluorodeoxyglucose (PET-FDG) scan, played a crucial role in confirming the diagnosis and assessing disease extension. The standard treatment is the complete excision of the tumor. Nevertheless, when it comes to tumors located in the head and neck region, defining standardized margins proves to be a challenge. Radiotherapy can play an important role, particularly in those with tumors larger than 5 cm or positive margins. While chemotherapy offers certain advantages, its application remains a subject of controversy despite its potential benefits. Timely referral and multidisciplinary management are essential in optimizing patient outcomes. Although synovial sarcoma poses diagnostic and therapeutic challenges, advances in diagnostic techniques and personalized medicine offer hope for improved outcomes.
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Affiliation(s)
- Soraia Gonçalves
- Family Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
| | - Catarina Soares
- Family Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
| | - Rita Ribeiro
- Family Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
| | - Sílvia Sousa
- Family Medicine, Unidade Local de Saúde do Alto Minho, Viana do Castelo, PRT
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190
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Yao Y, Zhao Y, Lu L, Zhao Y, Lin X, Xia J, Zheng X, Shen Y, Cai Z, Li Y, Yang Z, Lin D. Prediction of histopathologic grades of myxofibrosarcoma with radiomics based on magnetic resonance imaging. J Cancer Res Clin Oncol 2023; 149:10169-10179. [PMID: 37264266 DOI: 10.1007/s00432-023-04939-0] [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: 04/22/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE To develop a radiomics-based model from preoperative magnetic resonance imaging (MRI) for predicting the histopathological grades of myxofibrosarcoma. METHODS This retrospective study included 54 patients. The tumors were classified into high-grade and low-grade myxofibrosarcoma. The tumor size, signal intensity heterogeneity, margin, and surrounding tissue were evaluated on MRI. Using the least absolute shrinkage and selection operator (LASSO) algorithms, 1037 radiomics features were obtained from fat-suppressed T2-weighted images (T2WI), and a radiomics signature was established. Using multivariable logistic regression analysis, three models were built to predict the histopathologic grade of myxofibrosarcoma. A radiomics nomogram represents the integrative model. The three models' performance was evaluated using the receiver operating characteristics (ROC) and calibration curves. RESULTS The high-grade myxofibrosarcoma had greater depth (P = 0.027), more frequent heterogeneous signal intensity at T2WI (P = 0.015), and tail sign (P = 0.014) than the low-grade tumor. The area under curve (AUC) of these conventional MRI features models was 0.648, 0.656, and 0.668, respectively. Seven radiomic features were selected by LASSO to construct the radiomics signature model, with an AUC of 0.791. The AUC of the integrative model based on radiomics signature and conventional MRI features was 0.875. The integrative model's calibration curve and insignificant Hosmer-Lemeshow test statistic (P = 0.606) revealed good calibration. CONCLUSION An integrative model using radiomics signature and three conventional MRI features can preoperatively predict low- or high-grade myxofibrosarcoma.
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Affiliation(s)
- Yubin Yao
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Road, Shantou, 515031, People's Republic of China
| | - Yan Zhao
- Central Laboratory, Clinical Research Center, Shantou Central Hospital, No. 114 Waima Road, Shantou, 515031, People's Republic of China
| | - Liejing Lu
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, People's Republic of China
| | - Yongqiang Zhao
- Department of Pathology, Shantou Central Hospital, No. 114 Waima Road, Shantou, 515031, People's Republic of China
| | - Xiaokun Lin
- Department of Radiology, The First People's Hospital of Jiexi, No. 7 Dangxiao Road, Jieyang, 515400, People's Republic of China
| | - Jianfeng Xia
- Department of Radiology, The First People's Hospital of Qinzhou, No. 47 Qianjin Road, Qinzhou, 535000, People's Republic of China
| | - Xufeng Zheng
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Road, Shantou, 515031, People's Republic of China
| | - Yi Shen
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Road, Shantou, 515031, People's Republic of China
| | - Zonghuan Cai
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Road, Shantou, 515031, People's Republic of China
| | - Yangkang Li
- Department of Radiology, Cancer Hospital, Shantou University Medical College, No. 7 Raoping Road, Shantou, 515041, People's Republic of China
| | - Zehong Yang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, People's Republic of China
| | - Daiying Lin
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Road, Shantou, 515031, People's Republic of China.
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191
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Mazzaro RT, Vaz MV, Badin RC, Bernardina ED, Manaças LRA. Management of chemotherapy-induced febrile neutropenia and use of granulocyte colony-stimulating factor in patients with soft tissue or bone sarcoma. J Oncol Pharm Pract 2023; 29:1428-1436. [PMID: 36226408 DOI: 10.1177/10781552221131901] [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: 11/15/2022]
Abstract
INTRODUCTION Febrile neutropenia, an oncological complication related to myelosuppressive chemotherapy, can lead to unplanned hospitalization, morbidity, mortality, and changes in the oncological therapeutic plan. The present study aimed (1) to determine the prevalence of chemotherapy-induced febrile neutropenia requiring hospitalization and the use of granulocyte colony-stimulating factor and (2) to evaluate its consequences for the oncological treatment of patients with soft tissue or bone sarcomas. METHODS This is a cross-sectional and retrospective study (January 2018 to December 2019) carried out in a reference oncology hospital in the Brazilian public health system. Inpatients diagnosed with chemotherapy-induced febrile neutropenia, older than the age of 18 years, and treated with granulocyte colony-stimulating factor were included in the study. RESULTS Twenty-nine chemotherapy-induced febrile neutropenia events were identified, involving 25 patients. Among the febrile neutropenia events, 90% were grade 4, and 59% occurred during palliative chemotherapy. Among patients with febrile neutropenia, 31% had arterial hypertension or/and diabetes mellitus comorbidities, 34% had infectious skin sites, such as compression ulcers and tumor wounds, and 31% had infections with defined etiologic agents. Treatment of hospitalized patients was performed with cefepime in combinations or alone (97%) and filgrastim. The outcomes related to chemotherapy-induced febrile neutropenia were chemotherapy dose reduction (31%), chemotherapy cycle delays (21%), chemotherapy treatment suspension (17%), deaths (7%), and other associated complications (10%). Granulocyte colony-stimulating factor prophylaxis was prescribed in 72.41% of febrile neutropenia events. The frequency of febrile neutropenia concerning total chemotherapy cycles was 2.15%. CONCLUSION Even with granulocyte colony-stimulating factor prophylaxis, an overall prevalence of 2.15% of febrile neutropenia associated with hospitalization was observed, causing negative outcomes in chemotherapy treatment of patients.
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Affiliation(s)
- Raphaele Teixeira Mazzaro
- Department of Clinical Pharmacy, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA) - Cancer Hospital II, Rio de Janeiro, Brazil
| | - Mahanna Vanzeler Vaz
- Department of Clinical Pharmacy, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA) - Cancer Hospital II, Rio de Janeiro, Brazil
| | - Rebeka Caribé Badin
- Department of Clinical Pharmacy, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA) - Cancer Hospital II, Rio de Janeiro, Brazil
| | - Eliza Dalla Bernardina
- Department of Clinical Pharmacy, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA) - Cancer Hospital II, Rio de Janeiro, Brazil
| | - Liliane Rosa Alves Manaças
- Department of Clinical Pharmacy, Brazilian National Cancer Institute José Alencar Gomes da Silva (INCA) - Cancer Hospital II, Rio de Janeiro, Brazil
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192
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Huff D, Horsley RK, Seetharam M, Larsen BT. Undifferentiated Pleomorphic Sarcoma Presenting as Hip Pain. Am J Med 2023; 136:e171-e172. [PMID: 37148991 DOI: 10.1016/j.amjmed.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/09/2023] [Accepted: 04/10/2023] [Indexed: 05/08/2023]
Affiliation(s)
| | | | | | - Brandon T Larsen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, Ariz
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193
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Pegoraro F, Santangelo D, Santangelo A, Pelosio L, Jamshidi A, Camera L, Imbriaco M, Mainolfi CG, Insabato L, Accarino R, Giuliano M, Carlomagno N, D'Alessandro V, Santangelo ML. R0 surgical resection of giant dedifferentiated retroperitoneal liposarcomas in the COVID era with and without nephrectomy: A case report. Oncol Lett 2023; 26:410. [PMID: 37600332 PMCID: PMC10436160 DOI: 10.3892/ol.2023.13996] [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: 02/23/2023] [Accepted: 06/13/2023] [Indexed: 08/22/2023] Open
Abstract
Retroperitoneal sarcomas (RPSs) are rare findings that can grow into large masses without eliciting severe symptoms. At present, surgical resection is the only radical therapy, whenever it can be performed with the aim to achieve a complete removal of the tumor. The present report describes two consecutive cases of RPSs that resulted in dedifferentiated liposarcomas (DDLPSs) and these patients underwent R0 surgical resection with and without a nephron-sparing procedure. The diagnostic workup, the surgical approach, the impact of late surgical management due to the COVID pandemic and the latest literature on the topic are discussed and analyzed. The patients, who refused to undergo any medical examination during the prior 2 years due to the COVID pandemic, were admitted to Federico II University Hospital (Naples, Italy) complaining about weight loss and general abdominal discomfort. In the first case, a primitive giant abdominal right neoplasm of retroperitoneal origin enveloping and medializing the right kidney was observed. The second patient had a similar primitive retroperitoneal giant left neoplasm, which did not affect the kidney. Given the characteristics of the masses and the absence of distant metastases, after a multidisciplinary discussion, radical surgical removal was carried out for both patients. The lesions appeared well-defined from the surrounding tissues, and markedly compressed all the adjacent organs, without signs of infiltration. In the first patient, the right kidney was surrounded and undetachable from the tumor and it was removed en bloc with the mass. The second patient benefited from a nephron-sparing resection, due to the existence of a clear cleavage plane. The postoperative courses were uneventful. Both the histological examinations were oriented towards a DDLPS and both patients benefited from adjuvant chemotherapy. In conclusion, the treatment of giant RPS is still challenging and requires multidisciplinary treatment as well as, when possible, radical surgical removal. The lack of tissue infiltration and the avoidance of excision or reconstruction of major organs (including the kidney) could lead to an easier postoperative course and an improved prognosis. When possible, surgical management of recurrences or incompletely resected masses must be pursued. Since the COVID pandemic caused limited medicalization of a number of population groups and delayed diagnosis of other oncologic diseases, an increased number of DDLPSs could be expected in the near future.
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Affiliation(s)
- Francesca Pegoraro
- Operative Unit of Hepato-Biliary-Pancreatic, Minimally Invasive and Robotic Surgery and Kidney Transplantation, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Domenico Santangelo
- Department of Radiology, ‘Scientific Hospitalization and Treatment Institute’ San Raffaele Hospital, I-20132 Milano, Italy
| | - Alfonso Santangelo
- Department of General Surgery and Emergency Surgery, ‘Scientific Hospitalization and Treatment Institute’ San Raffaele Hospital, I-20132 Milano, Italy
| | - Luigi Pelosio
- Operative Unit of General Surgery and Retroperitoneal Diseases, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Akbar Jamshidi
- Operative Unit of General Surgery and Retroperitoneal Diseases, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Luigi Camera
- Operative Unit of Diagnostic Imaging and Radiotherapy, Federico II University Hospital, I-80131 Naples, Italy
| | - Massimo Imbriaco
- Operative Unit of Diagnostic Imaging and Radiotherapy, Federico II University Hospital, I-80131 Naples, Italy
| | - Ciro Gabriele Mainolfi
- Operative Unit of Diagnostic Imaging and Radiotherapy, Federico II University Hospital, I-80131 Naples, Italy
| | - Luigi Insabato
- Operative Unit of Pathology, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
| | - Rossella Accarino
- Operative Unit of Pathology, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
| | - Mario Giuliano
- Operative Unit of Medical Oncology, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Nicola Carlomagno
- Operative Unit of General Surgery and Kidney Transplantation, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
| | - Vincenzo D'Alessandro
- Operative Unit of General Surgery and Retroperitoneal Diseases, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Michele L. Santangelo
- Operative Unit of General Surgery and Kidney Transplantation, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
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Kawakita Y, Anan K, Kurata K, Koga K, Saimura M, Tamiya S, Nishihara K, Mitsuyama S, Nakano T. Anaplastic lymphoma kinase-positive inflammatory myofibroblastic tumor of the breast: a case report and review of the literature. Surg Case Rep 2023; 9:152. [PMID: 37656266 PMCID: PMC10474000 DOI: 10.1186/s40792-023-01732-6] [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: 04/11/2023] [Accepted: 08/20/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Few reports of inflammatory myofibroblastic tumor (IMT) of the breast have been published worldwide. Furthermore, primary anaplastic lymphoma kinase (ALK)-positive IMT of the breast is extremely rare. To date, only six patients with ALK-positive IMT have been reported in the literature. CASE PRESENTATION A 52-year-old woman underwent a medical examination, and a left breast mass was detected. She did not feel a mass in her chest. Mammography showed a focal asymmetric density at the lower outer portion of the left breast. Breast ultrasonography showed a 1.2-cm hypoechoic lesion with relatively clear boundaries and poor blood flow. Magnetic resonance imaging and computed tomography revealed a solitary heterogeneous mass in the left breast. Pathologic examination revealed a fibrosing lesion with proliferation of fibroblastic cells arranged in a storiform pattern and admixed inflammatory cells. Immunohistochemical examination showed that the tumor cells were positive for ALK. Under the preoperative diagnosis of IMT, we performed partial mastectomy with adequate margins. The postoperative diagnosis was pathologically confirmed as IMT. Immunohistochemical staining also showed overexpression of ALK-1 in the tumor. The patient had a good clinical course for 24 months postoperatively, without recurrence or metastasis. CONCLUSIONS IMT of the breast shows nonspecific imaging findings, making preoperative diagnosis difficult. Nevertheless, IMT has the characteristics of low-grade neoplasms with recurrence, invasion, and metastatic potential. Our report emphasizes the importance of determining a treatment plan as soon as possible based on an accurate diagnosis to improve the prognosis of this disease.
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Affiliation(s)
- Yasutaka Kawakita
- Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku Kokurakita-Ku, Kitakyushu, Fukuoka, 802-0077, Japan.
- Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka Yahatanishi-Ku, Kitakyushu, Fukuoka, 807-8555, Japan.
| | - Keisei Anan
- Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku Kokurakita-Ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Kanako Kurata
- Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku Kokurakita-Ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Kenichiro Koga
- Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku Kokurakita-Ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Michiyo Saimura
- Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku Kokurakita-Ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Sadafumi Tamiya
- Department of Pathology, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku Kokurakita-Ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Kazuyoshi Nishihara
- Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku Kokurakita-Ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Shoshu Mitsuyama
- Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku Kokurakita-Ku, Kitakyushu, Fukuoka, 802-0077, Japan
| | - Toru Nakano
- Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku Kokurakita-Ku, Kitakyushu, Fukuoka, 802-0077, Japan
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Eid M, Hafez H, El-Shaqanqery HE, Samir O, El Nadi I, Elwakeel M, Salama A, Younes A, Ahmed G, Yasser N, Kieran MW, Sayed A, Haddad AE. Predictive value of micro-RNA expression profiling in pediatric desmoid fibromatosis. Acta Oncol 2023; 62:1014-1020. [PMID: 37493630 DOI: 10.1080/0284186x.2023.2238881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 06/07/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Mohamed Eid
- Department of Pediatric Oncology, Children's Cancer Hospital Egypt (CCHE 57357), Cairo, Egypt
| | - Hanafy Hafez
- Department of Pediatric Oncology, Children's Cancer Hospital Egypt (CCHE 57357), Cairo, Egypt
- Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Hend E El-Shaqanqery
- Genomics Department, Children's Cancer Hospital Egypt (CCHE 57357), Cairo, Egypt
| | - Omar Samir
- Genomics Department, Children's Cancer Hospital Egypt (CCHE 57357), Cairo, Egypt
| | - Inas El Nadi
- Department of Pediatric Oncology, Children's Cancer Hospital Egypt (CCHE 57357), Cairo, Egypt
- Department of Medical Oncology, Beni-Swef University, Cairo, Egypt
| | - Madeeha Elwakeel
- Department of Diagnostic Radiology, Children's Cancer Hospital Egypt (CCHE 57357), National Cancer Institute Cairo University, Cairo, Egypt
| | - Asmaa Salama
- Department of Surgical Pathology, National Cancer Institute, Children's Cancer Hospital Egypt (CCHE 57357), Cairo University, Cairo, Egypt
| | - Alaa Younes
- Surgical Oncology Department, Children's Cancer Hospital Egypt (CCHE 57357), National Cancer Institute, Cairo University, Cairo, Egypt
| | - Gehad Ahmed
- Surgical Oncology Department, Surgery Department, Children's Cancer Hospital, Egypt (CCHE), Helwan University, Cairo, Egypt
| | - Nouran Yasser
- Biostatistician - Clinical Research Department, Children's Cancer Hospital Egypt (CCHE), Cairo, Egypt
| | - Mark W Kieran
- Department of Pediatric Oncology, Children's Cancer Hospital Egypt (CCHE 57357), Cairo, Egypt
| | - Ahmed Sayed
- Genomics Department, Children's Cancer Hospital Egypt (CCHE 57357), Cairo, Egypt
| | - Alaa El Haddad
- Department of Pediatric Oncology, Children's Cancer Hospital Egypt (CCHE 57357), Cairo, Egypt
- Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
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Büyükceran İ, Aydın Şimşek Ş, Bayar E, Cengiz T, Coşkun HS, Dabak N. Evaluation of Bone and Soft Tissue Tumors of the Shoulder Girdle. Cureus 2023; 15:e46162. [PMID: 37905248 PMCID: PMC10613316 DOI: 10.7759/cureus.46162] [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: 09/28/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION The shoulder girdle comprises the scapula, clavicle, proximal humerus, and the soft tissues surrounding these structures. Bone and soft tissue tumors are notably more prevalent in the lower extremity than in the upper extremity. However, the shoulder ranks as the third most common site for primary tumors, following the hip-pelvis and knee. MATERIALS AND METHODS This study conducted a retrospective examination of patients who presented with pain and swelling in the shoulder and its vicinity. The evaluation was carried out using a multidisciplinary approach by the Bone and Soft Tissue Tumors Council. RESULTS The study included 224 patients diagnosed with a tumoral lesion in the shoulder girdle between 2004 and 2021. Among these patients, 22 were assessed to have lesions other than tumors, while 105 (51.98%) had benign lesions, and 97 had malignant lesions. The most prevalent benign lesions were cystic bone lesions (30) and soft tissue lipomas (10). The primary form of malignant lesion was metastatic tumors (49). CONCLUSION Pathologies in the shoulder girdle may manifest through pain, palpable swelling, pathological fractures, or may be incidentally detected via radiological imaging. Notably, pain, hypercalcemia, and pathological fractures are significant indicators, especially in cases of bone metastases, which often follow a highly fatal course when involving long bones. The musculoskeletal system is the third most common site for metastasis, following the lungs and liver. Hence, particular attention should be directed toward metastatic concerns in the shoulder and its surrounding area.
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Affiliation(s)
- İsmail Büyükceran
- Department of Orthopedics and Traumatology, Ondokuz Mayis University, Faculty of Medicine, Samsun, TUR
| | - Şafak Aydın Şimşek
- Department of Orthopedics and Traumatology, Ondokuz Mayis University, Faculty of Medicine, Samsun, TUR
| | - Ercan Bayar
- Department of Orthopedics and Traumatology, Ondokuz Mayis University, Faculty of Medicine, Samsun, TUR
| | - Tolgahan Cengiz
- Department of Orthopedics and Traumatology, Inebolu State Hospital, Kastamonu, TUR
| | - Hüseyin Sina Coşkun
- Department of Orthopedics and Traumatology, Ondokuz Mayis University, Faculty of Medicine, Samsun, TUR
| | - Nevzat Dabak
- Department of Orthopedics and Traumatology, Ondokuz Mayis University, Faculty of Medicine, Samsun, TUR
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197
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Guddi RS, Bharti K, Mishra A, Sinha DK, Haldar D, Azad S. Diversity of small round cell sarcoma in soft tissues around bone among Indian patients. Bioinformation 2023; 19:871-875. [PMID: 37908610 PMCID: PMC10613818 DOI: 10.6026/97320630019871] [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: 08/01/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 11/02/2023] Open
Abstract
Round cell tumors are a group of malignant tumors which shows overlapping microscopic features of small round monotonous cells with hyper-chromatic nucleus. It mostly occurs in children, adolescent, and young adults. The ancillary technique to confirm the differential diagnosis of round cells sarcoma is immuno-histo chemistry (IHC). Therefore, it is of interest to document the diversity of small round cell sarcoma in soft tissues around bones among Indian patients using IHC. A total of 334 cases among Indians were studied. Among them 160 cases were Non-Hodgkin's Lymphoma, 82 cases are poorly differentiated carcinoma and 92 cases of round cell sarcoma. Out of 92 cases, there were (40%) 27 cases of Wilms tumour, with the highest incidence. The highest incidence was observed in 0-14 years of age group with highest incidence in males. The distribution and diverse histology of different small round cell sarcoma offers challenge in the diagnosis by histopathology. Most frequent round cell tumour is Wilms tumour, followed by Rhabdomyosarcoma. Data shows the role of IHC in classifying soft tissue sarcoma but some time result of IHC remains inconclusive, where cytogenetic is important.
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Affiliation(s)
- Rani Singh Guddi
- />Department of Pathology, Indira Gandhi Institute of Medical Sciences, Bihar, India
| | - Kumari Bharti
- />Department of Pathology, Indira Gandhi Institute of Medical Sciences, Bihar, India
| | - Anuja Mishra
- />PathologyConsultant Pathologist, Indira Pathlabs (A unit of Indira IVF Pvt. Ltd.), Patna, Bihar, India
| | - Dinesh Kumar Sinha
- />Department of Radiation Oncology, Indira Gandhi Institute of Medical Sciences, Bihar, India
| | | | - Shabana Azad
- />Oncopathology, Homi Bhabha Cancer Hospital, Varanasi, Uttar Pradesh, India
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198
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Tan YL, Ong W, Tan JH, Kumar N, Hallinan JTPD. Epithelioid Sarcoma of the Spine: A Review of Literature and Case Report. J Clin Med 2023; 12:5632. [PMID: 37685699 PMCID: PMC10488709 DOI: 10.3390/jcm12175632] [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: 07/21/2023] [Revised: 08/24/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
Epithelioid sarcoma is a rare malignant mesenchymal tumor that represents less than 1% of soft-tissue sarcomas. Despite its slow growth, the overall prognosis is poor with a high rate of local recurrence, lymph-node spread, and hematogenous metastasis. Primary epithelioid sarcoma arising from the spine is extremely rare, with limited data in the literature. We review the existing literature regarding spinal epithelioid sarcoma and report a case of epithelioid sarcoma arising from the spinal cord. A 54 year old male presented with a 1-month history of progressive left upper-limb weakness and numbness. Magnetic resonance imaging (MRI) of the spine showed an enhancing intramedullary mass at the level of T1 also involving the left T1 nerve root. Systemic radiological examination revealed no other lesion at presentation. Surgical excision of the mass was performed, and histology was consistent with epithelioid sarcoma of the spine. Despite adjuvant radiotherapy, there was aggressive local recurrence and development of intracranial metastatic spread. The patient died of the disease within 5 months from presentation. To the best of our knowledge, spinal epithelioid sarcoma arising from the spinal cord has not yet been reported. We review the challenges in diagnosis, surgical treatment, and oncologic outcome of this case.
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Affiliation(s)
- Yi Liang Tan
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore; (W.O.); (J.T.P.D.H.)
| | - Wilson Ong
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore; (W.O.); (J.T.P.D.H.)
| | - Jiong Hao Tan
- University Spine Centre, Department of Orthopaedic Surgery, National University Health System, 1E, Lower Kent Ridge Road, Singapore 119228, Singapore; (J.H.T.); (N.K.)
| | - Naresh Kumar
- University Spine Centre, Department of Orthopaedic Surgery, National University Health System, 1E, Lower Kent Ridge Road, Singapore 119228, Singapore; (J.H.T.); (N.K.)
| | - James Thomas Patrick Decourcy Hallinan
- Department of Diagnostic Imaging, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore; (W.O.); (J.T.P.D.H.)
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore
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Iluz A, Maoz M, Lavi N, Charbit H, Or O, Olshinka N, Demma JA, Adileh M, Wygoda M, Blumenfeld P, Gliner-Ron M, Azraq Y, Moss J, Peretz T, Eden A, Zick A, Lavon I. Rapid Classification of Sarcomas Using Methylation Fingerprint: A Pilot Study. Cancers (Basel) 2023; 15:4168. [PMID: 37627196 PMCID: PMC10453223 DOI: 10.3390/cancers15164168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Sarcoma classification is challenging and can lead to treatment delays. Previous studies used DNA aberrations and machine-learning classifiers based on methylation profiles for diagnosis. We aimed to classify sarcomas by analyzing methylation signatures obtained from low-coverage whole-genome sequencing, which also identifies copy-number alterations. DNA was extracted from 23 suspected sarcoma samples and sequenced on an Oxford Nanopore sequencer. The methylation-based classifier, applied in the nanoDx pipeline, was customized using a reference set based on processed Illumina-based methylation data. Classification analysis utilized the Random Forest algorithm and t-distributed stochastic neighbor embedding, while copy-number alterations were detected using a designated R package. Out of the 23 samples encompassing a restricted range of sarcoma types, 20 were successfully sequenced, but two did not contain tumor tissue, according to the pathologist. Among the 18 tumor samples, 14 were classified as reported in the pathology results. Four classifications were discordant with the pathological report, with one compatible and three showing discrepancies. Improving tissue handling, DNA extraction methods, and detecting point mutations and translocations could enhance accuracy. We envision that rapid, accurate, point-of-care sarcoma classification using nanopore sequencing could be achieved through additional validation in a diverse tumor cohort and the integration of methylation-based classification and other DNA aberrations.
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Affiliation(s)
- Aviel Iluz
- Leslie and Michael Gaffin Center for Neuro-Oncology, Hadassah Medical Center and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
- Agnes Ginges Center for Human Neurogenetics, Department of Neurology, Hadassah Medical Center and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Myriam Maoz
- Oncology Department, Sharett Institute of Oncology, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Nir Lavi
- Leslie and Michael Gaffin Center for Neuro-Oncology, Hadassah Medical Center and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
- Agnes Ginges Center for Human Neurogenetics, Department of Neurology, Hadassah Medical Center and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
- Department of Military Medicine and “Tzameret”, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Hanna Charbit
- Leslie and Michael Gaffin Center for Neuro-Oncology, Hadassah Medical Center and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
- Agnes Ginges Center for Human Neurogenetics, Department of Neurology, Hadassah Medical Center and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Omer Or
- Orthopedic Department, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Noam Olshinka
- Orthopedic Department, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Jonathan Abraham Demma
- Surgical Department, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Mohammad Adileh
- Surgical Department, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Marc Wygoda
- Radiotherapy Institute, Sharett Institute of Oncology, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Philip Blumenfeld
- Radiotherapy Institute, Sharett Institute of Oncology, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Masha Gliner-Ron
- Radiology Department, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Yusef Azraq
- Radiology Department, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Joshua Moss
- Oncology Department, Sharett Institute of Oncology, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Tamar Peretz
- Oncology Department, Sharett Institute of Oncology, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Amir Eden
- Department of Genetics, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Aviad Zick
- Oncology Department, Sharett Institute of Oncology, Hadassah Medical Organization and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Iris Lavon
- Leslie and Michael Gaffin Center for Neuro-Oncology, Hadassah Medical Center and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
- Agnes Ginges Center for Human Neurogenetics, Department of Neurology, Hadassah Medical Center and Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
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Zhao Z, Chen X, Xu J, Shi Y, Mak TK, Huo M, Zhang C. Whole exome sequencing of well-differentiated liposarcoma and dedifferentiated liposarcoma in older woman: a case report. Front Med (Lausanne) 2023; 10:1237246. [PMID: 37649981 PMCID: PMC10464618 DOI: 10.3389/fmed.2023.1237246] [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: 06/12/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
Background Common kinds of soft tissue sarcomas (STS) include well-differentiated liposarcoma (WDLPS) and dedifferentiated liposarcoma (DDLPS). In this case, we present a comprehensive clinical profile of a patient who underwent multiple recurrences during the progression from WDLPS to DDLPS. Case presentation A 62-year-old Asian female underwent retroperitoneal resection of a large tumor 11 years ago, the initial pathology revealed a fibrolipoma-like lesion. Over the next six years, the patient underwent three resections for recurrence of abdominal tumors. Postoperative histology shows mature adipose tissue with scattered "adipoblast"-like cells with moderate-to-severe heterogeneous spindle cells, pleomorphic cells, or tumor giant cells. Immunohistochemistry (IHC) demonstrated positive staining for MDM2 and CDK4, confirming that the abdominal tumor was WDLPS and gradually progressing to DDLPS. Post-operative targeted sequencing and IHC confirmed the POC1B::ROS1 fusion gene in DDLPS. Whole-exome sequencing (WES) revealed that WDLPS and DDLPS shared similar somatic mutations and copy number variations (CNVs), whereas DDLPS had more mutated genes and a higher and more concentrated amplification of the chromosome 12q region. Furthermore, somatic mutations in DDLPS were significantly reduced after treatment with CDK4 inhibitors, while CNVs remained elevated. Conclusion Due to the high likelihood of recurrence of liposarcoma, various effective treatments should be taken into consideration even if surgery is the primary treatment for recurrent liposarcoma. To effectively control the course of the disease following surgery, combination targeted therapy may be a viable alternative to chemotherapy and radiotherapy in the treatment of liposarcoma.
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Affiliation(s)
- Zidan Zhao
- Digestive Diseases Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Xiaoyan Chen
- Digestive Diseases Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Jie Xu
- Department of Pathology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Yuntao Shi
- Digestive Diseases Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Tsz Kin Mak
- Digestive Diseases Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Mingyu Huo
- Digestive Diseases Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
- Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Changhua Zhang
- Digestive Diseases Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
- Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, China
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