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Fioravanzo A, Martignoni G, Brunelli M, Segala D, Erdini F. Report of two primary renal tumors with myxoid features. Differential diagnosis between benign and malignant entities. Pathologica 2022; 113:427-435. [PMID: 34974548 PMCID: PMC8720392 DOI: 10.32074/1591-951x-180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/30/2020] [Indexed: 11/30/2022] Open
Abstract
Renal mesenchymal neoplasms are rare entities which can have a benign or a malignant behavior. Herein we describe two renal mesenchymal tumors with myxoid stroma, investigating the wide spectrum of differential diagnosis. With our first case we considered some benign entities such as myxoma, myxoid leiomyoma, and mixed epithelial and stromal tumor; with our second case we considered some sarcomas with myxoid features such as myxofibrosarcoma, low-grade fibromyxoid sarcoma, dedifferentiated liposarcoma, and myxoid liposarcoma. During the diagnostic process, it is important to integrate histopathological, immunohistochemical, and molecular data in order to avoid misdiagnosis. We concluded our second case report was a myxofibrosarcoma grade 1. To the best of our knowledge, we described the fourth primary renal myxofibrosarcoma reported in literature.
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Affiliation(s)
- Adele Fioravanzo
- Department of Diagnostics and Public Health, Section of Anatomical Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - Guido Martignoni
- Department of Diagnostics and Public Health, Section of Anatomical Pathology, University and Hospital Trust of Verona, Verona, Italy.,Pathology Unit, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health, Section of Anatomical Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - Diego Segala
- Pathology Unit, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Francesco Erdini
- Department of Diagnostics and Public Health, Section of Anatomical Pathology, University and Hospital Trust of Verona, Verona, Italy
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Zhang B, Bai M, Tian R, Hao S. Idiopathic and radiation-induced myxofibrosarcoma in the head and neck-case report and literature review. Chin Neurosurg J 2021; 7:48. [PMID: 34823603 PMCID: PMC8620227 DOI: 10.1186/s41016-021-00267-9] [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: 05/18/2021] [Accepted: 11/08/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Myxofibrosarcoma (MFS), especially radiation-Induced MFS (RIMFS) in the head and neck, is an extremely rare malignant fibroblastic tumor. The diagnosis and treatment of MFS remain great challenges. In the present study, we presented one case of RIMFS. Combined with previous literature, the clinical features, essentials of diagnosis, and treatment modalities of MFS in the head and neck were reviewed to better understand this rare entity. CASE PRESENTATION We reported a case of RIMFS under the left occipital scalp in a 20-year-old girl with a history of medulloblastoma surgery and radiotherapy in 2006. A total tumor resection was performed with preservation of the overlying scalp the underlying bone, and no adjuvant therapy was administered after the first operation. The postoperative pathological diagnosis was high-grade MFS. The tumor relapsed 6 months later, and then, a planned extensive resection with negative surgical margins was carried out, followed by radiotherapy. No relapse occurred in a 12-month postoperative follow-up. CONCLUSIONS Planned gross total resection (GTR) with negative margins is the reasonable choice and footstone of other treatments for MFS. Ill-defined infiltrated borders and the complicated structures make it a great trouble to achieve total resection of MFS in the head and neck, so adjuvant radiotherapy and chemotherapy seem more necessary for these lesions.
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Affiliation(s)
- Bin Zhang
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, People's Republic of China
| | - Miao Bai
- Department of Neurology, Tang Du Hospital, Air Force Medical University, Xi'an, China
| | - Runfa Tian
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, People's Republic of China
| | - Shuyu Hao
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, People's Republic of China.
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Yamanaka R, Hayano A. Radiation-Induced Sarcomas of the Central Nervous System: A Systematic Review. World Neurosurg 2017; 98:818-828.e7. [DOI: 10.1016/j.wneu.2016.11.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 10/31/2016] [Accepted: 11/01/2016] [Indexed: 02/07/2023]
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Costa DA, Barata P, Gouveia E, Mafra M. Right cardiac intracavitary metastases from a primary intracranial myxofibrosarcoma. BMJ Case Rep 2016; 2016:bcr-2015-214052. [PMID: 27013654 DOI: 10.1136/bcr-2015-214052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Primary intracranial myxofibrosarcoma is exceedingly rare, with less than 10 cases published. We present a case of a 23-year-old man with previous history of a primary low grade myxofibrosarcoma of the left parietal-occipital convexity resected in March 1999. He subsequently underwent several interventions for multiple local recurrent disease until March 2004. At that time, complete remission was documented. About 8 years later, in February 2012, the patient was admitted to the emergency room with refractory acute pulmonary oedema. On work up, sustained monomorphic ventricular tachycardia and hyperechoic myocardial mass with invasion of the right ventricular cavity were detected. Electrical cardioversion was unsuccessful and irreversible cardiac arrest followed. The autopsy confirmed multiple bilateral lung metastases, malignant pulmonary embolism and myocardial invasion by the primary tumour, with intracavitary cardiac thrombosis and absence of intracranial disease. To the best of our knowledge, this is the first report of extracranial metastases of this neoplasm.
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Affiliation(s)
- Diogo Alpuim Costa
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Lisbon, Portugal Underwater and Hyperbaric Medicine Centre, Portuguese Navy, Lisbon, Portugal Nova Medical School, Lisbon, Portugal
| | - Pedro Barata
- Nova Medical School, Lisbon, Portugal Department of Medical Oncology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Emanuel Gouveia
- Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Lisbon, Portugal
| | - Manuela Mafra
- Pathology Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal Instituto Português de Oncologia de Lisboa Francisco Gentil, EPE, Lisbon, Portugal
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Li W, Li D, Zhu X, Lu S, He C, Yang Q. Low-grade myxofibrosarcoma following a metal implantation in femur: a case report. Diagn Pathol 2014; 9:6. [PMID: 24444015 PMCID: PMC3926977 DOI: 10.1186/1746-1596-9-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 12/27/2013] [Indexed: 12/15/2022] Open
Abstract
UNLABELLED Myxofibrosarcoma is a myxoid variant of malignant fibrous histiocytoma that most commonly involves the extremities of elderly people. However, a primary myxofibrosarcoma with bone invasion in young adults is extremely rare. Herein, we report the case of a 31-year-old male with a gradually enlarging left thigh mass, who had a history of left femur fracture and received an open reduction and internal fixation with titanium alloy plates and screws 33 months previously. Imaging investigations revealed an irregularly shaped soft tissue mass around the left femur shaft and a partial bone defect in the middle one-third of the left femur. Pathological examination of the resected specimen showed a multi-nodular appearance, abundant myxoid matrix and elongated curvilinear capillaries. Immunohistochemical studies revealed that the tumor cells was positive for VIM and MDM2, and was negative for CK, MSA, SMA, DES, S-100 and CD34. Labeling index of Ki-67 was 25%. Based on the morphological finding and immunostaining, it was diagnosed as a low-grade myxofibrosarcoma. The clinical and imaging examinations did not reveal the evidence of a primary cancer elsewhere, and the patient had no personal or family history of malignancy. To our knowledge, this is the first case of a primary myxofibrosarcoma developed following a fracture and metal implantation in young adults. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1745984882113605.
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Affiliation(s)
| | - Dan Li
- Department of Pathology, Gannan Medical University, No, 1, Yixueyuan Road, Ganzhou, Jiangxi 341000, China.
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Tearada H, Nagata M, Mugiya S, Ozono S. High-grade myxofibrosarcoma presenting at the spermatic cord after radiotherapy for prostate cancer. BMJ Case Rep 2012. [PMID: 23195821 DOI: 10.1136/bcr-03-2012-6082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 72-year-old man with a history of prostate cancer presented 7 years postradiotherapy with a painless, egg-sized, rapidly growing nodule on the left groin at the radiation site. He underwent left high orchiectomy under a diagnosis of groin lymph node metastasis of prostate cancer. The tumour had penetrated deep into the internal inguinal ring and was resected as proximally as possible to the internal ring with a positive surgical margin. Macroscopically, the left testis was intact in the resected specimen. Immunohistochemical staining revealed that the tumour consisted of myxofibrosarcoma (MFS) with spindle cells; and was positive for vimentin, cytokeratin (AE1/AE3), MIB-1 and CD68, and negative for α-SMA, S-100, CD34 and myogenin. Thus, the tumour was diagnosed as high-grade MFS of the spermatic cord. Postoperative CT revealed a right renal tumour and adrenal tumour. Right radial nephrectomy was performed and the patient was doing well at 10-month follow-up.
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Affiliation(s)
- Hiroshi Tearada
- Department of Urology, Terada Clinic, Hamamatsu, Shizuoka, Japan.
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Primary cerebral myxofibrosarcoma: clinical, morphologic, immunohistochemical, molecular, and ultrastructural study of an infrequent tumor in an extraordinary localization. J Pediatr Hematol Oncol 2011; 33:e279-83. [PMID: 21716137 DOI: 10.1097/mph.0b013e318211834e] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Herein, we describe an intracerebral primary low-grade myxofibrosarcoma occurring in a 9-year-old boy. The lesion measured 7 cm and occupied the left parieto-occipital region. A gross-total removal of the tumor was performed. Nine months later, radiologic follow-up revealed a local recurrence which was again surgically removed. The patient then underwent radiotherapy and chemotherapy. He was well and disease-free at 6 months follow-up. The tumor was composed of spindle, stellated, and multinucleated cells embedded in a myxoid background. Foci of increased cellularity, pleomorphism, and high mitotic rate were present. The tumor borders were sharply demarcated from the non-neoplastic nervous parenchyma. Immunohistochemical staining showed that the neoplastic cells were vimentine and CD34 positive. Fluorescence in-situ hybridization analyses did not show FUS and EWSR1 gene rearrangements. Primary intracranial myxofibrosarcomas are very rare (to the best of our knowledge, less than 10 published cases in the international literature). We believe each new case should be recorded to produce a better clinical, pathologic, molecular, prognostic, and therapeutic characterization of this lesion.
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Bandino JP, Norton SA, Aldrich SL, Wisco OJ, Hodson DS, Murchland MR, Grande DJ. Low-grade myxofibrosarcoma presenting at the site of prior high-grade disease. J Cutan Pathol 2011; 38:808-13. [PMID: 21752050 DOI: 10.1111/j.1600-0560.2011.01740.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Myxofibrosarcoma is one of the most common soft tissue sarcomas occurring in older adults. It can arise de novo or can be radiation induced, and the term myxofibrosarcoma was originally devised to encompass a spectrum of myxoid tumors with characteristics similar to malignant fibrous histiocytoma (MFH). Confusion exists, however, regarding the distinction between microscopic grade and characteristics of myxofibrosarcoma and MFH. Correct classification is vital to prognosis, as the degree of myxoid change is inversely related to the incidence of metastasis. We present a case of a 76-year-old man with a history of high-grade MFH of the left lower extremity, status post excision and radiation therapy, who presented 2 years later with a regional metastatic recurrence of high-grade MFH to the left groin as well as new nodules adjacent to and within his prior excision and radiation site. These new nodules were determined to represent low-grade myxofibrosarcoma. These new low-grade lesions either represent a low-grade recurrence of high-grade sarcoma or a new, radiation-induced soft tissue sarcoma occurring at the same site. Radiotherapy, however, is an unlikely cause; specific postradiation sarcoma criteria have not been fulfilled. This article discusses both the nosology and histopathological spectrum of these important soft tissue sarcomas, their aggressive and recurrent nature and their association with radiation therapy.
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Affiliation(s)
- Justin P Bandino
- San Antonio Uniformed Services Health Education Consortium, San Antonio, TX, USA.
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Moritani S, Ichihara S, Hasegawa M, Takada S, Takahashi T, Kato E, Mii S, Iwakoshi A. Dedifferentiation and progression of an intracranial solitary fibrous tumor: Autopsy case of a Japanese woman with a history of radiation therapy of the head during infancy. Pathol Int 2010; 61:143-9. [DOI: 10.1111/j.1440-1827.2010.02627.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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