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Rungsiprakarn P, Ryan AL, Wong DD, Luo M, Kazahaya K, Arkader A, Lau LMS, Ajuyah P, Rudzinski E, Kreiger PA, Roebuck DJ, Surrey LF, Foo TSY. Keratin-Positive Giant Cell Tumor of Bone and Soft Tissue With HMGA2::NCOR2 Fusion in Children Under 10 With Response to Imatinib Therapy: A Case Series. JCO Precis Oncol 2024; 8:e2300659. [PMID: 38935896 DOI: 10.1200/po.23.00659] [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: 12/06/2023] [Revised: 04/03/2024] [Accepted: 04/25/2024] [Indexed: 06/29/2024] Open
Abstract
HMGA2::NCOR2 keratin-positive giant cell tumors in children with response to imatinib in an infant.
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Affiliation(s)
- Phassawan Rungsiprakarn
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Anne L Ryan
- Department of Hematology, Oncology and Bone Marrow Transplant, Perth Children's Hospital, Nedlands, Australia
- Telethon Kids Insitute, University of Western Australia, Nedlands, Australia
| | - Daniel D Wong
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Australia
| | - Minjie Luo
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ken Kazahaya
- Division of Pediatric Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA
| | - Alexandre Arkader
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Division of Orthopedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Loretta M S Lau
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, Australia
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Kensington, Australia
| | | | - Erin Rudzinski
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA
- Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, WA
| | - Portia A Kreiger
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Derek J Roebuck
- Department of Medical Imaging, Perth Children's Hospital, Nedlands, Australia
- Division of Pediatrics, Medical School, University of Western Australia, Crawley, Australia
| | - Lea F Surrey
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Tiffany S Y Foo
- PathWest Laboratory Medicine, Perth Children's Hospital, Nedlands, WA, Australia
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2
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Spierenburg G, Staals EL, Palmerini E, Randall RL, Thorpe SW, Wunder JS, Ferguson PC, Verspoor FGM, Houdek MT, Bernthal NM, Schreuder BHWB, Gelderblom H, van de Sande MAJ, van der Heijden L. Active surveillance of diffuse-type tenosynovial giant cell tumors: A retrospective, multicenter cohort study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:107953. [PMID: 38215550 DOI: 10.1016/j.ejso.2024.107953] [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: 10/17/2023] [Revised: 12/19/2023] [Accepted: 01/05/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Diffuse-type tenosynovial giant cell tumor (D-TGCT) is a mono-articular, soft-tissue tumor. Although it can behave locally aggressively, D-TGCT is a non-malignant disease. This is the first study describing the natural course of D-TGCT and evaluating active surveillance as possible treatment strategy. METHODS This retrospective, multicenter study included therapy naïve patients with D-TGCT from eight sarcoma centers worldwide between 2000 and 2019. Patients initially managed by active surveillance following their first consultation were eligible. Data regarding the radiological and clinical course and subsequent treatments were collected. RESULTS Sixty-one patients with primary D-TGCT were initially managed by active surveillance. Fifty-nine patients had an MRI performed around first consultation: D-TGCT was located intra-articular in most patients (n = 56; 95 %) and extra-articular in 14 cases (24 %). At baseline, osteoarthritis was observed in 13 patients (22 %) on MRI. Most of the patients' reported symptoms: pain (n = 43; 70 %), swelling (n = 33; 54 %). Eight patients (13 %) were asymptomatic. Follow-up data were available for 58 patients; the median follow-up was 28 months. Twenty-one patients (36 %) had radiological progression after 21 months (median). Eight of 45 patients (18 %) without osteoarthritis at baseline developed osteoarthritis during follow-up. Thirty-seven patients (64 %) did not clinically deteriorate during follow-up. Finally, eighteen patients (31 %) required a subsequent treatment. CONCLUSION Active surveillance can be considered adequate for selected therapy naïve D-TGCT patients. Although follow-up data was limited, almost two-thirds of the patients remained progression-free, and 69 % did not need treatment during the follow-up period. However, one-fifth of patients developed secondary osteoarthritis. Prospective studies on active surveillance are warranted.
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Affiliation(s)
- Geert Spierenburg
- Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, the Netherlands.
| | - Eric L Staals
- Third Orthopaedic Clinic and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Emanuela Palmerini
- Osteooncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Robert Lor Randall
- Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA, USA
| | - Steven W Thorpe
- Department of Orthopaedic Surgery, University of California-Davis, Sacramento, CA, USA
| | - Jay S Wunder
- Division of Orthopaedic Surgery, University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Peter C Ferguson
- Division of Orthopaedic Surgery, University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Floortje G M Verspoor
- Department of Orthopedic Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Matthew T Houdek
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Nicholas M Bernthal
- Department of Orthopaedic Surgery, University of California-Los Angeles, Los Angeles, CA, USA
| | | | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Lizz van der Heijden
- Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, the Netherlands
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Bruns J, Rosenbaum B, Thorns C. Localized pigmented villo-nodular synovitis of trochanteric bursa. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2023; 12:Doc08. [PMID: 38024102 PMCID: PMC10665716 DOI: 10.3205/iprs000178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
This is the first report on a localized pigmented villo-nodular synovitis (PVNS or TSGCT) occurring in the trochanteric bursa. Bursal involvement in PVNS is extremely rare. Most often PVNS occurs either as a localized or diffuse lesion in a major synovial joint, such as the knee, ankle joint or hip joint. In principle, all synovial structures can be involved. The case reported here is remarkable regarding the long period between the occurrence of the first symptoms and the final diagnosis as well as the age of the female patient (75 yrs). Therapeutically a complete resection was performed in order to avoid recurrence. More then three years later the patient did well and there has been no evidence of recurrence yet.
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Affiliation(s)
- Juergen Bruns
- Dept. of Orthopedic Surgery, Wilhelmsburg Hospital Groß-Sand, Hamburg, Germany
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Hoa DH, Ngoc DV, Chau NM, Ninh TP, Sang NV, Long VT. Pigmented villonodular synovitis of the knee in a child: a case report. Radiol Case Rep 2022; 17:1798-1802. [PMID: 35369540 PMCID: PMC8965772 DOI: 10.1016/j.radcr.2022.03.006] [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: 02/16/2022] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022] Open
Abstract
Pigmented villonodular synovitis is a rare proliferative process, especially in children. Pigmented villonodular synovitis can affect the synovial joint, tendon sheaths, and bursa membranes. Within synovial joint involvement, it is commonly seen in the knee joint but hip, ankle, shoulder, wrist, and other joints can be involved. The appearance characteristic is found on a magnetic resonance imaging scan. Complete excision and synovectomy are the usual treatment. In this article, we report a case of pigmented villonodular synovitis of the knee in a 12- year-old girl who underwent total synovectomy after the diagnosis was confirmed by biopsy. Three years after surgery, neither recurrence nor joint degeneration was found. The osteochondral defect at the tibial plateau was filled with calcium phosphate bone paste.
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Affiliation(s)
- Dang Hong Hoa
- Musculoskeletal Dept of University of Medical and Pharmacy, Vietnam National University, Ha Noi, Vietnam
- Department of Rheumatology, Tam Anh Hospital, Ha Noi, Vietnam
| | - Doan Van Ngoc
- Department of Radiology, E Hospital, Ha Noi, Vietnam
| | | | - Tran Phan Ninh
- Department of Radiology, Vietnam National Children's Hospital, Ha Noi, Vietnam
| | - Nguyen Van Sang
- Department of Radiology, E Hospital, Ha Noi, Vietnam
- Department of Radiology, Medlatec Hospital, Ha Noi, Vietnam
- Department of Radiology, Thai Nguyen Pharmacy and Medical University, Thai Nguyen, Vietnam
- Corresponding author.
| | - Vu Tri Long
- Department of Radiology, E Hospital, Ha Noi, Vietnam
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Sbaraglia M, Gambarotti M, Businello G, Righi A, Fassan M, Dei Tos AP. Intra-Articular Tumors. Surg Pathol Clin 2021; 14:665-677. [PMID: 34742486 DOI: 10.1016/j.path.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The intra-articular space is a relatively rare site of occurrence of neoplastic diseases. The 2 distinct groups of clinicopathologic entities that exhibit an almost exclusive tropism for the joints are represented by synovial chondromatosis and tenosynovial giant cell tumors (TGCT). Synovial chondromatosis is a locally aggressive chondrogenic neoplasm that very rarely can show malignant behavior. TGCT occur in 2 main variants, the localized variant and the more locally aggressive diffuse type. Malignant TCGT is exceedingly rare and is characterized by significant rates of both local recurrence and metastatic spread.
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Affiliation(s)
- Marta Sbaraglia
- Department of Pathology, Azienda Ospedale-Università Padova, Padua, Italy; Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | - Marco Gambarotti
- Unit of Surgical Pathology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Gianluca Businello
- Department of Pathology, Azienda Ospedale-Università Padova, Padua, Italy; Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | - Alberto Righi
- Unit of Surgical Pathology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Matteo Fassan
- Department of Pathology, Azienda Ospedale-Università Padova, Padua, Italy; Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | - Angelo P Dei Tos
- Department of Pathology, Azienda Ospedale-Università Padova, Padua, Italy; Department of Medicine, University of Padua School of Medicine, Padua, Italy.
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Uncommon and peculiar soft tissue sarcomas: Multidisciplinary review and practical recommendations. Spanish Group for Sarcoma research (GEIS -GROUP). Part II. Cancer Treat Rev 2021; 99:102260. [PMID: 34340159 DOI: 10.1016/j.ctrv.2021.102260] [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] [Received: 04/18/2021] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 12/14/2022]
Abstract
Among all Soft Tissue sarcomas there are some subtypes with low incidence and/or peculiar clinical behaviour, that need to be consider separately. Most of them are orphan diseases, whose biological characteristics imply a clearly different diagnostic and therapeutic approach from other more common sarcoma tumors. We present a brief and updated multidiciplinary review, focused on practical issues, aimed at helping clinicians in decision making. In this second part we review these subtypes: Alveolar Soft Part Sarcoma, Epithelioid Sarcoma, Clear Cell Sarcoma, Desmoplastic Small Round Cell Tumor, Rhabdoid Tumor, Phyllodes Tumor, Tenosynovial Giant Cell Tumors, Myoepithelial Tumor, Perivascular Epithelioid Cell Neoplasms (PEComas), Extraskeletal Myxoid Chondrosarcoma, NTRK-fusions Sarcomas. Most of them present their own radiological and histopathological feautures, that are essential to know in order to achieve early diagnosis. In some of them, molecular diagnosis is mandatory, not only in the diagnosis, but also to plan the treatment. On the other hand, and despite the low incidence, a great scientific research effort has been made to achieve new treatment opportunities for these patients even with approved indications. These include new treatments with targeted therapies and immunotherapy, which today represent possible therapeutic options. It is especially important to be attentive to new and potential avenues of research, and to promote the conduct of specific clinical trials for rare sarcomas.
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Cassier PA, Italiano A, Gomez-Roca C, Le Tourneau C, Toulmonde M, D'Angelo SP, Weber K, Loirat D, Jacob W, Jegg AM, Michielin F, Christen R, Watson C, Cannarile M, Klaman I, Abiraj K, Ries CH, Weisser M, Rüttinger D, Blay JY, Delord JP. Long-term clinical activity, safety and patient-reported quality of life for emactuzumab-treated patients with diffuse-type tenosynovial giant-cell tumour. Eur J Cancer 2020; 141:162-170. [PMID: 33161240 DOI: 10.1016/j.ejca.2020.09.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study investigated the safety, clinical activity and patient-reported outcomes of patients with diffuse-type tenosynovial giant-cell tumour (dTGCT) of the soft tissue who were treated with emactuzumab, a humanised anti-colony stimulating factor 1 receptor (CSF1R) monoclonal antibody and were followed up for up to 2 years after the start of treatment. METHODS In this open-label phase 1 study (ClinicalTrials.govNCT01494688), patients received intravenous (IV) emactuzumab from 900 to 2000 mg every two weeks in the dose-escalation phase and at the optimal biological dose of 1000 mg with different schedules in the dose-expansion phase. Adverse event (AE) rates and biomarker assessments from tumour biopsies were analysed. Quality of life was assessed using a standard questionnaire (EuroQol-5D-3L) and the WOMAC® 3.1 Osteoarthritis Index. Tumour responses were determined with magnetic resonance imaging. RESULTS Altogether, 63 patients were enrolled into the study. The most frequently reported AEs were pruritus, asthenia and oedema. In 36 patients for whom biopsy tissue was available a substantial decrease of CSF1R-positive and CD68/CD163-positive macrophages was detected. The independently reviewed best overall objective response rate (ORR) (Response Evaluation Criteria in Solid Tumors version 1.1) was 71%. Responses were durable, and an ORR of 70% and 64% was determined after one or two years after enrolment into the study. Clinical activity was accompanied by an improvement in EuroQol-5D-3L and particularly the joint disorder-specific WOMAC score. CONCLUSIONS Systemic therapy of dTGCT patients with emactuzumab resulted in pronounced and durable responses associated with symptomatic improvement and a manageable safety profile.
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Affiliation(s)
| | | | - Carlos Gomez-Roca
- Institut Claudius Regaud, Département D'Oncologie Médicale, Toulouse, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris & Saint-Cloud, France; INSERM U900 Research Unit, Saint-Cloud, France; Paris-Saclay University, Paris, France
| | | | - Sandra P D'Angelo
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | | | - Delphine Loirat
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris & Saint-Cloud, France
| | - Wolfgang Jacob
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany.
| | - Anna-Maria Jegg
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Francesca Michielin
- Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | - Randolph Christen
- Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | | | - Michael Cannarile
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Irina Klaman
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Keelara Abiraj
- Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
| | - Carola H Ries
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Martin Weisser
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Dominik Rüttinger
- Pharma Research and Early Development (pRED), Roche Innovation Center Munich, Penzberg, Germany
| | - Jean-Yves Blay
- Centre Léon Bérard, Département D'Oncologie Médicale, Lyon, France; Université Claude Bernard Lyon I, Lyon, France; Unicancer, Paris, France
| | - Jean-Pierre Delord
- Institut Claudius Regaud, Département D'Oncologie Médicale, Toulouse, France
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