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Carsuzaa F, Fieux M, Piguel X, Frouin E. Recurrent peripartum alveolar soft-part sarcoma: Case report using CARE methodology. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:231-233. [PMID: 37263820 DOI: 10.1016/j.anorl.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Alveolar soft-part sarcoma (ASPS) is a rare malignant sarcoma with only a few cases reported in the sinus and head and neck region. It shows strong female predominance. Hormone-dependent recurrence was never reported. CASE REPORT A 35 year-old woman presented nasal cavity ASPS during her first pregnancy, middle-ear ASPS during the second, and a third ASPS in the sinus outside of any peripartum period, with unfavorable progression and metastasis, terminating in death. DISCUSSION Pathology analysis of the tumors showed positive immunolabeling for progesterone receptors in the two peripartum episodes. This was thus the first report of peripartum recurrence of ASPS with strong progesterone sensitivity, reinforcing the suspected biological link between ASPS and progesterone. This case report may be a preliminary finding suggesting progesterone blockers as a novel treatment for recurrent ASPS.
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Affiliation(s)
- F Carsuzaa
- Service ORL, chirurgie cervico-maxillo-faciale et audiophonologie, CHU de Poitiers, 86000 Poitiers, France
| | - M Fieux
- Service d'ORL, d'otoneurochirurgie et de chirurgie cervico-faciale, hospices civils de Lyon, centre hospitalier Lyon Sud, 69310 Pierre-Bénite cedex, France; Université de Lyon, université Lyon 1, 69003 Lyon, France
| | - X Piguel
- Service d'endocrinologie, CHU de Poitiers, 86000 Poitiers, France
| | - E Frouin
- Service d'anatomie et de cytologie pathologiques, CHU de Poitiers, 86000 Poitiers, France.
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2
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Zhao P, Li H, Ren H. Alveolar soft tissue sarcoma: a report of 50 cases at a single institution. Acta Chir Belg 2022:1-9. [PMID: 35236247 DOI: 10.1080/00015458.2022.2049060] [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: 11/01/2022]
Abstract
BACKGROUND Alveolar soft-part sarcoma (ASPS) is a rare soft tissue sarcoma subtype, occurring mainly in young people, with poor prognosis. MATERIALS AND METHODS We conducted a retrospective analysis of localized or metastatic ASPS patients admitted to the First Affiliated Hospital of Zhengzhou University (China) from 2012 to 2020, focusing on treatment and prognosis. RESULTS The median age at diagnosis was 24 years (range: 1.4-78 years). Women (n = 29, 58%), especially those aged <30 years, dominated this series. The most common metastasis site was lung. Thirty-one (62%) patients developed lung metastasis (localized: n = 9 [18%]; metastatic: n = 22 [44%]). Only a tumor maximum diameter ≥ 5 cm was associated with a high lung metastasis rate (p = 0.039). The mean follow-up time was 37.5 months (1-108 months), and the 5-year overall survival (OS) rate was 84.7%. Univariate analysis indicated that distant metastasis observed at the initial visit and incomplete resection of the primary tumor were associated with poor OS. For localized cases, neither surgery plus radiotherapy (p = 0.486) nor surgery plus chemotherapy (p = 0.536) improved progression-free survival compared to surgery alone. Among the metastatic cases, the disease control rate (PR + SD) was higher for targeted therapy (60%) and combined immunosuppressive therapy (100%) than for conventional cytotoxic chemotherapy (26%). CONCLUSIONS Postoperative adjuvant radiotherapy and chemotherapy do not provide good local control for patients with localized disease. Although there is no standard treatment strategy for patients with advanced or metastatic disease, they can benefit from targeted therapy and/or immunosuppressive therapy.
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Affiliation(s)
- Pengyuan Zhao
- Department of Pathology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
- Basic Medicine College, Zhengzhou University, Zhengzhou, China
| | - Huixiang Li
- Department of Pathology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
- Basic Medicine College, Zhengzhou University, Zhengzhou, China
| | - Huayan Ren
- Department of Pathology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
- Basic Medicine College, Zhengzhou University, Zhengzhou, China
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3
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Principe DR, Mohindra NA, Munshi HG, Kamath SD. Alveolar soft part sarcoma mimics prostate cancer metastasis. Oxf Med Case Reports 2019; 2019:507-509. [PMID: 31908823 PMCID: PMC6937446 DOI: 10.1093/omcr/omz122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 01/22/2023] Open
Abstract
A 61-year-old man presented to the oncology clinic with Gleason 9 (4 + 5) prostate cancer. Staging CT showed multiple nodules in both lungs. Since the lung lesions were too small for biopsy, he was started on anti-androgen therapy for suspected metastatic, hormone-sensitive prostate cancer. While his prostate-specific antigen decreased from 32 to <0.1 ng/ml, the multiple lung lesions showed no response on subsequent imaging. The patient presented during follow-up with severe right leg pain, at which time magnetic resonance imaging revealed a large, hyperintense mass in the femur. The mass was resected along with two lung nodules, with pathology demonstrating metastatic alveolar soft part sarcoma. This serves as an important reminder that lesions suspicious for metastases may be due to cancers of multiple primary origins, particularly if the pattern of metastasis is atypical or there is varied response to therapy.
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Affiliation(s)
- Daniel R Principe
- Medical Scientist Training Program, University of Illinois College of Medicine, Chicago, IL, USA
| | - Nisha A Mohindra
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hidayatullah G Munshi
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Suneel D Kamath
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Wang Y, Cui J, Yan X, Jin R, Hong X. Alveolar soft part sarcoma with multiple brain and lung metastases in pregnancy: A case report and literature review. Medicine (Baltimore) 2017; 96:e8790. [PMID: 29145339 PMCID: PMC5704884 DOI: 10.1097/md.0000000000008790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONAL Alveolar soft part sarcomas (ASPSs) with multiple brain metastases in pregnancy is a rare entity. PATIENT CONCERNS We report our experience with a 19-year-old pregnant woman who presented with intermittent headaches and vomiting at 38 weeks gestation. DIAGNOSES The patient was initially diagnosed as brain metastasis according to computed tomography and magnetic resonance imaging (MRI) imaging. INTERVENTIONS Cesarean section and craniotomy (complete resection of both brain metastatic lesions) was performed sequentially. OUTCOMES A healthy baby girl was delivered safely and no neonatal malformations were found. Histological analysis confirmed the diagnosis of ASPS. Follow-up MRI performed 10 months after surgery revealed no residual tumor or signs of recurrence. LESSONS We report a case of ASPS with multiple brain and lung metastases in a pregnant woman. We recommend timely MRI examination for diagnosis and have discussed the approach to the treatment of pregnant women with brain metastasis.
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Affiliation(s)
- Yubo Wang
- Department of Neurosurgery, First Hospital of Jilin University
| | - Jiayue Cui
- Department of Histology and Embryology, College of Basic Medical Sciences, Jilin University
| | - Xu Yan
- Department of Pathology, First Hospital of Jilin University, Changchun, Jilin, P.R. China
| | - Rihua Jin
- Department of Neurosurgery, First Hospital of Jilin University
| | - Xinyu Hong
- Department of Neurosurgery, First Hospital of Jilin University
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Alveolar Soft Part Sarcoma with Unusual Cardiac Metastasis: A Case Report and Review of the Literature. Case Rep Cardiol 2017; 2017:7248727. [PMID: 28845314 PMCID: PMC5563395 DOI: 10.1155/2017/7248727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 07/04/2017] [Indexed: 11/18/2022] Open
Abstract
Alveolar soft part sarcoma is a very uncommon soft tissue malignancy which accounts for <1% of soft tissue sarcoma. It is a malignant and highly vascular tumor arising most commonly in the musculature of the lower extremities, with metastasis primarily to the lungs, bones, and brain. Cardiac metastasis is very rare and only 5 cases have been reported in the literature so far. We report a case of a young woman with a history of surgically resected alveolar soft part sarcoma of left thigh who presented with persistent dry cough and was found to have a cardiac mass, which on biopsy proved to be alveolar soft part sarcoma.
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Peters SM, Perrino MA, Yoon AJ, Philipone EM. Alveolar soft part sarcoma metastatic to the mandible: A report and review of literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:379-382. [PMID: 28774857 DOI: 10.1016/j.jormas.2017.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/26/2017] [Accepted: 07/11/2017] [Indexed: 11/19/2022]
Abstract
Alveolar soft part sarcoma (ASPS) is a rare neoplasm constituting less than 1% of all soft tissue sarcomas. It tends to occur in the deep soft tissues of the lower extremities, however approximately 5-12% of cases are primary to the head and neck region. ASPS metastatic to the oral cavity is rare, with only four documented cases in the literature. Here, we present the case of a 29-year-old woman with ASPS metastatic to the mandible. To the best of our knowledge, this represents only the 5th documented case of ASPS metastatic to the oral cavity, and more specifically, the 3rd documented case of mandibular metastasis.
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Affiliation(s)
- S M Peters
- Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, 630, West 168th Street, PH15W-1562, 10032 New York, NY, United States
| | - M A Perrino
- Division of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine, 630, West 168th Street, PH15W-1562, 10032 New York, NY, United States
| | - A J Yoon
- Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, 630, West 168th Street, PH15W-1562, 10032 New York, NY, United States
| | - E M Philipone
- Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, 630, West 168th Street, PH15W-1562, 10032 New York, NY, United States.
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Wang H, Jacobson A, Harmon DC, Choy E, Hornicek FJ, Raskin KA, Chebib IA, DeLaney TF, Chen YLE. Prognostic factors in alveolar soft part sarcoma: A SEER analysis. J Surg Oncol 2016; 113:581-6. [DOI: 10.1002/jso.24183] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 01/10/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Haotong Wang
- Department of Radiation Oncology; Massachusetts General Hospital; Boston Massachusetts
| | - Alex Jacobson
- Department of Radiation Oncology; Massachusetts General Hospital; Boston Massachusetts
| | - David C. Harmon
- Department of Medical Oncology; Massachusetts General Hospital; Boston Massachusetts
- Harvard Medical School; Boston Massachusetts
| | - Edwin Choy
- Department of Medical Oncology; Massachusetts General Hospital; Boston Massachusetts
- Harvard Medical School; Boston Massachusetts
| | - Francis J. Hornicek
- Harvard Medical School; Boston Massachusetts
- Department of Orthopedic Oncology; Massachusetts General Hospital; Boston Massachusetts
| | - Kevin A. Raskin
- Harvard Medical School; Boston Massachusetts
- Department of Orthopedic Oncology; Massachusetts General Hospital; Boston Massachusetts
| | - Ivan A. Chebib
- Harvard Medical School; Boston Massachusetts
- Department of Pathology; Massachusetts General Hospital; Boston Massachusetts
| | - Thomas F. DeLaney
- Department of Radiation Oncology; Massachusetts General Hospital; Boston Massachusetts
- Harvard Medical School; Boston Massachusetts
| | - Yen-Lin E. Chen
- Department of Radiation Oncology; Massachusetts General Hospital; Boston Massachusetts
- Harvard Medical School; Boston Massachusetts
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Chen Z, Sun C, Sheng W, Yuan B, Wu K, Tian Y, Wu C, Han J, Feng H. Alveolar soft-part sarcoma in the left forearm with cardiac metastasis: A case report and literature review. Oncol Lett 2015; 11:81-84. [PMID: 26870171 PMCID: PMC4727202 DOI: 10.3892/ol.2015.3889] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 09/15/2015] [Indexed: 02/02/2023] Open
Abstract
Alveolar soft-part sarcoma (ASPS) is an uncommon soft-tissue neoplasm, which is commonly found in the deep soft tissues of the extremities, with a propensity for recurrence and metastasis. However, the metastasis of ASPS to the heart is exceedingly rare. The present study reports such a rare case with cardiac metastasis. Using computed tomography, a 37-year-old man was diagnosed with brain, lung and spleen metastases from a previously treated ASPS in the left forearm. Cardiac metastasis was then diagnosed 1 month later. Despite chemotherapy and palliative whole-brain radiotherapy, the patient succumbed to the disease shortly after. This case suggests that the widespread metastases and cardiac involvement of ASPS may result in a poor outcome.
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Affiliation(s)
- Zheng Chen
- Department of Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Chengtao Sun
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Wei Sheng
- Department of Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Baoying Yuan
- Department of Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Kaidi Wu
- Department of Obstetrics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Yang Tian
- Department of Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Changshun Wu
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Junqing Han
- Department of Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Hong Feng
- Department of Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
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Viry F, Orbach D, Klijanienko J, Fréneaux P, Pierron G, Michon J, Neuenschwander S, Brisse HJ. Alveolar soft part sarcoma-radiologic patterns in children and adolescents. Pediatr Radiol 2013; 43:1174-81. [PMID: 23681452 DOI: 10.1007/s00247-013-2667-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 01/17/2013] [Accepted: 01/27/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Alveolar soft part sarcoma is a rare but highly malignant tumour and little is known about its radiologic pattern in children. OBJECTIVE To describe the radiologic features of alveolar soft part sarcoma in children and adolescents. MATERIALS AND METHODS We retrospectively analysed the clinical and imaging data of six children age 7-17 years at diagnosis, with histologically or genetically proven alveolar soft part sarcoma. RESULTS The tumours were located deep within muscles of the limbs (n = 4), in chest wall muscle (n = 1) and in the orbit (n = 1). High-flow feeding arteries, large drainage veins and intense enhancement were consistent findings by all imaging modalities. At MRI, all tumours demonstrated high signal intensity on T2-weighted images and high or iso-intense signal on T1-W imaging compared to muscle. In tumours larger than 70 mm in one dimension (n = 3/6), large vessels converging toward the tumour centre led to a highly vascularised central stellar area pattern. Five children demonstrated synchronous (n = 4/5) and metachronous (n = 1/5) lung metastases. CONCLUSION Alveolar soft part sarcoma should be suggested when a highly vascularised, intramuscular mass demonstrating large feeding and drainage vessels converging toward a central stellar area is seen in children, especially if synchronous lung metastases are present.
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Affiliation(s)
- Flore Viry
- Department of Radiology, Institut Curie, Paris, France.
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10
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Itani M, Shabb NS, Haidar R, Khoury NJ. AIRP Best Cases in Radiologic-Pathologic Correlation: Alveolar Soft-Part Sarcoma. Radiographics 2013; 33:585-93. [DOI: 10.1148/rg.332115173] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Alveolar soft part sarcoma 'revisited': clinicopathological review of 47 cases from a tertiary cancer referral centre, including immunohistochemical expression of TFE3 in 22 cases and 21 other tumours. Pathology 2012; 44:11-7. [PMID: 22173238 DOI: 10.1097/pat.0b013e32834d7ba4] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Alveolar soft part sarcoma accounts for 0.5-1.0% of soft tissue sarcomas in the United States. At our Hospital, it constitutes 1.8% of the newly diagnosed soft tissue sarcomas. Lately, TFE3 has been found to be a useful immunohistochemical marker for diagnosing this sarcoma. METHODS We reviewed 47 cases of alveolar soft part sarcoma that were either treated at Tata Memorial Hospital, Mumbai, India, or were referred in consultation from various parts of India. TFE3 immunohistochemical staining was performed on 22 alveolar soft part sarcomas and on 21 other tumours. RESULTS Unlike most other large series, 58% of patients were males and 40% were females. The ages ranged from 2 to 54 years (median 24 years). Tumours were located in the deep soft tissues of lower extremities (54%), upper extremities (13%), head and neck (11%), retroperitoneum (10%), chest wall (6%), pelvis (4%), and were positive for TFE3 (20/22, 91%), desmin (3/18, 16%), myoglobin (1/6, 17%) and smooth muscle actin (1/9, 11%). TFE3 was positive in tumour controls that comprised paragangliomas (3/4), translocation related renal cell carcinoma (1/1), adrenocortical carcinoma (1/3) and granular cell tumour (1/3). Treatment consisted of primary surgical excision, metastatectomy, chemotherapy and radiotherapy. Seven tumours (24%) recurred locally and 21 of 29 (72%) metastasised, mainly to the lungs. Follow-up information (5-108 months, median 27.5 months) was available for 22 patients. No patients died in the relatively short follow-up period. CONCLUSIONS TFE3 is a useful immunohistochemical marker for diagnosis of an alveolar soft part sarcoma. Awareness of other tumours expressing TFE3 is vital. Alveolar soft part sarcoma has a high metastasis rate but relatively good short-term survival. Surgical excision with follow-up forms the present management.
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Abstract
After a brief discussion of the rarity of soft tissue sarcomas in children and of the limited ability of magnetic resonance imaging to provide a tissue diagnosis, this article discusses the incidence, presentation, treatment, prognosis, and imaging characteristics of the more common and unusual pediatric soft tissue sarcomas. It begins with extensive discussion of rhabdomyosarcoma, synovial sarcoma, and congenital/infantile fibrosarcoma. It then presents a more abbreviated discussion of uncommon tumors such as alveolar soft part sarcoma, epithelioid sarcoma, extraosseous Ewing's sarcoma, granulocytic sarcoma, hemangiopericytoma, liposarcoma, malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, and undifferentiated sarcoma.
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Affiliation(s)
- Rebecca Stein-Wexler
- Department of Radiology, University of California at Davis, Sacramento, CA 95817, USA.
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13
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Malouf GG, Camparo P, Molinié V, Dedet G, Oudard S, Schleiermacher G, Theodore C, Dutcher J, Billemont B, Bompas E, Guillot A, Boccon-Gibod L, Couturier J, Escudier B. Transcription factor E3 and transcription factor EB renal cell carcinomas: clinical features, biological behavior and prognostic factors. J Urol 2010; 185:24-9. [PMID: 21074195 DOI: 10.1016/j.juro.2010.08.092] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE Translocation renal cell carcinomas represent a distinct clinicopathological entity. Studying the natural history, biological behavior and potential prognostic factors are crucially warranted. MATERIALS AND METHODS We selected 54 patients with renal cell carcinoma with positive nuclear transcription factor E3 and transcription factor EB expression from the Juvenile RCC Network. Recurrence-free survival and overall survival were assessed. RESULTS Median patient age was 24 years (range 1 to 64) and the male-to-female ratio was 1:1.4. At diagnosis 35 patients (65%) had local disease while 19 (35%) presented with distant metastases. The latter patients were older (median age 36 years) and predominantly male (male-to-female ratio 2) whereas the former group had a median age of 16 years and a male-to-female ratio of 1:2.5. Overall 36 patients underwent complete tumor resection and of these 8 had recurring cancer. On univariate analysis only lymph node involvement and American Joint Committee on Cancer stage were associated with poor recurrence-free survival. When stratified according to lymph node status age 25 years or older was found to predict relapse (p = 0.03). With a median followup of 19.2 months (range 1 to 58) 3-year overall survival was 14.3% in patients with distant metastasis and 70.6% in those without distant metastasis. Distant metastasis developed in the 2 patients with ASPSCR1-TFE3 fusion vs 1 of 11 with other fusion genes. CONCLUSIONS Transcription factor E3 and transcription factor EB renal cell carcinoma display different clinical behavior according to gender and age. Lymph node involvement represents the only factor that predicts recurrence. ASPSCR1-TFE3 might be the most aggressive among the transcription factor E3 fusion genes.
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Affiliation(s)
- Gabriel G Malouf
- Department of Medicine, Institut Gustave Roussy, Villejuif, France.
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14
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Rocha LA, Rizo VHT, Romañach MJ, de Almeida OP, Vargas PA. Oral metastasis of alveolar soft-part sarcoma: a case report and review of literature. ACTA ACUST UNITED AC 2010; 109:587-93. [PMID: 20303057 DOI: 10.1016/j.tripleo.2009.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Accepted: 12/09/2009] [Indexed: 10/19/2022]
Abstract
Alveolar soft-part sarcoma (ASPS) is a rare malignant neoplasm with uncertain histogenesis and with a distinctive morphology. It has been described in the oral cavity, but this is the first report of ASPS metastasizing to the maxillary tuber region. A 27-year-old male patient, who was under chemotherapy treatment for ASPS of the thigh, presented in our dental clinic with a painless and pedunculated nodule on the right tuber maxillae. The nodule was erythematous with smooth and lobular surface, measuring 3 cm in maximum diameter. An incisional biopsy was performed and the diagnosis of metastatic ASPS was made. Histologically, the tumor was characterized by a proliferation of polyhedral cells in pseudoalveolar pattern. Tumor cells were large, showing granular cytoplasm, periodic acid-Schiff positive diastase-resistant intracytoplasmic material, and vesicular nuclei with prominent nucleoli. Unfortunately, the patient died 2 months after the diagnosis of the oral metastasis. Metastases of ASPS to the mouth are very rare and indicate a poor prognosis.
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Affiliation(s)
- Lília Alves Rocha
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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15
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Eley KA, Afzal T, Shah KA, Watt-Smith SR. Alveolar soft-part sarcoma of the tongue: report of a case and review of the literature. Int J Oral Maxillofac Surg 2010; 39:824-6. [PMID: 20335005 DOI: 10.1016/j.ijom.2010.02.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Revised: 12/05/2009] [Accepted: 02/18/2010] [Indexed: 10/19/2022]
Abstract
Alveolar soft part sarcoma (ASPS) accounts for less than 1% of all sarcomas. More frequently encountered within the lower limbs, the authors present a 24-year-old male with ASPS presenting as an asymptomatic swelling of the lateral tongue. At 12 months post wide local excision of the lesion, the patient remains well with no evidence of local or regional recurrence. Histological and immunohistochemical features are diagnostic of ASPS. Whilst rare, head and neck surgeons should be aware of ASPS as a potential cause of slow growing lesions, as early surgical resection is vital in view of the propensity for metastatic spread.
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Affiliation(s)
- K A Eley
- Department of Oral and Maxillofacial Surgery, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK.
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16
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Luo J, Melnick S, Rossi A, Burke RP, Pfeifer JD, Dehner LP. Primary cardiac alveolar soft part sarcoma. A report of the first observed case with molecular diagnostics corroboration. Pediatr Dev Pathol 2008; 11:142-7. [PMID: 17378669 DOI: 10.2350/06-12-0199.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Accepted: 03/05/2007] [Indexed: 11/20/2022]
Abstract
A case of primary alveolar soft part sarcoma (ASPS) of the heart is reported in an 11-year-old female as 1 of 16 cases of ASPS presenting in the first 2 decades of life in our institutional 17-year review period. The classic alveolar or organoid pattern was inconspicuous as compared to a more diffuse or formless pattern consisting of a population of uniform round cells with abundant eosinophilic cytoplasm, but in addition there was a second, minor population of gigantiform tumor cells with a variety of unusual shapes. Scattered tumor cells contained dense eosinophilic condensations in the cytoplasm. Other unusual features for ASPS in our case included a lymphohistocytic reaction and zonal necrosis. Immunohistochemistry revealed nuclear reactivity for TFE3, and the ASPL-TFE3 fusion transcript was identified by reverse-transcriptase polymerase chain reaction. The only other examples of ASPS involving the heart were 3 cases in the literature of metastatic disease from tumors arising in the soft tissues. This initial case of primary cardiac ASPS joins the list of other types of sarcomas in children that have been reported as primary neoplasms of the heart.
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Affiliation(s)
- Jean Luo
- Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish and St Louis Children's Hospitals, Washington University Medical Center, St Louis, MO, USA
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Strunk T, Bastian PJ, Ellinger J, Biermann K, Müller SC. [Aggressive course of a malignant alveolar soft tissue sarcoma]. Urologe A 2007; 46:1422-4. [PMID: 17641862 DOI: 10.1007/s00120-007-1509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Alveolar soft part sarcoma is a rare soft tissue tumor. Most patients who are affected by this sarcoma are between 15 and 35 years old. The tumor is characterized by its uncommon location of metastasis. Publications concerning this sarcoma subform are rare and the best therapeutic procedure is not yet clear. Surgical excision, radiation and chemotherapy are performed, whereas complete surgical excision achieves the best results in long-term follow-up. We report a patient's history who rapidly died of his sickness despite the low initial tumor stage.
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MESH Headings
- Abdominal Neoplasms/diagnosis
- Abdominal Neoplasms/pathology
- Abdominal Neoplasms/radiotherapy
- Abdominal Neoplasms/surgery
- Aged
- Capillaries/pathology
- Diagnosis, Differential
- Disease Progression
- Fatal Outcome
- Humans
- Lymph Node Excision
- Lymph Nodes/pathology
- Lymphatic Metastasis/pathology
- Lymphoma, Non-Hodgkin/pathology
- Male
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/radiotherapy
- Neoplasm Recurrence, Local/surgery
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/radiotherapy
- Neoplasms, Second Primary/surgery
- Radiotherapy, Adjuvant
- Retreatment
- Sarcoma, Alveolar Soft Part/diagnosis
- Sarcoma, Alveolar Soft Part/pathology
- Sarcoma, Alveolar Soft Part/radiotherapy
- Sarcoma, Alveolar Soft Part/surgery
- Testicular Neoplasms/pathology
- Tomography, X-Ray Computed
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Affiliation(s)
- T Strunk
- Klinik und Poliklinik für Urologie, Medizinische Einrichtungen der Universität Bonn, 53127 Bonn.
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18
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Abstract
This article provides an overview of the pathology of alveolar soft part sarcoma, focused on its morphology, special stains useful in diagnosis, and the clinical and radiographic features of the disease. Alveolar soft part sarcoma is a rare neoplasm of unknown histogenesis with poor prognosis. Although there are several immunohistochemical stains available to help reach the diagnosis, the morphology of the tumor should be considered the main diagnostic feature. The periodic acid-Schiff stain is the best single stain that supports the diagnosis.
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Affiliation(s)
- Neda Zarrin-Khameh
- Baylor College of Medicine, Department of Pathology, One Balyor Plaza, Houston, TX 77030, USA.
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19
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Anderson ME, Hornicek FJ, Gebhardt MC, Raskin KA, Mankin HJ. Alveolar soft part sarcoma: a rare and enigmatic entity. Clin Orthop Relat Res 2005; 438:144-8. [PMID: 16131883 DOI: 10.1097/01.blo.0000180049.50832.4a] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
UNLABELLED Alveolar soft part sarcoma is a rare malignant tumor with unusual clinical behavior. Treatment of alveolar soft part sarcoma has been difficult to evaluate because of the small numbers of cases seen, but it seemed that although treatment of the primary tumor in alveolar soft part sarcoma often is successful, treatment of metastatic tumors is unsuccessful. A review of outcome after treatment of primary and metastatic disease in the 15 patients in our database with alveolar soft part sarcoma was done in order to evaluate this issue. Nine of 15 patients presented with metastatic disease and one further patient developed metastases. Treatment of primary tumors involved surgical excision in all but one patient and radiation in all patients. Adjuvant chemotherapy was administered to one patient with localized disease and to six patients with metastatic disease. There were no local recurrences. Treatment of metastatic tumors involved chemotherapy in seven patients, metastectomy in three patients, and radiation in two patients. All instances of the metastatic disease either recurred or progressed. Overall survival was 75% at 5 years and 40% at 10 years with a mean survival of 6.5 years, despite the high number of patients with metastatic disease. Current treatment results in good local control of primary tumors, but poor control of metastatic tumors. New approaches to treatment of metastatic alveolar soft part sarcoma must be investigated and applied. LEVEL OF EVIDENCE Therapeutic study, Level IV-1 (case series). See the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Megan E Anderson
- Harvard Combined Orthopaedic Oncology Program, Boston, MA 02215, USA.
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