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Wakely PE, Saoud C, Ali SZ. Synovial sarcoma: cytopathology of 51 cases highlighting the application of ancillary molecular testing. J Am Soc Cytopathol 2023:S2213-2945(23)00026-1. [PMID: 37127512 DOI: 10.1016/j.jasc.2023.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/15/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION Among sarcomas, synovial sarcoma (SS) is defined by its unique SS18 cytogenetic translocation. Fine needle aspiration (FNA) biopsy is in a key position to exploit this uniqueness for diagnostic purposes. MATERIALS AND METHODS Our cytopathology files were searched for examples of SS with histopathologic verification. FNA biopsy, imprint smears, and core needle biopsy (CNB) were performed using standard techniques. RESULTS Fifty-one cases from 49 patients (male/female ratio, 1:1; age range, 12-79 years; mean age, 40 years) met the inclusion criteria. Of the 51 cases, 44 (86%) were FNAs, 6 were cytology imprints, and 1 was pleural fluid. Eleven aspirates had concurrent CNB. All cases had tissue confirmation. The biopsy sites included extremities (n = 24; 47%), trunk (n = 12; 24%), lung (n = 8; 16%), head or neck (n = 6; 12%), and pleural fluid (n = 1; 2%). The aspirates were from primary (n = 36; 71%), metastatic (n = 12; 24%), and recurrent (n = 3; 5%) neoplasms. The cytologic diagnoses were SS (69%), suspicious for SS (12%), malignancy (10%), spindle cell neoplasm (4%), and malignancy other than SS (6%). In general, smears and imprints contained dense cell aggregates and single cells composed of a monotonous population having fusiform, rounded, or ovoid banal nuclei and scant cytoplasm. Poorly differentiated SS showed both large epithelioid cell and small cell cytomorphology. When performed, SS18 immunohistochemical and genetic testing was positive in all 19 FNA and 3 CNB cases. CONCLUSIONS When coupled with appropriate ancillary testing, FNA biopsy allows for a specific, accurate diagnosis of SS in most cases.
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Affiliation(s)
- Paul E Wakely
- Department of Pathology, The Ohio State University Wexner Medical Center, James Cancer Hospital and Solove Research Institute, Columbus, Ohio.
| | - Carla Saoud
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Syed Z Ali
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland
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2
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Turk Y, Karimov Z, Ozdemir M, Ertan Y, Makay O. Composite pheochromocytoma with spindle cell sarcoma - a rare tumor of the adrenal gland: case report. Hormones (Athens) 2022; 21:507-511. [PMID: 35304732 DOI: 10.1007/s42000-022-00363-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/08/2022] [Indexed: 12/23/2022]
Abstract
Composite pheochromocytomas with a non-pheochromocytoma component stemming from an embryological origin other than the neural crest comprise a unique entity. We present a patient diagnosed with a composite pheochromocytoma with spindle cell sarcoma, which is, to our knowledge, the first case reported in the current literature. A 45-year-old female patient with elevated blood pressure had undergone adrenalectomy for clinically and radiologically diagnosed pheochromocytoma. Macroscopic examination of the specimen showed an encapsulated mass containing two nodules. One tumor was composed of large polygonal neoplastic cells with round vesicular nuclei and granular cytoplasm forming the characteristic Zellballen pattern consistent with pheochromocytoma, while the other was composed of spindle cells with hyperchromatic nuclei and prominent nucleoli, thus resembling a sarcoma. The patient was discharged on the fourth post-operative day without any complications. Even though for both tumors surgical resection is the main treatment modality, our case report aims to shed light on and discuss the etiology and management of a rarely presented composite pheochromocytoma and spindle cell sarcoma.
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Affiliation(s)
- Yigit Turk
- Division of Endocrine Surgery, Department of General Surgery, Ege University Hospital, 35100, Izmir, Turkey
| | - Ziya Karimov
- Medicine Program and Research Education Program, Ege University Faculty of Medicine, 35100, Izmir, Turkey
| | - Murat Ozdemir
- Division of Endocrine Surgery, Department of General Surgery, Ege University Hospital, 35100, Izmir, Turkey
| | - Yesim Ertan
- Division of Endocrinopathology, Department of Pathology, Ege University Hospital, 35100, Izmir, Turkey
| | - Ozer Makay
- Division of Endocrine Surgery, Department of General Surgery, Ege University Hospital, 35100, Izmir, Turkey.
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3
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León-Asuero-Moreno I, Fernández-Rodríguez P, Masero Carretero J, Herrera Martínez Y, Jiménez-Hoyuela García J, Acevedo Báñez I. [18F]FDG PET/CT in an azygos vein spindle-cell sarcoma in a patient with thoracic pain. Rev Esp Med Nucl Imagen Mol 2022; 41:188-189. [DOI: 10.1016/j.remnie.2021.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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4
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Lundeberg KR, Vidis LJ, Martin J, Randolph-Habecker J. Invaluable role of histopathology in the diagnosis of cutaneous leiomyosarcoma in insulin injection site reaction. BMJ Case Rep 2021; 14:14/11/e241333. [PMID: 34799385 PMCID: PMC8606758 DOI: 10.1136/bcr-2020-241333] [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] [Indexed: 11/16/2022] Open
Abstract
Soft tissue sarcomas (STSs) are rare and may often be misdiagnosed, resulting in delays in treatment. A 67-year-old cisgender woman with type 2 diabetes mellitus and obesity presented to her primary care physician with a mass on her left proximal arm. The clinical opinion of the attending physician was that of an insulin injection site reaction. After further evaluation from the physician, the patient was diagnosed with a lipoma without confirmatory histology. The patient continued to present with an enlarging mass, decline in health status and continued with local wound care. The patient underwent a confirmatory biopsy following which, the patient was diagnosed with leiomyosarcoma. This case report highlights the case of a person with a low or moderate income with a self-reported low health literacy living in a rural community and how STS may be misdiagnosed in medically underserved. The patient’s primary or oncology care team are not involved in the production or review of this case report.
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Affiliation(s)
- Kathleen Renee Lundeberg
- Student Physician, Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, Washington, USA
| | - Laura J Vidis
- Student Physician, Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, Washington, USA.,Department of Pathology & Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Jennifer Martin
- School of Occupational Therapy, Texas Woman's University, Dallas, Texas, USA
| | - Julie Randolph-Habecker
- Department of Biomedical Sciences, Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, Washington, USA
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5
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León-Asuero-Moreno I, Fernández-Rodríguez P, Masero Carretero JM, Herrera Martínez Y, Jiménez-Hoyuela García JM, Acevedo Báñez I. 18F-FDG PET/CT in an azygos vein spindle-cell sarcoma in a patient with thoracic pain. Rev Esp Med Nucl Imagen Mol 2021; 41:S2253-654X(21)00022-6. [PMID: 33637462 DOI: 10.1016/j.remn.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/16/2021] [Accepted: 01/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
- I León-Asuero-Moreno
- Servicio de Medicina Nuclear, Department of Nuclear Medicine, Virgen Macarena University Hospital, Sevilla, España
| | - P Fernández-Rodríguez
- Servicio de Medicina Nuclear, Department of Nuclear Medicine, Virgen del Rocío University Hospital, Sevilla, España.
| | - J M Masero Carretero
- Servicio de Anatomía Patológica, Department of Pathology, Virgen del Rocío University Hospital, Sevilla, España
| | - Y Herrera Martínez
- Servicio de Medicina Nuclear, Department of Nuclear Medicine, Virgen del Rocío University Hospital, Sevilla, España
| | - J M Jiménez-Hoyuela García
- Servicio de Medicina Nuclear, Department of Nuclear Medicine, Virgen del Rocío University Hospital, Sevilla, España
| | - I Acevedo Báñez
- Servicio de Medicina Nuclear, Department of Nuclear Medicine, Virgen del Rocío University Hospital, Sevilla, España
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6
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Schwitzer D, Kim R, Williams F, Hammer D. Spindle Cell Sarcoma of the Maxilla: A Rare Entity, Case Report, and Review of the Literature. J Oral Maxillofac Surg 2020; 78:1334-1342. [PMID: 32147227 DOI: 10.1016/j.joms.2020.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 10/25/2022]
Abstract
Spindle cell sarcoma (SCS) is a malignancy, with the most recent Surveillance, Epidemiology, and End Results (SEER) data citing a total of 250 reported cases occurring in the head and neck. Of these cases, none originated in the maxillofacial hard tissue. To the best of our knowledge, only 2 cases of primary osseous SCS of the maxillofacial region have been reported. These cases were not accounted for in the SEER data. The diagnosis of SCS requires its differentiation from other sarcomas and spindle cell neoplasms. Therefore, a comprehensive review to reinforce its inclusion in oral and maxillofacial surgeons' differential diagnosis for osseous neoplastic pathology is desired. In the present case report, we have described a maxillary SCS in a patient with an initial diagnosis of a spindle cell lesion of uncertain biologic behavior. We reviewed the data for SCS, including the epidemiologic data, diagnostic challenges, clinical and radiographic presentations, prognostic indicators, and treatment.
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Affiliation(s)
- David Schwitzer
- Resident, Department of Oral and Maxillofacial Surgery, Parkland Memorial Hospital, UT Southwestern Medical Center, Dallas, TX.
| | - Roderick Kim
- Director of Research and Assistant Fellowship Director, Division of Maxillofacial Oncology and Reconstructive Surgery, John Peter Smith Hospital, Fort Worth, TX
| | - Fayette Williams
- Faculty, Division and Fellowship Director, Division of Maxillofacial Oncology and Reconstructive Surgery, John Peter Smith Hospital, Fort Worth, TX
| | - Daniel Hammer
- Fellow, Division of Maxillofacial Oncology and Reconstructive Surgery, John Peter Smith Hospital, Fort Worth, TX
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7
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Bryer E, Hartner L. The Heart of the Matter: A Unique Convergence of Cardiac Neoplasm, Hereditary Nonpolyposis Colorectal Cancer, and Spindle Cell Sarcoma. EUROPEAN MEDICAL JOURNAL 2019. [DOI: 10.33590/emj/10313115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Primary cardiac tumours are exceedingly unusual and aggressive; they often develop in younger patients and present with advanced disease. The rarity and heterogeneity of primary cardiac tumours challenge the standardisation of therapeutic guidelines. Undifferentiated primary cardiac spindle cell sarcomas, a distinct subset of primary cardiac sarcomas, are especially unique with <20 cases reported worldwide, the majority of which are of left atrial origin. This article presents a review of the aetiology, pathophysiology, and therapy of undifferentiated primary cardiac spindle cell sarcomas. In conjunction, the authors present a unique case of a woman with hereditary nonpolyposis colorectal cancer (Lynch syndrome) who presented with a primary cardiac spindle cell sarcoma of left ventricular origin; this is the first case of this type and location of cardiac tumour reported in a patient with Lynch syndrome.
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Affiliation(s)
- Emily Bryer
- Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Lee Hartner
- Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
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8
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Paek SH, Lee KE, Kim HS, Woo J, Lim W. Spindle Cell Sarcoma Mimicking Supraclavicular Lymph Node Metastasis of Breast Cancer. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:194-197. [PMID: 30760697 PMCID: PMC6388761 DOI: 10.12659/ajcr.913581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Patient: Female, 45 Final Diagnosis: Spindle cell sarcoma Symptoms: Palpable mass Medication: — Clinical Procedure: Surgery and radiotherapy Specialty: Surgery
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Affiliation(s)
- Se Hyun Paek
- Department of Surgery, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Kyoung Eun Lee
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Han Su Kim
- Department of Otorhinolaryngology, Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Joohyun Woo
- Department of Surgery, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Woosung Lim
- Department of Surgery, College of Medicine, Ewha Womans University, Seoul, South Korea
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9
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Barber SR, Kopach P, Genega EM, Carroll TL. Low grade spindle cell sarcoma of the true vocal folds. OTOLARYNGOLOGY CASE REPORTS 2018. [DOI: 10.1016/j.xocr.2017.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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10
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Feng L, Wang M, Yibulayin F, Zhang H, Yang YL, Ren F, Wushou A. Spindle cell sarcoma: a SEER population-based analysis. Sci Rep 2018; 8:5024. [PMID: 29568070 PMCID: PMC5864760 DOI: 10.1038/s41598-018-23145-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 03/01/2018] [Indexed: 01/01/2023] Open
Abstract
Due to the substantial limitation of study population, Spindle cell sarcoma (SCS) was unexplored comprehensively. In this study, we investigated the clinical characteristics and disease specific prognostic factors of SCS. 3299 SCS cases were identified and extracted from Surveillance, Epidemiology, and End Results (SEER) database (1973–2017). White people account for 79.1% with median age of 57 years without predominance in any gender. Significant disease specific survival (DSS) and overall survival (OS) were found differentiated in age, T stage, N stage, M stage, AJCC stage, SEER historic stage, tumor locations, surgery, and pathologic grade. In the multivariate Cox analysis, the age >64 years (for DSS, P < 0.001 and for OS, P < 0.001; Reference age ≤64 years), AJCC stage III (for DSS, P = 0.006 and for OS, P = 0.04; Reference: AJCC stage I), and non-surgical treatment (for DSS, P < 0.001 and for OS, P < 0.001; Reference: surgery) were independently associated with worse DSS and OS. In brief, our study demonstrated that SCS mostly found in white people at fifth to seventh decades of life without gender predilection. The patient’s age, AJCC stage, tumor location and surgery were independent prognostic indicators for both DSS and OS of SCS.
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Affiliation(s)
- Lei Feng
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, China.,Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, China
| | - Meng Wang
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, China.,Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, China
| | - Feiluore Yibulayin
- Department of Epidemiology and Biostatistics, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, China.,Department of preventive medicine, school of public health, Fudan University, Shanghai, 200001, China
| | - Hao Zhang
- Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, China.,Department of Epidemiology and Biostatistics, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, China
| | - Yin-Long Yang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200001, China
| | - Fei Ren
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Alimujiang Wushou
- Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, China. .,Oral Biomedical Engineering Laboratory, Shanghai Stomatological Hospital, Fudan University, Shanghai, 200001, China.
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11
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Panagopoulos I, Gorunova L, Lobmaier I, Bjerkehagen B, Heim S. Identification of SETD2-NF1 fusion gene in a pediatric spindle cell tumor with the chromosomal translocation t(3;17)(p21;q12). Oncol Rep 2017; 37:3181-3188. [PMID: 28498454 PMCID: PMC5442398 DOI: 10.3892/or.2017.5628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 03/29/2017] [Indexed: 01/20/2023] Open
Abstract
Spindle cell tumors are clinically heterogeneous but morphologically similar neoplasms. The term refers to the tumor cells' long and slender microscopic appearance. Distinct subgroups of spindle cell tumors are characterized by chromosomal translocations and also fusion genes. Other spindle cell tumors exist that have not yet been found to have characteristic, let alone pathognomonic, genetic or pathogenetic features. Continuous examination of spindle cell tumors is likely to reveal other subgroups that may, in the future, be seen to correspond to meaningful clinical differences and may even be therapeutically decisive. We analyzed genetically a pediatric spindle cell tumor. Karyotyping showed the tumor cells to carry a t(3;17)(p21;q12) chromosomal translocation whereas RNA sequencing identified a SETD2-NF1 fusion gene caused by the translocation. RT-PCR together with Sanger sequencing verified the presence of the above-mentioned fusion transcript. Interphase FISH analysis confirmed the existence of the chimeric gene and showed that there was no reciprocal fusion. The fusion transcript codes for a protein in which the last 114 amino acids of SETD2, i.e., the entire Set2 Rpb1 interacting (SRI) domain of SETD2, are replaced by 30 amino acids encoded by the NF1 sequence. The result would be similar to that seen with truncating SETD2 mutations in leukemias. Absence of the SRI domain would result in inability to recruit SETD2 to its target gene locus through binding to the phosphor-C-terminal repeat domain of elongating RNA polymerase II and may affect H3K36 methylation. Alternatively, loss of one of two functional SETD2 alleles might be the crucial tumorigenic factor.
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Affiliation(s)
- Ioannis Panagopoulos
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Ludmila Gorunova
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Ingvild Lobmaier
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Bodil Bjerkehagen
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Sverre Heim
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
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13
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Chen J, Zhang J, Dowell JD, Xi W, Zhang X, Chen S. A spindle cell sarcoma of liver supplied by internal mammary artery. Diagn Interv Imaging 2014; 96:103-5. [PMID: 25533497 DOI: 10.1016/j.diii.2014.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- J Chen
- Department of Radiology, Jiangsu Cancer Hospital & Cancer Hospital of Nanjing Medical University (NMU), 42, Baiziting, Nanjing 210009, China
| | - J Zhang
- Department of Pathology, Jiangsu Cancer Hospital & Cancer Hospital of Nanjing Medical University (NMU), Nanjing 210009, China
| | - J D Dowell
- Division of Interventional Radiology, Department of Radiology, Wexner Medical Center, The Ohio State University, Columbus, Ohio 43210, USA
| | - W Xi
- Department of Radiology, Jiangsu Cancer Hospital & Cancer Hospital of Nanjing Medical University (NMU), 42, Baiziting, Nanjing 210009, China
| | - X Zhang
- Department of Radiology, Jiangsu Cancer Hospital & Cancer Hospital of Nanjing Medical University (NMU), 42, Baiziting, Nanjing 210009, China
| | - S Chen
- Department of Radiology, Jiangsu Cancer Hospital & Cancer Hospital of Nanjing Medical University (NMU), 42, Baiziting, Nanjing 210009, China.
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L'heureux-Lebeau B, Saliba I. Updates on the diagnosis and treatment of intracranial nerve malignant peripheral nerve sheath tumors. Onco Targets Ther 2013; 6:459-70. [PMID: 23667313 PMCID: PMC3650571 DOI: 10.2147/ott.s41397] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Indexed: 01/30/2023] Open
Abstract
Background: Malignant peripheral nerve sheath tumors (MPNSTs) are rare entities and MPNSTs of intracranial nerves are even more sporadic. MPNSTs present diagnosis and treatment challenges since there are no defined diagnosis criteria and no established therapeutic strategies. Methods: We reviewed literature for MPNST-related articles. We found 45 relevant studies in which 60 cases were described. Results: We identified 60 cases of intracranial nerve MPNSTs. The age ranged from 3 to 75 years old. Male to female ratio was 1.5:1. The most involved cranial nerves (CNs) were CN VIII (60%), CN V (27%), and CN VII (10%). Most of the MPNSTs reported (47%) arose sporadically, 40% arose from a schwannoma, 8% arose from a neurofibroma, and 6% arose from an unspecified nerve tumor. Twenty patients had a history of radiation exposure, four patients had neurofibromatosis type 1 (NF1), four patients had neurofibromatosis type 2 (NF2), and NF2 was suspected in two other patients. Twenty-two patients were treated with radiotherapy and presented a higher survival rate. Seventy-two percent of patients died of their disease while 28% of patients survived. One-year survival rate was 33%. Forty-five percent of tumors recurred and 19% of patients had metastases. Conclusion: MPNSTs involving CNs are very rare. Diagnosis is made in regards to the histological and pathological findings. Imaging may help orient the diagnosis. A preexisting knowledge of the clinical situation is more likely to lead to a correct diagnosis. The mainstay of treatment is radical surgical resection with adjuvant radiotherapy. Since these tumors are associated with a poor prognosis, a close follow-up is mandatory.
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