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Miller J, Fitzpatrick B, Begley B, Frank S, Mazzei C, Giacalone J, Wittig J. Presentation, treatment, and outcomes of chondrosarcoma in young adult patients less than age 50: A case series of ten patients. J Cancer Res Ther 2024; 20:1061-1065. [PMID: 39023620 DOI: 10.4103/jcrt.jcrt_2392_21] [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: 12/29/2021] [Accepted: 01/24/2023] [Indexed: 07/20/2024]
Abstract
ABSTRACT Chondrosarcoma is an aggressive bone tumor typically affecting older adults in the 6th and 7th decade. These tumors often present as painful masses in the pelvis, ribs, and long bones and have certain characteristic features on the imaging leading to the diagnosis. The occurrence of these tumors in the young adult population is a rare condition that is not well described. Often, they may be confused with benign counterparts, enchondroma or osteochondroma, which does not require any treatment and are very common. The aim of this case series was to analyze the patient presentation and radiographic image findings as well as surgical treatment and outcomes of ten young adults with chondrosarcoma over a three-year period. Overall, imaging of these tumors in young adults did not necessarily demonstrate all typical features of chondrosarcomas such as endosteal scalloping, calcifications, lobular growth, and high uptake on whole-body bone scans. One patient in the case series passed away from complications from dedifferentiated chondrosarcoma, and nine patients have recovered with no local recurrence.
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Affiliation(s)
- Justin Miller
- Department of Orthopedic Surgery, Morristown Medical Center, Morristown, NJ, United States
| | - Brendan Fitzpatrick
- Jacobs School of Medicine and Biomedical Sciences - University at Buffalo, Buffalo, NY, United States
| | - Brian Begley
- Medical student, Cooper Medical School of Rowan University, Camden, NJ, United States
| | - Samantha Frank
- Department of Orthopedic Surgery, Morristown Medical Center, Morristown, NJ, United States
| | - Christopher Mazzei
- Department of Orthopedic Surgery, Morristown Medical Center, Morristown, NJ, United States
| | - Joseph Giacalone
- Department of Orthopedic Surgery, Morristown Medical Center, Morristown, NJ, United States
| | - James Wittig
- Department of Orthopedic Surgery, Morristown Medical Center, Morristown, NJ, United States
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2
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Song C, Zhang Y, Cheng J. Extraskeletal Mesenchymal Chondrosarcoma in Nasal Cavity: A Rare Case Report. EAR, NOSE & THROAT JOURNAL 2024; 103:25-28. [PMID: 34318691 DOI: 10.1177/01455613211029797] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Extraskeletal mesenchymal chondrosarcoma (ESMC) originate from the nasal cavity have rarely been reported, especially its imaging features, which makes the preoperative diagnosis difficult. Here, we report the clinical, computed tomography, and magnetic resonance imaging features of a 60-year-old female patient with pathologically confirmed ESMC in the nasal cavity to help provide more reference for diagnosis before operation. Extraskeletal mesenchymal chondrosarcoma in the nasal cavity demonstrates typical imaging features, such as mesh-like enhancement, calcification, hemorrhage, necrosis, cystic degeneration, and so on.
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Affiliation(s)
- Chengru Song
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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3
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Dang HN, Tran PA, Dang TN, Le TT, Le VT, Nguyen HH, Luong HT. Pancreatic metastasis of mesenchymal chondrosarcoma: a surgical case report and review of literature. Ann Med Surg (Lond) 2024; 86:580-587. [PMID: 38222770 PMCID: PMC10783418 DOI: 10.1097/ms9.0000000000001549] [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: 10/21/2023] [Accepted: 11/19/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction Mesenchymal chondrosarcoma (MC) is a rapidly progressive sarcoma that predominantly impacts the bones. Making up only 3% of chondrosarcomas, about one-third of these tumours develop in extra-skeletal sites. Case presentation The authors present a clinical case of a 42-year-old patient who was diagnosed with MC 8 years ago, now admitted to the hospital with a palpable epigastric mass. Clinical and laboratory examinations showed consistent results for MC tumours, with metastasis to the body and tail of the pancreas and invasion of the splenic vein. Surgical resection and systemic screening were performed to ensure that there were no lesions elsewhere. Regular follow-up has found no localized lesions or complications after 15 months. Clinical discussion Metastatic extra-skeletal mesenchymal chondrosarcoma of the pancreas is exceptionally rare. To our current understanding, only 14 such cases have been documented in medical literature. The symptoms of pancreatic metastasis are diverse and the radiographic features of metastatic mesenchymal chondrosarcoma are not typically distinct. Conclusions Although MC tumours do not frequently occur in sites other than the axial system, a tumour presenting later in a patient with a history of MC should be reviewed to confirm the diagnosis of metastatic MC. Treatment can vary between surgery, radiation therapy and systemic therapy.
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Affiliation(s)
- Hung N. Dang
- Departement of Abdominal Surgery, Hue Central Hospital
| | - Phong A. Tran
- Departement of Abdominal Surgery, Hue Central Hospital
| | | | - Thai T. Le
- Departement of Abdominal Surgery, Hue Central Hospital
| | - Vi T.T. Le
- Radiology, Hue University of Medicine and Pharmacy, Hue, Vietnam
| | - Hau H.T. Nguyen
- Faculty of Medicine, College of Medicine and Pharmacy, Duy Tan University
- Insitute for Research and Training in Medicine, Biology and Pharmacy, Duy Tan University, Da Nang
| | - Hiep T. Luong
- Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, Vietnam
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Shahnazari R, Montazer F, Shirzadi S, Karaji S. Extraskeletal mesenchymal chondrosarcoma arising from soft tissues: A rare case report. Cancer Rep (Hoboken) 2023; 6:e1883. [PMID: 37559178 PMCID: PMC10598256 DOI: 10.1002/cnr2.1883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Chondrosarcomas are an exceedingly rare form of cancer, impacting only a few individuals per million. Among chondrosarcomas, a small fraction belongs to the mesenchymal sub-type. Furthermore, only one-third of mesenchymal chondrosarcomas manifest in extraskeletal locations. CASE A 38-year-old woman was referred by a midwife after experiencing pain in the right upper quadrant of her right breast for 2 months. The mass had been palpable for 1 week before the initial assessment. According to radiological evaluations, the tumor is outside breast tissue and not connected to the bones. Hence, a biopsy of the mass is done. The biphasic morphology of the tumor during pathological evaluation, in addition to immunohistochemistry testing, confirms the diagnosis of extraskeletal mesenchymal chondrosarcoma (EMCS). Finally, the mass was surgically removed, and 6 months of chemotherapy were administered to the patient. CONCLUSION Given the tumor's rarity and the lack of established guidelines, diagnosing EMCS can be challenging and prone to errors. As such, meticulous sampling, along with precise pathological and imaging investigations, is imperative to accurately establish the diagnosis of these tumors.
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Affiliation(s)
- Razieh Shahnazari
- Radiology Department of Iran University of Medical Sciences (IUMS)TehranIran
| | - Fatemeh Montazer
- Firoozabadi Clinical Research Development Unit (FACRDU)Iran University of Medical Sciences (IUMS)TehranIran
| | - Shahriar Shirzadi
- Radiology Department of Hamedan University of Medical SciencesHamedan University of Medical SciencesHamedanIran
| | - Sina Karaji
- Radiology Department of Iran University of Medical Sciences (IUMS)TehranIran
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Hayashida S, Ikenaga N, Nakata K, Nakamura S, Abe T, Ideno N, Endo M, Noguchi S, Oda Y, Nakamura M. Repeated robotic pancreatectomy for recurrent pancreatic metastasis of mesenchymal chondrosarcoma: A case report. Asian J Endosc Surg 2023; 16:795-799. [PMID: 37574440 DOI: 10.1111/ases.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/31/2023] [Indexed: 08/15/2023]
Abstract
Mesenchymal chondrosarcoma is a rare subset of sarcomas accounting for 3%-10% of all cases of chondrosarcomas. Radical resection is the only curative strategy, even in patients with metastatic tumors. However, data regarding treatment strategies remain limited owing to the small number of cases. Herein, we report a patient who underwent repeated robotic pancreatectomy for recurrent pancreatic metastasis originating from extraskeletal mesenchymal chondrosarcoma of the pelvis. First, robotic pancreaticoduodenectomy with a reconstruction of pancreaticogastrostomy was performed for synchronous pancreatic metastasis 5 months after the primary resection of mesenchymal chondrosarcoma. Ten months after robotic pancreaticoduodenectomy, tumor recurrence was observed at the tail end of the pancreas, which was removed by reperforming robotic distal pancreatectomy. Given the precise tissue manipulation that can be achieved with robotic articulated forceps, the peripheral splenic artery and pancreas were easily isolated and divided in close proximity to the tumor. The central part of the pancreas was preserved. Robotic surgery allowed safe and effective resection of the reconstructed remnant pancreas. The patient survived for 28 months after primary tumor resection. Repeated pancreatectomy with minimally invasive techniques is a feasible and curative treatment for metastatic mesenchymal chondrosarcoma.
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Affiliation(s)
- Sayuri Hayashida
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Ikenaga
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohei Nakata
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - So Nakamura
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiya Abe
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noboru Ideno
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Makoto Endo
- Department of Orthopedics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shoko Noguchi
- Department of Diagnostic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Diagnostic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Nakamura
- Departments of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Gómez-León N, Galán-González I, Moreno-Casado MJ, Benavides-de-Quirós C, Muñoz-Hernández P, Fernández-Rico P, Rodríguez-Laval V. Chondroid Tumors: Review of Salient Imaging Features and Update on the WHO Classification. Curr Probl Diagn Radiol 2023; 52:197-211. [PMID: 36797102 DOI: 10.1067/j.cpradiol.2023.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 11/17/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
Chondrogenic tumors are typically well recognized on radiographs, but differentiation between benign and malignant cartilaginous lesions can be difficult both for the radiologist and for the pathologist. Diagnosis is based on a combination of clinical, radiological and histological findings. While treatment of benign lesions does not require surgery, the only curative treatment for chondrosarcoma is resection. This article (1) emphasizes the update of the WHO classification and its diagnostic and clinical effects; (2) describes the imaging features of the various types of cartilaginous tumors, highlighting findings that can help differentiate benign from malignant lesions; (3) presents differential diagnoses; and (4) provides pathologic correlation. We attempt to offer valuable clues in the approach to this vast entity.
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Affiliation(s)
- Nieves Gómez-León
- Department of Radiology, Princesa Hospital, Autónoma University, Madrid, Spain.
| | - Itxaso Galán-González
- Department of Radiology, University Hospital La Princesa, Madrid, Spain; Health Research Institute Princesa, Autonomous University of Madrid, Madrid, Spain
| | | | - Carmen Benavides-de-Quirós
- Department of Radiology, University Hospital La Princesa, Madrid, Spain; Health Research Institute Princesa, Autonomous University of Madrid, Madrid, Spain
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7
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Kim JH, Lee SK. Classification of Chondrosarcoma: From Characteristic to Challenging Imaging Findings. Cancers (Basel) 2023; 15:cancers15061703. [PMID: 36980590 PMCID: PMC10046282 DOI: 10.3390/cancers15061703] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
Chondrosarcomas can be classified into various forms according to the presence or absence of a precursor lesion, location, and histological subtype. The new 2020 World Health Organization (WHO) Classification of Tumors of Soft Tissue and Bone classifies chondrogenic bone tumors as benign, intermediate (locally aggressive), or malignant, and separates atypical cartilaginous tumors (ACTs) and chondrosarcoma grade 1 (CS1) as intermediate and malignant tumors. respectively. Furthermore, the classification categorizes chondrosarcomas (including ACT) into eight subtypes: central conventional (grade 1 vs. 2–3), secondary peripheral (grade 1 vs. 2–3), periosteal, dedifferentiated, mesenchymal, and clear cell chondrosarcoma. Most chondrosarcomas are the low-grade, primary central conventional type. The rarer subtypes include clear cell, mesenchymal, and dedifferentiated chondrosarcomas. Comprehensive analysis of the characteristic imaging findings can help differentiate various forms of chondrosarcomas. However, distinguishing low-grade chondrosarcomas from enchondromas or high-grade chondrosarcomas is radiologically and histopathologically challenging, even for experienced radiologists and pathologists.
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Affiliation(s)
- Jun-Ho Kim
- Department of Orthopaedic Surgery, Center for Joint Diseases, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea
| | - Seul Ki Lee
- Department of Radiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Correspondence:
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Pan SY, Lai CZ, Chen WC, Chen YH, Lin CH, Chang H, Huang CP, Yeh CC. Chondrosarcoma of Ureter in an Elderly Patient: A Case Report. Medicina (B Aires) 2023; 59:medicina59030454. [PMID: 36984455 PMCID: PMC10051176 DOI: 10.3390/medicina59030454] [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: 01/27/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 02/26/2023] Open
Abstract
Chondrosarcoma is a rare type of cancer that can affect the upper urinary tract. Because of its rarity, the clinical presentation of chondrosarcoma can be similar to other urinary tract conditions, such as renal colic, hematuria, and urothelial carcinoma. The primary treatment for chondrosarcoma is the surgical removal of the tumor, and radiation or chemotherapy may be used for advanced cases. However, because of the limited number of patients with this condition, there are no established guidelines for chemotherapy, and the outcomes are unclear. In this case, we present a 71-year-old female patient who was diagnosed with ureteral chondrosarcoma. She presented with abdominal pain and hydronephrosis, and a tumor was found beneath a small stone. The patient underwent nephroureterectomy and received oral fluorouracil chemotherapy due to the advanced stage of the disease. Fortunately, the patient survived, and at the 7 months post-operative follow-up there was no evidence of recurrence. In conclusion, the chondrosarcoma of the upper urinary tract is a rare condition that can be difficult to diagnose due to its similarity to other urinary tract conditions. Treatment typically involves the surgical removal of the tumor, with radiation or chemotherapy reserved for advanced cases. However, because of the limited number of patients, there are no established guidelines for chemotherapy, and the outcomes of treatment are unclear.
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Affiliation(s)
- Szu-Ying Pan
- Department of Urology, China Medical University Hospital, Taichung 404332, Taiwan
| | - Chien-Zhi Lai
- School of Medicine, College of Medicine, China Medical University, Taichung 404333, Taiwan
| | - Wen-Chi Chen
- Department of Urology, China Medical University Hospital, Taichung 404332, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413305, Taiwan
| | - Che-Hung Lin
- Division of Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung 404332, Taiwan
| | - Han Chang
- School of Medicine, College of Medicine, China Medical University, Taichung 404333, Taiwan
- Department of Pathology, China Medical University Hospital, Taichung 404332, Taiwan
| | - Chi-Ping Huang
- Department of Urology, China Medical University Hospital, Taichung 404332, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 404333, Taiwan
| | - Ching-Chung Yeh
- Department of Urology, China Medical University Hospital, Taichung 404332, Taiwan
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9
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Esfahani MM, Mirazimi SMA, Azadbakht J, Dashti F. Retroperitoneal mesenchymal chondrosarcoma with metastasis to iliac vein: A rare case report and review of the literature. Clin Case Rep 2022; 10:e6633. [DOI: 10.1002/ccr3.6633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Mahsa Masjedi Esfahani
- Department of Diagnostic Radiology, Kashan School of Medicine Kashan University of Medical Sciences Kashan Iran
| | - Seyed Mohammad Ali Mirazimi
- Department of Diagnostic Radiology, Kashan School of Medicine Kashan University of Medical Sciences Kashan Iran
| | - Javid Azadbakht
- Department of Diagnostic Radiology, Kashan School of Medicine Kashan University of Medical Sciences Kashan Iran
| | - Fatemeh Dashti
- Department of Diagnostic Radiology, Kashan School of Medicine Kashan University of Medical Sciences Kashan Iran
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Safaric Tepes P, Segovia D, Jevtic S, Ramirez D, Lyons SK, Sordella R. Patient-derived xenografts and in vitro model show rationale for imatinib mesylate repurposing in HEY1-NCoA2-driven mesenchymal chondrosarcoma. J Transl Med 2022; 102:1038-1049. [PMID: 36775418 DOI: 10.1038/s41374-021-00704-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 01/17/2023] Open
Abstract
Mesenchymal chondrosarcoma (MCS) is a high-grade malignancy that represents 2-9% of chondrosarcomas and mostly affects children and young adults. HEY1-NCoA2 gene fusion is considered to be a driver of tumorigenesis and it has been identified in 80% of MCS tumors. The shortage of MCS samples and biological models creates a challenge for the development of effective therapeutic strategies to improve the low survival rate of MCS patients. Previous molecular studies using immunohistochemical staining of patient samples suggest that activation of PDGFR signaling could be involved in MCS tumorigenesis. This work presents the development of two independent in vitro and in vivo models of HEY1-NCoA2-driven MCS and their application in a drug repurposing strategy. The in vitro model was characterized by RNA sequencing at the single-cell level and successfully recapitulated relevant MCS features. Imatinib, as well as specific inhibitors of ABL and PDGFR, demonstrated a highly selective cytotoxic effect targeting the HEY1-NCoA2 fusion-driven cellular model. In addition, patient-derived xenograft (PDX) models of MCS harboring the HEY1-NCoA2 fusion were developed from a primary tumor and its distant metastasis. In concordance with in vitro observations, imatinib was able to significantly reduce tumor growth in MCS-PDX models. The conclusions of this study serve as preclinical results to revisit the clinical efficacy of imatinib in the treatment of HEY1-NCoA2-driven MCS.
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Affiliation(s)
- Polona Safaric Tepes
- Cold Spring Harbor Laboratory, 1 Bungtown Road, Cold Spring Harbor, NY, 11724, USA.
- Faculty of Pharmacy, University of Ljubljana, Kongresni trg 12, 1000, Ljubljana, Slovenia.
| | - Danilo Segovia
- Cold Spring Harbor Laboratory, 1 Bungtown Road, Cold Spring Harbor, NY, 11724, USA
- Graduate Program in Molecular and Cellular Biology, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY, 11794, USA
| | - Sania Jevtic
- Phytoform Labs Ltd., Lawes Open Innovation Hub, West Common, Harpenden, Hertfordshire, England, UK
| | - Daniel Ramirez
- Hospital for Special Surgery, Pathology and Laboratory Medicine, 535 E 70th St, New York, NY, 10021, USA
| | - Scott K Lyons
- Cold Spring Harbor Laboratory, 1 Bungtown Road, Cold Spring Harbor, NY, 11724, USA
| | - Raffaella Sordella
- Cold Spring Harbor Laboratory, 1 Bungtown Road, Cold Spring Harbor, NY, 11724, USA
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11
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Strach MC, Grimison PS, Hong A, Boyle R, Stalley P, Karim R, Connolly EA, Bae S, Desai J, Crowe P, Singhal N, Bhadri VA. Mesenchymal chondrosarcoma: An Australian multi-centre cohort study. Cancer Med 2022; 12:368-378. [PMID: 35603739 PMCID: PMC9844591 DOI: 10.1002/cam4.4849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/29/2022] [Accepted: 05/04/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Mesenchymal chondrosarcoma (MCS) is an ultra-rare sarcoma that follows a more aggressive course than conventional chondrosarcoma. This study evaluates prognostic factors, treatments (surgery, chemotherapy, and radiation), and outcomes in an Australian setting. METHODS We collected demographics, clinicopathological variables, treatment characteristics, and survival status from patients with MCS registered on the national ACCORD sarcoma database. Outcomes include overall survival (OS) and progression-free survival (PFS). RESULTS We identified 22 patients with MCS between 2001-2022. Median age was 28 (range 10-59) years, 19 (86%) had localised disease at diagnosis of whom 16 had surgery (84%), 11 received radiation (58%), and 10 chemotherapy (53%). Ten (52%) developed recurrence and/or metastases on follow-up and three patients with initial metastatic disease received surgery, radiation, and chemotherapy. At a median follow-up of 50.9 (range 0.4-210) months nine patients had died. The median OS was 104.1 months (95% CI 25.8-182.3). There was improved OS for patients with localised disease who had surgical resection of the primary (p = 0.003) and those with ECOG 0-1 compared to 2-3 (p = 0.023) on univariate analysis. CONCLUSIONS This study demonstrates contemporary Australian treatment patterns of MCS. The role of chemotherapy for localised disease remains uncertain. Understanding treatment patterns and outcomes help support treatment decisions and design of trials for novel therapeutic strategies.
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Affiliation(s)
- Madeleine C. Strach
- Chris O'Brien LifehouseSydneyNew South WalesAustralia,Royal Prince Alfred HospitalSydneyNew South WalesAustralia,The University of SydneyFaculty of Medicine and HealthSydneyNew South WalesAustralia,Present address:
The Christie NHS Foundation TrustManchesterUK
| | - Peter S. Grimison
- Chris O'Brien LifehouseSydneyNew South WalesAustralia,Royal Prince Alfred HospitalSydneyNew South WalesAustralia
| | - Angela Hong
- Chris O'Brien LifehouseSydneyNew South WalesAustralia
| | - Richard Boyle
- Chris O'Brien LifehouseSydneyNew South WalesAustralia,Royal Prince Alfred HospitalSydneyNew South WalesAustralia
| | - Paul Stalley
- Chris O'Brien LifehouseSydneyNew South WalesAustralia,Royal Prince Alfred HospitalSydneyNew South WalesAustralia
| | | | | | - Susie Bae
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia,Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Jayesh Desai
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia,Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Philip Crowe
- Prince of Wales HospitalSydneyNew South WalesAustralia
| | - Nimit Singhal
- Cancer Centre, Royal Adelaide Hospital and Department of MedicineUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Vivek A. Bhadri
- Chris O'Brien LifehouseSydneyNew South WalesAustralia,Royal Prince Alfred HospitalSydneyNew South WalesAustralia,The University of SydneyFaculty of Medicine and HealthSydneyNew South WalesAustralia
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12
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Reeves H, Smalle T. Complete surgical excision of a high‐grade extraskeletal mesenchymal chondrosarcoma, resulting in a longer survival than previously reported. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Hannah Reeves
- Translational Research and Animal Clinical Trial Study (TRACTS) Group U‐VET Animal Hospital, Melbourne, Veterinary School, Faculty of Veterinary and Agricultural Sciences University of Melbourne Werribee Melbourne VIC Australia
| | - Tesh Smalle
- Translational Research and Animal Clinical Trial Study (TRACTS) Group U‐VET Animal Hospital, Melbourne, Veterinary School, Faculty of Veterinary and Agricultural Sciences University of Melbourne Werribee Melbourne VIC Australia
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13
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Chen JJ, Chou CW. A Rare Case Report of Mesenchymal Chondrosarcoma with Pancreatic Metastasis. Medicina (B Aires) 2022; 58:medicina58050639. [PMID: 35630056 PMCID: PMC9144319 DOI: 10.3390/medicina58050639] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/28/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Mesenchymal chondrosarcoma is a rare but aggressive subtype of sarcoma. The majority of involvement locates in the axial skeleton. Treatment modalities include radical surgery, local radiotherapy, and systemic chemotherapy. However, the long-term survival outcome remains poor. Case presentation: We present the case of a 33-year-old male with a palpable chest wall mass for one year, diagnosed with mesenchymal chondrosarcoma with surgical removal. Later, he had an unusual pancreatic tail tumor as the first presentation of disease metastasis which was proven by surgical resection one year later. Conclusion: Although mesenchymal chondrosarcoma locates mainly in the axial skeletal system, extra-skeletal soft tissue or organ involvement might be seen occasionally. Active surveillance with multidisciplinary team management could significantly prolong survival outcomes.
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Affiliation(s)
- Jian-Jiun Chen
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Cheng-Wei Chou
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan
- Correspondence:
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14
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Extraskeletal Mesenchymal Chondrosarcoma of the Uterus. Diagnostics (Basel) 2022; 12:diagnostics12030643. [PMID: 35328196 PMCID: PMC8946862 DOI: 10.3390/diagnostics12030643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/28/2022] [Accepted: 03/04/2022] [Indexed: 11/17/2022] Open
Abstract
Mesenchymal chondrosarcoma is an uncommon malignant mesenchymal tumor with an aggressive behavior. Diagnoses of mesenchymal chondrosarcoma are established based on histomorphological, immunohistochemical, and molecular findings. Only one case of extraskeletal mesenchymal chondrosarcoma (EMC) of the uterus has been reported. This article presents the second case of primary uterine EMC, occurring in a 33-year-old woman. We describe the histological and immunophenotypical features of EMC. Our observations will help pathologists and clinicians perform accurate histological diagnoses of uterine EMC and plan appropriate treatment strategies for this rare tumor.
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Pruthi H, Bhujade H, Kundu R, Gy S. Bilateral renal metastases from extraskeletal mesenchymal chondrosarcoma of thigh. BMJ Case Rep 2022; 15:e246375. [PMID: 34996769 PMCID: PMC8744114 DOI: 10.1136/bcr-2021-246375] [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] [Accepted: 12/09/2021] [Indexed: 11/04/2022] Open
Abstract
Mesenchymal chondrosarcoma (MC) is a rare cartilaginous tumour that occurs in the extraskeletal locations in about one-third of cases. It is aggressive in behaviour and may involve the lower extremities, central nervous system or spine. Mesenchymal tumours are known for distant metastasis; however, metastasis to bilateral kidneys after treatment has not been reported earlier. We present a case of a soft-tissue intramuscular MC of the thigh in a 38-year-old patient which had been surgically excised after neoadjuvant chemotherapy. The patient presented with bilateral dense calcified renal masses after 6 years, which were cytologically proven as MC metastases. In the evaluation of bilateral calcified renal masses in patients with a history of MC, metastasis should be considered.
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Affiliation(s)
- Himanshu Pruthi
- Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Harish Bhujade
- Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Reetu Kundu
- Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Srinivasa Gy
- Radiotherapy and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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16
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Mahajan A, Shukla S, Agarwal U, Patil V, Rane S, Menon N, Noronha V, Patil V, Prabhash K. Diagnostic quandary over a cheek(y) neoplasm. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_274_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Hameed M. Malignant Cartilage-Forming Tumors. Surg Pathol Clin 2021; 14:605-617. [PMID: 34742483 DOI: 10.1016/j.path.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chondrosarcomas are heterogeneous matrix-producing cartilaginous neoplasms with variable clinical behavior. Subtypes include conventional (75%), dedifferentiated (10%), clear cell (2%), mesenchymal (2%), and periosteal chondrosarcoma (<1%). Tumor location and primary vs secondary also play a role. In conventional chondrosarcoma, histologic grading (I, II, and III) remains the gold standard for predicting recurrence and metastases. Due to the locally aggressive but overall nonmetastatic behavior, grade I chondrosarcomas (primary and secondary) of long and short tubular bones have been reclassified as atypical cartilaginous tumor. In this review, the pathologic features of malignant cartilage tumors are discussed with updates on recent genetic findings.
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Affiliation(s)
- Meera Hameed
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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18
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Goldenberg M, Ramgopal AA, Salgado CM, Reyes-Múgica M, Malek MM, Tersak JM. Mesenchymal chondrosarcoma of the chest wall in an adolescent patient: A case report and brief review of the literature. Cancer Rep (Hoboken) 2021; 5:e1453. [PMID: 34132499 PMCID: PMC8789610 DOI: 10.1002/cnr2.1453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/24/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Mesenchymal chondrosarcoma is a rare and aggressive bone tumor with few reports of primary tumor in the chest wall. Case We report a case of a 17‐year‐old male presenting with back pain and a posterior mediastinal mass. Imaging demonstrated what was thought to be a benign chondral tumor. The patient underwent resection which confirmed extraskeletal mesenchymal chondrosarcoma. The patient declined proposed adjuvant chemotherapy and underwent multiple resections for rapid local reoccurrence. He ultimately elected for hospice care. Conclusion The case highlights the importance of close disease monitoring and exploration of treatment options, given lack of established guidelines and consistent tumor features.
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Affiliation(s)
- Marti Goldenberg
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Archana Ar Ramgopal
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Cláudia M Salgado
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Miguel Reyes-Múgica
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marcus M Malek
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jean M Tersak
- UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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19
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Hasegawa H, Vakharia K, Graffeo CS, Carlson ML, Pollock BE, Brown PD, Perry A, Van Gompel JJ, Driscoll CLW, Link MJ. Long-term outcomes of grade I/II skull base chondrosarcoma: an insight into the role of surgery and upfront radiotherapy. J Neurooncol 2021; 153:273-281. [PMID: 33907967 DOI: 10.1007/s11060-021-03764-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/20/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To clarify the need for post-operative radiation treatment in skull base chondrosarcomas (SBCs). METHODS A retrospective analysis of patients with grade I or II SBC. Patients were divided according to post-surgical treatment strategies: (A) planned upfront radiotherapy and (B) watchful waiting. Tumor control and survival were compared between the treatment groups. The median follow-up after resection was 105 months (range, 9-376). RESULTS Thirty-two patients (Grade 1, n = 16; Grade 2, n = 16) were included. The most frequent location was petroclival (21, 64%). A gross total resection (GTR) was achieved in 11 patients (34%). Fourteen (44%) underwent upfront radiotherapy (group A) whereas 18 (56%) were followed with serial MRI alone (group B). The tumor control rate for the entire group was 77% and 69% at 10- and 15-year, respectively. Upfront radiotherapy (P = 0.25), extent of resection (P = 0.11) or tumor grade (P = 0.83) did not affect tumor control. The majority of Group B patients with recurrent tumors (5/7) obtained tumor control with repeat resection (n = 2), salvage radiotherapy (n = 2), or a combination of both (n = 1). The 10-year disease-specific survival was 95% with no difference between the group A and B (P = 0.50). CONCLUSION For patients with grade I/II SBC, a reasonable strategy is deferral of radiotherapy after maximum safe resection until tumor progression or recurrence. At that time, most patients can be successfully managed with salvage radiotherapy or surgery. Late recurrences may occur, and life-long follow-up is advisable.
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Affiliation(s)
- Hirotaka Hasegawa
- Departments of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.,Department of Neurosurgery, The University of Tokyo, Bunkyo, Tokyo, Japan
| | - Kunal Vakharia
- Departments of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Bruce E Pollock
- Departments of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Paul D Brown
- Departments of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Avital Perry
- Departments of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Michael J Link
- Departments of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
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20
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Meningeal mesenchymal chondrosarcoma: Case report. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.100914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Yao K, Duan Z, Yang S, Du Z, Wang Y, Qi X. OLIG2 Immunolabeling of Mesenchymal Chondrosarcoma: Report of 14 Cases. J Neuropathol Exp Neurol 2021; 79:959-965. [PMID: 32770197 DOI: 10.1093/jnen/nlaa079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 02/18/2020] [Accepted: 06/30/2020] [Indexed: 11/12/2022] Open
Abstract
Mesenchymal chondrosarcoma (MC) is a rare aggressive mesenchymal sarcoma. Specific markers for the differential diagnosis of MCs remain to be developed. OLIG2 expression has been reported only in neuroepithelial tumors. Recently, OLIG2 expression was found to be involved in the development of NCOA2 fusion-positive alveolar rhabdomyosarcomas. Therefore, we investigated whether OLIG2 expression could be used as a diagnostic marker for MC. We report the clinical pathological and immunohistochemical features of 14 MCs. All tumors showed typical pathological features including biphasic patterns with sheets of primitive round mesenchymal cells and interspersed islands of cartilage. These tumors expressed BCL2, SOX9, and CD99. OLIG2 was robustly expressed in 12/14 of MCs. NCOA2 rearrangement was found in 12 cases. OLIG2 expression was not found in the NCOA2 rearrangement-negative MCs. Notably, OLIG2 expression was not detected in 52 neoplasms (8 Ewing sarcomas, 23 hemangiopericytomas, and 21 chondrosarcomas) that are frequently misdiagnosed as MC. Our findings provide convincing evidence that OLIG2 can serve as a reliable marker in the differential diagnosis of MC and may be a unique neurodevelopmental gene expression signature for the NCOA2 rearranged MCs.
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Affiliation(s)
- Kun Yao
- Department of Pathology, San Bo Brain Hospital, Capital Medical University, Haidian District
| | - Zejun Duan
- Department of Pathology, San Bo Brain Hospital, Capital Medical University, Haidian District.,Department of Pathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shaomin Yang
- Department of Pathology, School of Basic Medical Sciences, Third Hospital, Peking University Health Science Center, Beijing
| | - Zunguo Du
- Department of Pathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yin Wang
- Department of Pathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xueling Qi
- Department of Pathology, San Bo Brain Hospital, Capital Medical University, Haidian District
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22
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Mesenchymal chondrosarcoma: imaging features and clinical findings. Skeletal Radiol 2021; 50:333-341. [PMID: 32734374 PMCID: PMC8491146 DOI: 10.1007/s00256-020-03558-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe imaging and clinical features of primary mesenchymal chondrosarcoma (MCS) and evaluate for presence of a distinct biphasic pattern on imaging. MATERIAL AND METHODS Patients with a pathologic diagnosis of MCS were identified along with imaging of their primary tumor. Size, location, appearance (lytic, sclerotic, or mixed), presence, extent and distribution of calcifications, cortical destruction, soft tissue extension, periosteal reaction, contrast enhancement, and radiotracer uptake were recorded. The presence of T2-hyperintense tumor lobules on MRI and a biphasic morphology (distinct calcified and non-calcified components) on CT were assessed. Presence and location of metastases were documented. RESULTS Twenty-three patients (mean age 28.0 ± 13.8 years) were reviewed (13 skeletal, 10 extraskeletal). Overall mean tumor size was 10.2 ± 7.2 cm, 7.1 ± 7.3 cm in non-metastatic and 13.2 ± 5.9 cm (p = 0.004) in metastatic cases. Locations were extremities (n = 11), head/neck (n = 4), chest wall (n = 4), pelvis (n = 3), and retroperitoneum (n = 1). Skeletal MCS were aggressive mixed lytic and sclerotic (n = 8), purely lytic (n = 4), or juxtacortical (n = 1) lesions with cortical destruction and soft tissue extension. Chondroid calcifications were common (80%). On MRI, the presence of T2-hyperintense lobules was seen in 35%. A biphasic morphology on imaging was seen in 30%. Metastases were common (52%) with the most common site being the lungs (75%). All tumors were hypermetabolic with a mean SUVmax of 14.3 (5.6-34) on PET/CT. CONCLUSION Skeletal MCS commonly present as aggressive lytic bone lesions with chondroid calcifications. A biphasic morphology was seen in one-third of cases. Metastases were common at initial presentation and more commonly seen with larger tumors.
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23
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Shah SN, Parameswaran A, Reddy PK. Metastatic Extraskeletal Mesenchymal Chondrosarcoma of the Pancreas: Report of an Unusual Case with Review of Literature. ASIAN JOURNAL OF ONCOLOGY 2021. [DOI: 10.1055/s-0040-1722807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
AbstractExtraskeletal mesenchymal chondrosarcoma (ESMC) metastasizing to the pancreas in isolation is a rare occurrence. We report a 49-year-old gentleman who had undergone excision of an ESMC of the thigh in 2009 and presented with sudden onset abdominal pain and icterus in 2019. Radiological imaging revealed calcified mass of the pancreas with multiple nodules with extension into the adipose tissue. Distal pancreatectomy was performed and the pathology revealed a bimorphic tumor composed of undifferentiated round blue cells with abrupt transition to hyaline cartilage, typical of mesenchymal chondrosarcoma. To the best of our knowledge, there are only seven prior cases of metastatic ESMC of the pancreas in the English literature. Surgical intervention appears to be the preferred modality of treatment for metastatic pancreatic tumors. These patients may have long latency period before metastasizing and seem to have a good survival period post excision.
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Affiliation(s)
- Saloni Naresh Shah
- Department of Histopathology and Cytology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Ashok Parameswaran
- Department of Histopathology and Cytology, Apollo Hospitals, Chennai, Tamil Nadu, India
| | - Prasanna Kumar Reddy
- Department of Surgical Gastroenterology and Minimal Access Surgery, Apollo Main Hospitals, Chennai, Tamil Nadu, India
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24
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To YH, Orme L, Lewin J. The Role of Systemic Therapies in the Management of Bone Sarcoma. Sarcoma 2021. [DOI: 10.1007/978-981-15-9414-4_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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25
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Improta L, Valeri S, Alloni R, Pagnoni C, Mallozzi Santa Maria F, Brunetti B, Greco C, Aprile I, Maselli M, Vincenzi B, Gronchi A. Locally recurrent extraskeletal myxoid chondrosarcoma of the shoulder: a case of complete neoadjuvant radiotherapy response. Clin Sarcoma Res 2020; 10:27. [PMID: 33308312 PMCID: PMC7731621 DOI: 10.1186/s13569-020-00150-8] [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: 06/11/2020] [Accepted: 12/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue tumor that typically affects the lower limbs of men between the ages of 50 and 60. EMC of the shoulder is rare with a high risk of local recurrence and distant metastasis. A planned surgical excision in sarcoma referral centers (SRCs) is mandatory to obtain the best outcome. The role of chemotherapy (CHT) and Radiotherapy (RT) on soft tissue chondrosarcoma is still controversial. CASE PRESENTATION A 47-year-old man presented to our referral center with a history of EMC in the right shoulder excised with microscopic positive surgical margins in a non-referral center. Staging imaging exams did not reveal distant metastasis or residual disease, but during follow-up a local recurrence was detected. After a multidisciplinary discussion, preoperative radiotherapy was administered with a total dose of 50 Gy, and then the patient underwent wide surgical excision. Histological examination was negative for viable tumor cells. No relapse occurred in a 24-months post-operative follow up. CONCLUSIONS The case here described suggests the importance of patient's management in SRCs. A planned combined treatments with both surgery and RT seems to be the best choice to improve local control. RT seems to be promising within this specific histotype. Further studies are needed to confirm if the observed efficacy of combined treatments reflects in a consistent survival benefit for EMC patients.
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Affiliation(s)
- Luca Improta
- Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Roma, RM, Italy
| | - Sergio Valeri
- Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Roma, RM, Italy.
| | - Rossana Alloni
- Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Roma, RM, Italy
| | - Chiara Pagnoni
- Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Roma, RM, Italy
| | | | - Beniamino Brunetti
- Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Roma, RM, Italy
| | - Carlo Greco
- Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Roma, RM, Italy
| | - Irene Aprile
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence, Italy
| | - Mirella Maselli
- Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Roma, RM, Italy
| | - Bruno Vincenzi
- Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128, Roma, RM, Italy
| | - Alessandro Gronchi
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Venezian, 1, 20133, Milan, MI, Italy
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Saito R, Senbokuya N, Yagi T, Yoshioka H, Kanemaru K, Kinouchi H. Primary Spinal Intradural Extramedullary Mesenchymal Chondrosarcoma. World Neurosurg 2020; 145:376-380. [PMID: 33049384 DOI: 10.1016/j.wneu.2020.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Among chondrosarcomas arising from bones and soft tissues, mesenchymal chondrosarcoma (MCS), especially primary spinal intradural extramedullary MCS, is extremely rare, and only 18 cases have been reported to date. We report an adult case of this rare condition mimicking meningioma. CASE DESCRIPTION A 42-year-old woman presented with paraplegia and sensory disturbance associated with right-sided Brown-Séquard syndrome following back pain. Magnetic resonance imaging showed an intradural mass in the right dorsal spinal canal with homogeneous enhancement and dural tail sign at the T8 level. Computed tomography demonstrated a calcified portion in the mass. Following T7-8 laminectomies, an intradural extramedullary tumor was completely removed after detaching the tumor from the dura mater. The histopathologic diagnosis was MCS, and positron emission tomography showed no metastatic lesions at other sites. The patient did not receive adjuvant therapy, and magnetic resonance imaging revealed no evidence of recurrence during 2-year follow-up. CONCLUSIONS Primary spinal intradural extramedullary MCS has been reported to have a better prognosis than MCS occurring in other regions. In a case with early complete surgical resection, adjuvant therapy should be considered at the time of recurrence.
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Affiliation(s)
- Ryu Saito
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Nobuo Senbokuya
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Takashi Yagi
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan.
| | - Hideyuki Yoshioka
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Kazuya Kanemaru
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
| | - Hiroyuki Kinouchi
- Department of Neurosurgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Japan
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Gopakumar S, Steele WJ, Muir M, Bhogani Z, Britz G. Intraspinal mesenchymal chondrosarcoma: An argument for aggressive local resection and adjuvant therapy based on review of the literature. Surg Neurol Int 2020; 11:95. [PMID: 33030461 PMCID: PMC7265351 DOI: 10.25259/sni_130_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/08/2020] [Indexed: 11/04/2022] Open
Abstract
Background Mesenchymal chondrosarcoma is a rare cartilaginous neoplasm that typically involves the axial skeleton. Despite a well-circumscribed appearance, this tumor has a tendency to recur both locally and with distant metastases. Case Description A 17-year-old patient presented with numbness and paresthesias in the lower extremities attributed to a T10-T11 intradural extramedullary mesenchymal chondrosarcoma. The patient was treated with aggressive local resection and adjuvant therapy. Here, this case and present literature are appropriately reviewed. Conclusion Although uncommon, intraspinal mesenchymal chondrosarcomas warrant both radical local resection and aggressive adjuvant therapy with chemoradiation to provide the greatest chance of progression-free survival.
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Affiliation(s)
- Sricharan Gopakumar
- Department of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, United States
| | - William J Steele
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, TX, United States
| | - Matthew Muir
- Department of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, United States
| | - Zain Bhogani
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, TX, United States
| | - Gavin Britz
- Department of Neurosurgery, Houston Methodist Hospital Neurological Institute, Houston, TX, United States
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28
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Shafaat O, Chapman PR, Zandifar A, Sotoudeh E, Baumgartner EM, Sotoudeh H. Heavily calcified parapharyngeal space mesenchymal chondrosarcoma: Imaging and pathological findings and a review of the literature. Neuroradiol J 2020; 34:45-48. [PMID: 32998632 DOI: 10.1177/1971400920962821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Parapharyngeal space (PPS) masses are relatively rare lesions of the head and neck, and account for 0.5-1.5% of head and neck lesions. The most common lesion to occur in the PPS is a benign salivary neoplasm, typically pleomorphic adenoma either from the deep parotid or from ectopic parotid tissue rests within the PPS. A calcified or ossified mass in this location is exceedingly rare, but a calcified variant of pleomorphic adenoma has been reported. In this study, we present a patient with a heavily calcified PPS mesenchymal chondrosarcoma with an unusual presentation. We discuss the imaging and pathologic findings followed by a review of the current literature.
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Affiliation(s)
- Omid Shafaat
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, USA.,Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Iran
| | - Philip R Chapman
- Division of Neuroradiology, Department of Radiology, University of Alabama at Birmingham, USA
| | - Alireza Zandifar
- Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Iran.,Department of Neurology, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Iran
| | | | | | - Houman Sotoudeh
- Division of Neuroradiology, Department of Radiology, University of Alabama at Birmingham, USA
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Abstract
The objective of this study was to evaluate the characteristics and oncologic outcomes of a single institution series of chondrosarcoma of pelvis and extremities in patients who were 21 years or younger. Between January 2006 and December 2016, we operated on 249 chondrosarcomas of the pelvis and extremities. Eleven (4%) of these were 21 years or younger. The mean age was 18 years (range 14-21 years). There were eight males and three females. Four occurred in the pelvis. The other sites were humerus (three) and one each in the scapula, clavicle, metatarsal and proximal femur. There were five primary chondrosarcomas and 6 (55%) secondary chondrosarcomas. After appropriate surgical excision, we had nine free margins and two margins were microscopically involved. None of the 11 patients received adjuvant chemotherapy or radiotherapy. One patient never followed up after surgery and another was lost to follow-up after 32 months. Eight were alive and one had died. All survivors had minimum follow-up of 2 years (range 26-106 months). There was one local recurrence. The overall and disease-free survival at 5 years for all patients was 89 %. There was no statistically significant difference in survival for primary chondrosarcomas compared to secondary chondrosarcomas (P = 0.061), or pelvic chondrosarcomas compared to other sites (P = 0.264). Chondrosarcomas in children and adolescents constitute <5% of all chondrosarcomas. Secondary chondrosarcomas constituted more than half the cases. Overall, outcomes in the young were no different from those in adults.
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30
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Tansir G, Rastogi S, Barwad A, Dhamija E. Long lasting response with trabectedin monotherapy in relapsed metastatic mesenchymal chondrosarcoma. Clin Sarcoma Res 2020; 10:16. [PMID: 32864096 PMCID: PMC7453529 DOI: 10.1186/s13569-020-00138-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background Mesenchymal chondrosarcoma is an exceedingly rare malignancy, accounting for around 5% of all patients with chondrosarcoma. It is a translocation-related sarcoma that tends to have both local and distant recurrences. Surgery is the mainstay of treatment in localised cases however treatment of advanced cases remains a challenge. The rarity of the disease precludes dedicated clinical trials and hence guidelines for its management are not well defined. The dearth in literature makes it pertinent that the cases treated with newer therapies must be reported to contribute to existing knowledge. Case presentation We hereby report a case of a 39-year old male without any comorbidity presenting with pelvic pain and was diagnosed as mesenchymal chondrosarcoma of the pelvis. He underwent an initial curative resection followed by a disease-free interval of 7 months. Subsequently, he was treated with pulmonary metastatectomy and local debulking surgery at time of initial relapse. He was then exposed to multiple lines of palliative chemotherapy, which limited our treatment options upon subsequent disease progression. Based on recent data, the patient was given trabectedin monotherapy as fourth line chemotherapy. He tolerated the therapy well and attained a progression-free survival of 12 months, which is an impactful figure in relapsed setting in this patient population. Conclusion This report aims to present a comprehensive review into available and newer treatment choices for mesenchymal chondrosarcoma, and to highlight trabectedin monotherapy as a possible therapeutic option for mesenchymal chondrosarcoma in the relapsed setting.
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Affiliation(s)
- Ghazal Tansir
- Sarcoma Medical Oncology Clinic, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sameer Rastogi
- Sarcoma Medical Oncology Clinic, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Adarsh Barwad
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Ekta Dhamija
- Department of Radiodiagnosis, Dr. B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Pinheiro TN, Leite MGM, Bindá FA, Dutra ALT, Sarmento N, Cabral LN, Consolaro A, Bacchi CE. Metastatic Biphasic Primitive Tumor in the Mandible of a Child. Eur J Dent 2020; 14:502-510. [PMID: 32542629 PMCID: PMC7440943 DOI: 10.1055/s-0040-1713306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Pediatric mandibular tumors present an aggressive biological behavior and difficult diagnosis. A wide range of odontogenic and nonodontogenic tumors comprise the spectrum of these lesions. We report a case of a 1-year-old male child patient showing facial asymmetry symptomatic of an expansive lesion extending throughout the body and ramus of the left hemimandible with a diameter of 8 cm. The histopathological report suggested a high-grade mucoepidermoid carcinoma (MEC), recommending further immunohistochemical investigation of the ectomesenchymal or neuroectodermal origin of the tumor cells. The patient evolved with extensive bilateral pleural effusion followed by metastasis in the middle third of the right humerus, and died 2 months after the first biopsy procedure by acute renal failure with tubular necrosis, before a final inconclusive immunohistochemical report was reached. The lack of resources for less-favored regions of Brazil impairs rapid biomolecular examinations such as immunohistochemical resulting in delay of appropriate therapeutic procedures.
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Affiliation(s)
- Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Surgical Pathology and Oral and Maxillofacial Pathology Service, Amazonas State University, Cachoeirinha, Manaus-AM, Brazil
| | - Milena Gomes Melo Leite
- Department of Oral Pathology and Oral Medicine, Surgical Pathology and Oral and Maxillofacial Pathology Service, Amazonas State University, Cachoeirinha, Manaus-AM, Brazil
| | - Fábio Arruda Bindá
- Department of Head and Neck Oncology, Fundação Centro de Controle de Oncologia do Estado do Amazonas, Planalto, Manaus-AM, Brazil
| | - André Luiz Tannus Dutra
- Department of Pediatric Dentistry, Amazonas State University, Cachoeirinha, Manaus-AM, Brazil
| | - Naelka Sarmento
- Department of Pediatric Dentistry, Amazonas State University, Cachoeirinha, Manaus-AM, Brazil
| | - Lioney Nobre Cabral
- Department of Oral Pathology and Oral Medicine, Amazonas State University, Cachoeirinha, Manaus-AM, Brazil
| | - Alberto Consolaro
- Department of Oral Pathology, Bauru School of Dentistry, University of São Paulo, Bauru-SP, Brazil
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Kim DH, Lee HS, Mun YH, Koh S, Park JS, Lee SM, Kang NW, Lee MY, Cho CW, Kim DD, Lee JY. An overview of chondrosarcoma with a focus on nanoscale therapeutics. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2020. [DOI: 10.1007/s40005-020-00492-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Xie L, Xu J, Sun X, Liu K, Li X, He F, Liu X, Gu J, Lv Z, Yang R, Tang X, Yan T, Li D, Yang Y, Dong S, Sun K, Shen D, Guo W. Apatinib for Treatment of Inoperable Metastatic or Locally Advanced Chondrosarcoma: What We Can Learn About the Biological Behavior of Chondrosarcoma from a Two-Center Study. Cancer Manag Res 2020; 12:3513-3525. [PMID: 32547189 PMCID: PMC7237692 DOI: 10.2147/cmar.s253201] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/05/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose For patients who have chondrosarcoma in the unresectable setting, antiangiogenic agents are reportedly effective. This multicenter, retrospective study investigated the antitumor activity of apatinib in patients with unresectable chondrosarcoma to gain insight into the biological behavior of this disease. Methods All of the patients with unresectable chondrosarcoma who were diagnosed between October 1, 2009, and November 1, 2019, in two sarcoma centers affiliated with Peking University were evaluated. Relevant information was collected from the medical records at both centers, from which patients receiving apatinib for systemic therapy were selected for analysis. Results In total, efficacy analysis was conducted in 33 patients with a median follow-up time of 22.1 (Q1, Q3, 14.6, 23.0) months. There were 20/33 (60.0%) conventional chondrosarcomas (grades 2–3), 5/33 (15.2%) dedifferentiated chondrosarcomas, 4/33 (12.1%) mesenchymal chondrosarcomas, 3/33 (9.1%) extraskeletal myxoid chondrosarcoma, and 1/33 (3.1%) clear-cell chondrosarcomas with 87.9% in metastatic and 12.1% in locally advanced states. The objective response rate was 6/33 (18.2%). The median progression-free survival (PFS) was 12.4 months (Q1, Q3, 7.0, 21.2), while the median overall survival has not yet been reached. Rare variants of chondrosarcoma tended to have a longer PFS than conventional chondrosarcoma (P=0.06). Based on clinicopathological factors Cox and univariate analysis, only extraskeletal myxoid chondrosarcoma and baseline target lesions <60 mm benefited from the drug apatinib (P=0.14 and P=0.00), respectively. Grade 3 or higher adverse events were frequent in 11/33 (39.3%) of patients who discontinued apatinib due to deterioration of their general condition. Conclusion Apatinib had clinically meaningful activity in patients with inoperable high-grade chondrosarcoma. However, special caution should be made in managing toxicity due to the indolent behavior and slow growth pattern after using this drug. Patients with a smaller tumor size and extraskeletal myxoid chondrosarcoma subtype might benefit from this therapy more. Clinical Trial Registration Registered February 7, 2020, with clinicaltrials.gov: NCT04260113.
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Affiliation(s)
- Lu Xie
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Jie Xu
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Xin Sun
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Kuisheng Liu
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Xiaowei Li
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Fangzhou He
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Xinyu Liu
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Jin Gu
- Surgical Oncology, Peking University Shougang Hospital, Beijing, People's Republic of China
| | - Zhe Lv
- Radiology Department, Peking University Shougang Hospital, Beijing, People's Republic of China
| | - Rongli Yang
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Xiaodong Tang
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Taiqiang Yan
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Dasen Li
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Yi Yang
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Sen Dong
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
| | - Kunkun Sun
- Pathology Department, Peking University People's Hospital, Beijing, People's Republic of China
| | - Danhua Shen
- Pathology Department, Peking University People's Hospital, Beijing, People's Republic of China
| | - Wei Guo
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, People's Republic of China
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Nachawi N, Lew M, Konopka K, Sandouk Z. A challenging case of Mesenchymal Chondrosarcoma involving the thyroid and special considerations for diagnosis. Clin Diabetes Endocrinol 2020; 6:6. [PMID: 32180995 PMCID: PMC7065336 DOI: 10.1186/s40842-020-00094-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/10/2020] [Indexed: 11/17/2022] Open
Abstract
Background Thyroid ultrasound is usually used to risk-stratify incidental thyroid nodules. Nodules with high risk sonographic features for malignancy are evaluated by fine-needle aspiration. The role of core needle biopsy for thyroid nodules is limited to cases where the fine needle aspiration is inconclusive. Case presentation We describe a rare case of mesenchymal chondrosarcoma of the thyroid gland with uncertain primary origin. Thyroid ultrasound showed right sided large, solid, hypoechoic nodule with calcifications and peripheral vascularity and unremarkable isthmus and left thyroid lobe. Fine needle aspiration of the right nodule suggested lymphocytic thyroiditis. The sonographic findings contradicted the typical bilateral clinical and sonographic picture of lymphocytic thyroiditis. A core needle biopsy showed mesenchymal chondrosarcoma. Conclusion This case highlights the importance of correlating pathologic diagnosis with sonographic findings, the appropriate utilization of fine needle aspiration and core needle biopsy to evaluate thyroid nodules and the rare incidence of mesenchymal chondrosarcoma involving the thyroid.
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Affiliation(s)
- Noura Nachawi
- 1Department of Internal Medicine, Saint Joseph Mercy Hospital Ann Arbor, Ann Arbor, MI USA
| | - Madelyn Lew
- 2Department of Pathology, University of Michigan, Ann Arbor, MI USA
| | - Kristine Konopka
- 2Department of Pathology, University of Michigan, Ann Arbor, MI USA
| | - Zahrae Sandouk
- 3Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI USA
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Amer KM, Munn M, Congiusta D, Abraham JA, Basu Mallick A. Survival and Prognosis of Chondrosarcoma Subtypes: SEER Database Analysis. J Orthop Res 2020; 38:311-319. [PMID: 31498474 DOI: 10.1002/jor.24463] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 07/10/2019] [Indexed: 02/04/2023]
Abstract
Chondrosarcomas are rare tumors and, historically, investigation of these tumors has been limited to small series and single-institution studies. There have been no studies that evaluated the identification or comparison of differences in prognostic factors between the five known non-conventional chondrosarcoma subtypes (myxoid, juxtacortical, clear-cell, mesenchymal, and dedifferentiated). The purpose of this paper was to determine the demographic, clinical, incidence, and tumor characteristics of all five known non-conventional chondrosarcoma subtypes, determine the 1-, 5-year, and median survival differences between these subtypes, and to determine the demographic and clinical variables that are significant prognostic indicators for each chondrosarcoma subtypes. We retrospectively reviewed the SEER database for all patients with non-conventional chondrosarcoma. χ2 testing was used for correlations between clinical variables. Kaplan-Meier and Cox proportional hazard analysis were used to compare survival of the subtypes, and to assess the prognostic value of age group, race, sex, grade, anatomic location, and metastatic involvement. Several demographic characteristics including gender, race, age, and grade varied between chondrosarcoma subtypes. The tumor characteristics showed marked differences in presence of metastasis on presentation between the subtypes with increasing order of rate of metastasis with juxtacortical (2.1%), clear cell (5.7%), myxoid (7.6%), mesenchymal (10.6%), and the highest in dedifferentiated (19.8%). One-, 5-year, and median survival differed significantly between chondrosarcomas subtypes. The highest median survival was found in the juxtacortical subtype (97 months), followed by clear cell (79 months), myxoid (60 months), mesenchymal (33.5 months), and lowest in dedifferentiated (11 months). The only prognostic variable that was shown to significantly impact the survival of each non-conventional chondrosarcoma subtype was a metastatic disease at diagnosis (p = 0.03 to p < 0.001). Subtyping classification of chondrosarcoma should be made whenever possible, given differences in survival and prognostic factors between chondrosarcoma subtypes. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:311-319, 2020.
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Affiliation(s)
- Kamil M Amer
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, 40 Bergen St., Newark, New Jersey, 07103
| | - Murty Munn
- Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Dominick Congiusta
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, 40 Bergen St., Newark, New Jersey, 07103
| | - John A Abraham
- Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.,Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Atrayee Basu Mallick
- Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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Intracranial Extraskeletal Mesenchymal Chondrosarcoma: Case Report and Review of the Literature of Reported Cases in Adults and Children. World Neurosurg 2019; 129:302-310. [PMID: 31158544 DOI: 10.1016/j.wneu.2019.05.221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 05/27/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Intracranial extraskeletal mesenchymal chondrosarcoma is a rare, malignant variant of chondrosarcoma that is characterized by undifferentiated mesenchymal cells interspersed with pockets of mature hyaline cartilage. CASE DESCRIPTION In this study, we report a 23-year-old female patient who underwent multiple craniotomies for tumor resection, as well as adjuvant radiotherapy and chemotherapy. We review the literature for reported cases and discuss the histopathologic features, radiologic findings, therapeutic approaches, and outcomes associated with this rare tumor. CONCLUSIONS Intracranial extra-skeletal mesenchymal chondrosarcomas are very aggressive tumors, and their management should emphasize attempting gross total resection followed by adjuvant treatment modalities, including radiation therapy and/or chemotherapy.
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Paasch C, De Santo G, Boettge KR, Strik MW. Mesenchymal chondrosarcoma metastasising to the pancreas. BMJ Case Rep 2018; 11:11/1/e226369. [PMID: 30598468 DOI: 10.1136/bcr-2018-226369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The mesenchymal chondrosarcoma (MC) is a rare malignant tumour and accounts for less than 3% of primary chondrosarcomas. Mostly MC arises from the craniofacial bones, the ribs, the ilium, the femur and the vertebrae. A 54-year-old man was treated due to an icterus of unknown origin. The medical history of the patient consists of a multimodal treated MC of the thoracic vertebrae. A CT imaging identified a 2×4 cm sized mass of the pancreatic head. Suspecting a pancreatic head carcinoma surgical removal was performed. Histopathological a metastasis of MC was diagnosed. Our patient left the hospital after 17 days and died 23 month after surgery. Metastases of MC to the pancreas are rare. When detecting a mass of the pancreas in patients with a medical history of an MC, a metastasis of these tumour should be taken in consideration.
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Affiliation(s)
| | | | | | - Martin W Strik
- General Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany
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Abstract
Extraskeletal mesenchymal chondrosarcoma is a rare soft tissue sarcoma arising from soft tissues, mainly of the lower extremities, meninges, and orbits. It usually presents during the second to third decades of life, and has a slight predominance in females. Histologically, it has a typical biphasic pattern comprising small cells and islands of hyaline cartilage. It can pose a diagnostic challenge in small biopsy specimens where 1 of the 2 components can be absent. The prognosis is extremely variable; survival varies depending on the location of the tumor.
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Affiliation(s)
| | - Nicole D. Riddle
- From the Department of Pathology, University of Texas Health Science Center, San Antonio. Dr Arora is now with the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas. Dr Riddle is now with the Department of Pathology, Cunningham Pathology, Birmingham, Alabama
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Sarcomas of the Oral and Maxillofacial Region: Analysis of 26 Cases with Emphasis on Diagnostic Challenges. Pathol Oncol Res 2018; 25:593-601. [PMID: 30382526 DOI: 10.1007/s12253-018-0510-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 10/15/2018] [Indexed: 10/28/2022]
Abstract
Sarcomas of the Oral and Maxillofacial Region (SOMR) are rare lesions which pose diagnostic and management challenges. We analyzed 26 cases of SOMR with respect to clinical presentation, histopathological subtype, treatment modalities, recurrence, and treatment outcome. In our series, Osteosarcoma (OS) was the most common type of sarcoma (7 cases), followed by 5 cases of Ewing's Sarcoma (ES), 3 cases each of Chondrosarcoma (CS) and Leiomyosarcoma (LMS), 2 cases each of Malignant Peripheral Nerve Sheath Tumor (MPNST), Pleomorphic Undifferentiated Sarcoma (PUS), Myeloid Sarcoma (MS)and Rhabdomyosarcoma (RMS). Surgery was the primary treatment modality in most cases and was combined with adjuvant chemo/ radiotherapy in few cases. 24 of the 26 cases were followed up for an average period of 40.67 months. Adverse disease outcomes like recurrence were seen in 2 cases whereas death due to the disease was reported in 7 cases. In view of the diagnostic challenges faced in SOMRs, it appears practical to stress on the underlying genetic aspects of the disease process rather than histological subtyping to improve disease outcome.
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Lu P, Xiao W, Gao Y, Mao Y. Primary orbital mesenchymal chondrosarcoma. Can J Ophthalmol 2018; 53:e205-e207. [PMID: 30340745 DOI: 10.1016/j.jcjo.2017.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/15/2017] [Accepted: 11/20/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Peng Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wei Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yang Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuxiang Mao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
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41
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Intracranial Mesenchymal Chondrosarcoma: Report of 16 Cases. World Neurosurg 2018; 116:e691-e698. [DOI: 10.1016/j.wneu.2018.05.069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 02/03/2023]
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Zhang H, Wang S, Cheng Z, Liu H. Primary extraskeletal mesenchymal chondrosarcoma arising from the iliac vein. Saudi Med J 2018; 38:1058-1061. [PMID: 28917072 PMCID: PMC5694641 DOI: 10.15537/smj.2017.10.20498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The iliac vein is an extremely rare site for mesenchymal chondrosarcoma, and patients with primary extraskeletal mesenchymal chondrosarcoma arising from a vein always suffer a very poor prognosis. We report a case of a 45-year-old female who presented with a 5-month history of left leg edema in 2015. Contrast-enhanced computed tomography showed a large mass in the left iliac vein with scattered calcifications. Wide-margin resection was performed, and histopathologic and immunohistochemical analyses confirmed the presence of intraluminal mesenchymal chondrosarcoma with local invasion out of the vein wall. Due to poor patient compliance, postoperative neoadjuvant chemotherapy and radiotherapy were not started, and a bone scan performed 16 weeks postoperatively showed multiple bone metastases. The patient died on the twenty-fourth postoperative week.
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Affiliation(s)
- Hua Zhang
- Department of Respiration, The First Hospital of Jilin University, Changchun, Jilin, China. E-mail.
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Toki S, Motoi T, Miyake M, Kobayashi E, Kawai A, Yoshida A. Minute mesenchymal chondrosarcoma within osteochondroma: an unexpected diagnosis confirmed by HEY1-NCOA2 fusion. Hum Pathol 2018; 81:255-260. [PMID: 29596896 DOI: 10.1016/j.humpath.2018.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 02/26/2018] [Accepted: 03/09/2018] [Indexed: 10/17/2022]
Abstract
Mesenchymal chondrosarcoma is rare and can be challenging to diagnose. Herein, we report a minute mesenchymal chondrosarcoma within an osteochondroma. A 12-year-old girl presented with an asymptomatic exophytic lesion of the rib. The tumor was clinically diagnosed as osteochondroma and was excised after observation for 3 years. The resected specimen revealed an unexpected minute (0.9 cm) "monophasic" mesenchymal chondrosarcoma in the apex of the lesion. The sarcoma consisted of monomorphic spindle cells without hyaline cartilage. Fluorescence in situ hybridization detected NCOA2 rearrangement, and reverse-transcription polymerase chain reaction and sequencing detected a HEY1 (exon 4)-NCOA2 (exon 13) fusion transcript. The patient did not receive adjuvant therapy and is alive with no recurrence 6 years after surgery. The present case highlights the value of careful pathological examination of specimens submitted as osteochondroma and emphasizes the usefulness of molecular assays in the diagnosis of mesenchymal chondrosarcoma in an atypical setting.
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Affiliation(s)
- Shunichi Toki
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo 104-0045, Japan; Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Toru Motoi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan
| | - Mototaka Miyake
- Department of Diagnostic Radiology, National Cancer Center Hospital, 104-0045 Tokyo, Japan
| | - Eisuke Kobayashi
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Akihiko Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo 104-0045, Japan; Rare Cancer Center, National Cancer Center Hospital, Tokyo 104-0045, Japan.
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Extraosseous Intradural Chondrosarcoma of the Cervical Spine: A Case Report with Brief Review of Literature. Case Rep Radiol 2018; 2018:6921020. [PMID: 29682386 PMCID: PMC5851319 DOI: 10.1155/2018/6921020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/30/2018] [Indexed: 12/20/2022] Open
Abstract
Mesenchymal chondrosarcoma (MCS) is a malignant cancer of the cartilage that accounts for less than 1% of all chondrosarcomas and typically occurs within the bone. One-third of all mesenchymal chondrosarcomas are extraosseous soft tissue sarcomas, rendering this as an uncommon entity. We report a rare case of an extraosseous chondrosarcoma with the cervical spinal canal in a 21-year-old male. The purpose of this case report is to discuss the imaging characteristics of this pathology proven diagnosis.
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46
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Rossetto A, Saccomano E, Zompicchiatti A, Avellini C, Toffoli S, Miolo G, Frustaci S, Uzzau A. Mesenchymal chondrosarcoma of the spleen: Report of a case. TUMORI JOURNAL 2018; 97:e10-5. [DOI: 10.1177/030089161109700423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Chondrosarcoma is a malignant tumor of chondrogenic origin and the mesenchymal type is a very rare finding. Mesenchymal chondrosarcoma tends to develop mostly in the skeleton but may also occur as a primary tumor in periosteal nervous and muscular tissues, the anterior cerebral falx, meninges, brain, maxillary sinus, eyelid, thyroid, pleura and mediastinum, while in the abdomen the most frequent locations are the kidney, retroperitoneum and even the perineum and the anogenital area. Apparently, the only splenic mesenchymal chondrosarcoma in the literature occurred in a dog. Methods and study design Our paper reports the case of a patient who had a diagnosis of mesenchymal chondrosarcoma of the spleen. Results We adopted surgery as the main therapeutic procedure without achieving complete recovery but preserving a good quality of life for our patient, minimizing the repercussions of the disease on her working and relational life. Conclusions The absence of important or invalidating symptoms and the persistence of good general conditions before and after each surgical operation encouraged us to adopt the surgical option as the most rational.
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Affiliation(s)
- Anna Rossetto
- Department of Surgery & Transplantation, University Hospital of Udine, Udine
| | - Enrico Saccomano
- Department of Surgery & Transplantation, University Hospital of Udine, Udine
| | - Aron Zompicchiatti
- Department of Surgery & Transplantation, University Hospital of Udine, Udine
| | - Claudio Avellini
- Department of Surgical Pathology, University Hospital of Udine, Udine
| | - Silvia Toffoli
- Department of Surgical Pathology, University Hospital of Udine, Udine
| | - GianMaria Miolo
- Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy
| | - Sergio Frustaci
- Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy
| | - Alessandro Uzzau
- Department of Surgery & Transplantation, University Hospital of Udine, Udine
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Cesari M, Bertoni F, Bacchini P, Mercuri M, Palmerini E, Ferrari S. Mesenchymal Chondrosarcoma. An Analysis of Patients Treated at a Single Institution. TUMORI JOURNAL 2018; 93:423-7. [DOI: 10.1177/030089160709300503] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background We analyzed clinical and treatment-related factors influencing the outcome of patients with mesenchymal chondrosarcoma (MC). Twenty-six patients (median age, 31 years) were identified using the Tumor Center and Chemotherapy Department database of the study institute. Methods Patients received surgery (24 patients) and/or radiotherapy (5 patients), and chemotherapy (12 patients). Results After a median follow-up of 48 months (7-237 months) 10 patients were alive. The 10-year overall survival (OS) was 27% in those who achieved complete surgical remission and 0% in those who did not (P = 0.0007). A worse 10-year probability of OS was observed in patients who were metastatic at presentation (metastatic 0%, localized 31%, P = 0.02), in patients with soft tissue MC (soft tissue MC 0%, bone MC 29%, P = 0.06) and in hemangiopericytoma-like MC (hemangiopericytoma-like MC 0%, Ewing's-like MC 33.5%, P = 0.9). In those patients who achieved complete surgical remission, the 10-year DFS was 76% for those who received chemotherapy and 17% for those who did not (P = 0.008). Conclusions Our experience confirmed the importance of complete surgical remission in MC treatment and suggests that the addition of chemotherapy should offer a benefit in terms of DFS. Due to the rarity of MC, multicentrer studies are needed to identify the most active chemotherapy regimen.
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Affiliation(s)
- Marilena Cesari
- Chemotherapy, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Franco Bertoni
- Pathology, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Patrizia Bacchini
- Pathology, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Mario Mercuri
- 5th Division of Orthopedic Surgery, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Emanuela Palmerini
- Chemotherapy, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
| | - Stefano Ferrari
- Chemotherapy, Department of Musculoskeletal Oncology, Istituti Ortopedici Rizzoli, Bologna, Italy
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48
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Wong KS, Jo VY. Cytologic diagnosis of round cell sarcomas in the era of ancillary testing: an updated review. J Am Soc Cytopathol 2018; 7:119-132. [PMID: 31043308 DOI: 10.1016/j.jasc.2017.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 11/29/2017] [Accepted: 12/11/2017] [Indexed: 10/18/2022]
Abstract
Round cell sarcomas constitute a large proportion of "small round blue cell tumors," which encompass a broad differential diagnosis and can be difficult to distinguish on cytomorphologic grounds alone. Numerous pathogenetic insights and advances in ancillary testing in soft tissue pathology over the last several decades have made accurate classification of soft tissue neoplasms increasingly feasible. Immunohistochemistry and genetic/molecular testing can now be performed on all cytologic preparations, including unstained smears, needle rinses, cell blocks, and liquid-based preparations, and this has greatly increased our diagnostic abilities. Nevertheless, there remain numerous diagnostic challenges, including variable sensitivity and specificity of available immunohistochemical markers, overlapping immunophenotypes between entities, and "promiscuity" of genetic alterations such as EWSR1 rearrangements, present in a multitude of tumor types. Herein we provide a review on the cytologic, immunohistochemical, and genetic features of the more frequently encountered round cell sarcomas, as well as recently described entities, with an emphasis on diagnostic pitfalls and judicious use of ancillary studies.
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Affiliation(s)
- Kristine S Wong
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Vickie Y Jo
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
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49
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Alkatan HM, Eberhart CG, Alshomar KM, Elkhamary SM, Maktabi AM. Primary mesenchymal chondrosarcoma of the orbit: Histopathological report of 3 pediatric cases. Saudi J Ophthalmol 2018; 32:69-74. [PMID: 29755276 PMCID: PMC5943970 DOI: 10.1016/j.sjopt.2018.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/17/2018] [Accepted: 02/26/2018] [Indexed: 11/23/2022] Open
Abstract
Mesenchymal chondrosarcoma (MCS) is an unusual tumor mainly found in the skeleton. Around third of the cases occur in extra-skeletal sites with the orbit being the third most common site in these cases. In previous reviews of the orbital cases, it has been concluded that orbital MCS tends to occur in women in the second or third decades of life. However, 8 cases of orbital MCS have been reported so far in the pediatric age group (age less than 18 years-old) one of which has been considered congenital MCS in a 5-days old newborn girl. We describe 3 additional pediatric cases with primary orbital MCS and they were all males. Our cases presented with proptosis and calcific orbital masses on imaging studies. Histopathological examination of the excised masses shared the typical presence of undifferentiated mesenchymal cells and immature areas of cartilage. The diagnosis of MCS was further confirmed by immunohistochemical staining. Brief review of the literature in relation to this diagnosis in the orbit is also presented.
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Affiliation(s)
- Hind M. Alkatan
- Ophthalmology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Pathology Department, King Saud University-Medical City, Riyadh, Saudi Arabia
| | - Charles G. Eberhart
- Departments of Pathology, Ophthalmology, and Oncology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | | | - Sahar M. Elkhamary
- Diagnostic Imaging Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Egypt
| | - Azza M.Y. Maktabi
- Pathology and Laboratory Medicine Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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50
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Hildreth BE, Birchard SJ, Rosol TJ, Drost WT. What Is Your Diagnosis? Extraskeletal mesenchymal chondrosarcoma. J Am Vet Med Assoc 2017; 251:647-650. [PMID: 28857701 DOI: 10.2460/javma.251.6.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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