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Bhargava A, Jajoo B, Telkhade T, Patel A, Bhawani J. Rare Encounter: Giant Hemangiopericytoma of Thigh in a Young Male. Cureus 2024; 16:e59514. [PMID: 38826872 PMCID: PMC11143947 DOI: 10.7759/cureus.59514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/02/2024] [Indexed: 06/04/2024] Open
Abstract
A rare tumor called hemangiopericytoma develops from the pericytes, the cells that surround blood vessels. They frequently grow slowly and might be asymptomatic initially. Although they can develop anywhere in the body, these tumors are most frequently found in the head, pelvis, and legs. This uncommon tumor originates in soft tissues like fat, muscles, tendons, nerves, blood vessels, and other fibrous tissues. The tumor in adolescence can be benign or malignant; it frequently develops in the bones but has the potential to metastasize to the lungs. Imaging tests, such as MRIs or CT scans, are commonly used in diagnosis to determine the location and size of the tumor. We present a case of a 23-year-old male who complained of swelling in his left thigh that had persisted for two years. He underwent multiple biopsies which were inconclusive until wide local excision of the swelling was done. On histopathology, the excised tumor was suggestive of hemangiopericytoma. The patient was advised of radiotherapy for completion of the treatment.
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Affiliation(s)
- Abhilasha Bhargava
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Bhushan Jajoo
- Surgical Oncology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Tejshri Telkhade
- Radiation Oncology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Patel
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jayashree Bhawani
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Nichol AA, Bernard BJ, Gilani S. A case report of sinonasal glomangiopericytoma: An important reminder to always collect specimen. Sci Prog 2024; 107:368504241253679. [PMID: 38720572 PMCID: PMC11080723 DOI: 10.1177/00368504241253679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
OBJECTIVES To present a case report of sinonasal glomangiopericytoma (GPC) in a female patient in her thirties and to highlight the importance of collecting pathology specimens even in routine sinus surgery cases. METHODS A case report detailing the diagnosis of GPC in a female in her thirties, including her initial presentation, treatment, and follow-up, along with a brief review of the literature. RESULTS Pathology of the collected specimen revealed sinonasal GPC along with chronic rhinosinusitis. Immunohistochemistry was positive for SMA, beta-catenin, and cyclin D1; and negative for STAT6, ERG, pankeratin, SOX10, and S100. CONCLUSION This diagnosis expands the knowledge around the demographic profile of GPC patients. GPC should be included in the differential diagnosis of sinonasal masses, even in younger patients. The case highlights the importance of collecting the entire pathology specimen in all cases, even of ones that seem routine and benign.
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Affiliation(s)
- Ariadne A. Nichol
- University of California, San Diego School of Medicine, La Jolla, CA, USA
| | - Benjamin J. Bernard
- Department of Otolaryngology, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - Sapideh Gilani
- Department of Otolaryngology, University of California, San Diego School of Medicine, San Diego, CA, USA
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Chowdhury Z, Mishrikotkar S, Nehra P, Patne S, Tripathi M. Exploring Solitary Fibrous Tumors at a Tertiary Cancer Center: Clinicopathological and Immunomorphologic Profile. Cureus 2024; 16:e56899. [PMID: 38659562 PMCID: PMC11042756 DOI: 10.7759/cureus.56899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2024] [Indexed: 04/26/2024] Open
Abstract
Background Solitary fibrous tumor (SFT) is a distinct fibroblastic tumor that can occur at any anatomical site and can manifest a variety of histopathological features. NAB2-STAT6 gene fusion has recently emerged as a sensitive and specific molecular marker and its surrogate on immunohistochemistry, STAT6 has also displayed considerable efficacy. Nevertheless, its histologic diversity can result in diagnostic challenges, especially when classic features are not apparent. Methods A retrospective study was conducted at a tertiary cancer centre in North India over 3 years to document the clinicopathologic and immunomorphologic profile of SFTs. Immunohistochemical analysis of BCOR and p53 were gauged additionally and patients were stratified according to Modified Demicco and Salas criteria for risk of metastasis. Results Sixteen patients of SFT were identified, affecting middle-aged men and women equally. Though lung/pleura are known to be involved commonly, SFT affects other sites such as the kidney, brain, buccal mucosa, liver, and penis as well. The majority endured localized disease while a lesser number suffered locoregional/distant spread. Two patients revealed features of a malignant profile. Risk stratification according to the Modified Demicco and Salas criteria evinced comparable results. No discernible relationship however was highlighted between the immunohistochemical expression of BCOR, p53, and any significant SFT parameter. Conclusion Although SFTs are very rare substantially benign mesenchymal neoplasms, pathologists must be conversant with their histological diversity and be vigilant of their malignant attributes. The worth of STAT6 immunohistochemistry for precise diagnosis and long-term studies for delineating clinical behavior cannot be overemphasized.
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Affiliation(s)
- Zachariah Chowdhury
- Oncopathology, Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH) (Tata Memorial Hospital), Varanasi, IND
| | - Soumya Mishrikotkar
- Oncopathology, Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH) (Tata Memorial Hospital), Varanasi, IND
| | - Pritika Nehra
- Oncopathology, Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH) (Tata Memorial Hospital), Varanasi, IND
| | - Shashikant Patne
- Oncopathology, Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH) (Tata Memorial Hospital), Varanasi, IND
| | - Mayank Tripathi
- Surgical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH) (Tata Memorial Hospital), Varanasi, IND
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Yavas A, Tan J, Ozkan HS, Yilmaz F, Reid MD, Bagci P, Shi J, Shia J, Adsay V, Klimstra DS, Basturk O. Solitary Fibrous Tumor of the Pancreas: Analysis of 9 Cases With Literature Review. Am J Surg Pathol 2023; 47:1230-1242. [PMID: 37573546 PMCID: PMC10592360 DOI: 10.1097/pas.0000000000002108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Solitary fibrous tumor (SFT) has been increasingly reported in various anatomic sites. However, it is still extremely rare in the pancreas. Herein, we present the first series of primary pancreatic SFTs. Nine cases of primary pancreatic SFTs were analyzed. The mean age was 60 years (36 to 76 y) with no sex predilection. Six tumors were in the head, 3 were in the tail. On imaging studies, tumors were described as a hypervascular mass, 2 revealed cystic areas, and 3 were favored to be neuroendocrine tumors. On biopsy, 2 cases were diagnosed as atypical spindle cell tumor; one was misdiagnosed as suspicious for sarcoma, and another case as metastatic renal cell carcinoma. Two were diagnosed as low-grade sarcoma and low-grade stromal tumor on frozen sections. Grossly, tumors were well-demarcated with a median size of 4 cm (0.9 to 15 cm). Microscopically, they were composed of ovoid to spindle tumor cells with no significant mitotic activity and were arranged in alternating hypercellular and hypocellular areas. Staghorn-like vessels and entrapped pancreatic parenchyma were also detected within all tumors. Tumor cells revealed diffuse/strong nuclear STAT6 expression in 7 of 8, CD34 in 7 of 9, and bcl-2 in 4 of 4 tested cases. One tested tumor harbored NAB2 - STAT6 fusion. Eight patients with available follow-up data were free of disease at a mean follow-up of 76 months (3 to 189 mo). SFT should be considered in the differential diagnoses of mesenchymal neoplasms of the pancreas. Immunohistochemical nuclear STAT6 expression is a characteristic feature of SFT. Primary pancreatic SFTs seem to have favorable biological behavior in our series.
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Affiliation(s)
- Aslihan Yavas
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Hulya Sahin Ozkan
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Funda Yilmaz
- Department of Pathology, Ege University, Izmir, Turkey
| | - Michelle D Reid
- Department of Pathology, Emory University Hospital, Atlanta, GA, USA
| | - Pelin Bagci
- Department of Pathology, Marmara University, Istanbul, Turkey
| | - Jiaqi Shi
- Department of Pathology and Clinical Labs, University of Michigan, Ann Arbor, MI, USA
| | - Jinru Shia
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Volkan Adsay
- Department of Pathology, Koc University, Istanbul, Turkey
| | - David S. Klimstra
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Olca Basturk
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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5
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Schauwecker N, Davis S, Perez A, Labby A, Mannion K, Sinard R, Lewis JS, Chandra R. Single Institution Experience With Sinonasal Glomangiopericytoma: A Case Series. EAR, NOSE & THROAT JOURNAL 2023:1455613231179688. [PMID: 37329279 DOI: 10.1177/01455613231179688] [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] [Indexed: 06/19/2023] Open
Abstract
Introduction: Sinonasal glomangiopericytoma (GPC) is an uncommon neoplasm, accounting for less than 0.5% of all sinonasal tumors. It is characterized as having low malignant potential, with complete surgical excision representing optimal treatment. Presenting symptoms are typically due to mass effect and vascularity of this tumor, often including unilateral nasal obstruction or epistaxis. Accounts of this tumor in the literature remain sparse. Methods: Single institution retrospective review. Results: Six cases of sinonasal GPC were identified from a review of the electronic medical records spanning from 2009 through 2021. Age at diagnosis ranged from 48 to 67 years, with a gender distribution of 5 males and 1 female. Most subjects presented with unilateral sinonasal obstruction of variable duration. Each underwent endoscopic resection of the mass with negative margins, and no adjuvant therapy was pursued. Pathologic specimens demonstrated a vascular patterned tumor with spindled cells surrounding vessels and were positive for smooth muscle actin and negative for cytokeratin. Active post-surgical follow-up ranged from 11 months to 10 years. All patients were without endoscopic evidence of recurrence, and 2 had post-operative imaging which showed no evidence of disease. Conclusions: This review of 6 cases of sinonasal GPC represents the largest known series of this rare pathology in the literature to date. Based on our experience, and in agreement with the available literature, this disease is reliably managed with complete surgical excision. Adjuvant therapy can be avoided in otherwise uncomplicated cases. Although rare, GPC should be considered in the differential diagnosis of all vascular sinonasal tumors.
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Affiliation(s)
- Natalie Schauwecker
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Seth Davis
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alexander Perez
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alex Labby
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kyle Mannion
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Robert Sinard
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James S Lewis
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rick Chandra
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
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Huang A, Su M, Jing Y, He S, He X, Ma J, Liu H. Orbital Primary Solitary Fibrous Tumor: A Proposed Recurrence Risk Prediction Model Based on 92 Cases. Hum Pathol 2023:S0046-8177(23)00104-1. [PMID: 37127080 DOI: 10.1016/j.humpath.2023.04.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/03/2023]
Abstract
Orbital primary solitary fibrous tumors (OPSFTs) are rare. To further characterize the clinical and pathological features of OPSFTs, 92 cases of OPSFT were analyzed to develop a risk prediction model. OPSFTs were equally distributed between males (n = 45) and females (n = 47) with a mean patient age of 40.8 years (median 39 years; range 5-70 years) at initial diagnosis. The mean tumor size was 2.79 cm (median 2.5 cm). Microscopically, the tumor cells were irregularly arranged in spindle, ovoid, or round shapes with varying amounts of collagen and branching blood vessels. Immunohistochemical staining showed positive STAT6 nuclear expression in all cases, loss of CD34 expression in seven cases, and a mean Ki-67 label index of 5.25% (range 1%-30%). All patients were initially surgically resected and had a median follow-up of 99 months: 33 patients recurred, 6 of whom presented with multiple recurrences and 1 with distant metastases. A predictive model for the risk of recurrence based on tumor size, mitosis, Ki-67 label index, and dominant constituent cell (DCC) was developed based on our results. In conclusion, OPSFTs are rare but can be reliably diagnosed based on characteristic morphological features and STAT6 immunohistochemistry. The rate of local recurrence of orbital tumors tends to be higher than the rate of distant metastases, which can be predicted by a risk stratification model specific to orbital tumors. Long-term clinical follow-up is recommended as advanced disease is common.
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Affiliation(s)
| | - Mingyue Su
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | | | | | | | - Jianmin Ma
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Shah R, Gupta R, Aiyer R. Endoscopic Excision of Sino Nasal Hemangiopericytoma. Indian J Otolaryngol Head Neck Surg 2022; 74:1274-1280. [PMID: 36452800 PMCID: PMC9702302 DOI: 10.1007/s12070-021-02387-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/11/2021] [Indexed: 11/25/2022] Open
Abstract
Hemangiopericytomas (HPCs) are rare vascular tumours originating from extra capillary cells called Zimmermann's pericytes. Only 5% of these lesions occur in the Sino nasal cavity. Sino nasal HPCs have a benign course with a high recurrence rate ranging from 9.5 to 50%. A radical surgical resection is considered the gold standard treatment either via external approach (lateral rhinotomy or Caldwell-Luc) or endoscopic approach. Three cases of Sino nasal hemangiopericytomas were treated at our institute. All these cases were operated via endoscopic approach. We are reporting their diagnostic work-up and the therapeutic management as case series. We also discuss epidemiological, clinical, morpho-pathological and radiological characteristics of this tumoral pathology. A treatment plan is also elucidated which may help to develop a long term treatment protocol for these lesions.
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Affiliation(s)
- Rahulkumar Shah
- Department of ENT and Head- Neck Surgery, Baroda Medical College, Vadodara, Gujarat India
| | - Rahul Gupta
- Department of ENT and Head- Neck Surgery, Baroda Medical College, Vadodara, Gujarat India
| | - Ranjan Aiyer
- Department of ENT and Head- Neck Surgery, Baroda Medical College, Vadodara, Gujarat India
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8
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Chintale SG, Katre MI, Kirdak VR, Shaikh KA, Chintale SS. Hemangiopericytoma an Incidental Parotid Swelling: a Rare Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:2417-2421. [PMID: 36452696 PMCID: PMC9702438 DOI: 10.1007/s12070-020-02204-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 10/05/2020] [Indexed: 11/24/2022] Open
Abstract
Hemangiopericytoma of the parotid gland is a very rare presentation in the head and neck region. It occurs mainly in the lower extremities, retroperitoneum, and pelvis. Here we reported a case of 14-year female patient present with painless swelling of the right cheek over the parotid region since 5 years.
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Affiliation(s)
- Sambhaji G. Chintale
- Department of Otorhinolaryngology, JIIUS IIMSR, Warudi Tq. Badnapur Dist., Jalna, 431202 India
- COSMO ENT Super Speciality Hospital and Research Center, Aurangabad, 43100 India
| | - Mahendra I. Katre
- Department of Head and Neck Onccology, Government Cancer Hospital, Aurangabad, 431001 India
| | - Vilas R. Kirdak
- Department of Otorhinolaryngology, JIIUS IIMSR, Warudi Tq. Badnapur Dist., Jalna, 431202 India
| | - Kaleem A. Shaikh
- Department of Otorhinolaryngology, JIIUS IIMSR, Warudi Tq. Badnapur Dist., Jalna, 431202 India
| | - Swati S. Chintale
- Department of Community Medicine, Government Cancer Hospital, Aurangabad, 431001 India
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Sixteen-Year Follow-Up in a Cavernous Sinus Hemangiopericytoma: Improved Outcomes over Radiotherapy Advances. Brain Sci 2022; 12:brainsci12091209. [PMID: 36138945 PMCID: PMC9497113 DOI: 10.3390/brainsci12091209] [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: 08/14/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022] Open
Abstract
Intracranial hemangiopericytomas are rare tumors, accounting for 1% of all central nervous system malignancies. This tumor is considered at high risk of local and also distant metastases. Surgical excision is the gold standard for treatment, but it is seldom curative by itself. Adjuvant radiotherapy is often recommended. We report an overview and update of the available literature on one such rare but aggressive mesenchymal tumor, using the case of a 46-year-old woman affected by hemangiopericytoma of the cavernous sinus surgically removed and treated with adjuvant radiotherapy at our institution. After seven years, the patient underwent a local recurrence and was treated with exeresis and Gamma Knife radiotherapy. Sixteen years after the initial diagnosis, she is still well with stable disease.
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10
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Liu X, Beltejar MJ, Liao X. Clinicopathologic characterization and assessment of prognostic factors for intraabdominal solitary fibrous tumors involving the gastrointestinal tract and liver. Virchows Arch 2022; 481:703-712. [PMID: 35978144 DOI: 10.1007/s00428-022-03396-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 10/15/2022]
Abstract
Solitary fibrous tumors (SFT) are rare mesenchymal neoplasms with a potential to metastasize in 10-30% of cases. Several risk models have been designed to predict tumor behavior at the pleura and extrapleural sites. Intrabdominal SFTs primarily involving the gastrointestinal tract (SFTGI) and liver (SFTL) are rare. We analyzed a series of SFTGI and SFTL to describe the clinicopathologic features and evaluate prognostic factors. The cohort included 33 males and 25 females, with a median age of 58.5 years and a mean tumor size of 15.6 cm. Patients with SFTL were predominantly older females compared to patients with SFTGI. By univariate analysis, high mitotic count (> 4/10 HPF), tumor size, tumor necrosis, and nuclear pleomorphism were associated with both disease-specific survival (DSS) and metastasis-free survival (MFS) (p < 0.05). Tumor location (SFTL vs. SFTGI) also predicted MFS (p = 0.026). Only very high mitotic count (> 9/10 HPF) predicted local recurrence-free survival (LFS, p = 0.001). Further analysis showed that all adverse histologic parameters (necrosis, hypercellularity, pleomorphism) correlated with high mitotic grade (> 4/10 HPF) (p < 0.05). On multivariate analysis, only mitosis predicted DSS (p = 0.023), MFS (p = 0.01), and LFS (p = 0.017). Validation of the 3 risk models (mDemicco, Salas, Pasquali) showed variable associations with DSS, MFS, and LFS, while a simplied 3-tiered risk model based on mitosis (0-4, 5-9, > 9/10 HPF) performed well in predicting all risks. Our results suggest that prognostication of SFTs is mainly associated with mitotic activity, supporting the use of mitosis (> 4 and/or > 9/10 HPF) for tumor grading and risk stratification at specific locations.
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Affiliation(s)
- Xiaoqin Liu
- From the Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael-John Beltejar
- From the School of Medicine and Dentistry (Medical Student), University of Rochester, Rochester, NY, USA
| | - Xiaoyan Liao
- From the Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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Edwards W, Craven C, Turner JR, Grossniklaus H, Wells J. Isolated hemangiopericytoma of the conjunctiva. Am J Ophthalmol Case Rep 2022; 25:101308. [PMID: 35112030 PMCID: PMC8790295 DOI: 10.1016/j.ajoc.2022.101308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 09/01/2021] [Accepted: 01/18/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To report a unique presentation of hemangiopericytoma and discuss the clinical course, pathological features, and management of this tumor. OBSERVATIONS An otherwise healthy 54-year-old Caucasian female presented with a painless conjunctival mass. The lesion gradually enlarged over a three-week period and was unresponsive to corticosteroid treatment. The mass was surgically removed, and histopathologic findings were consistent with hemangiopericytoma. CONCLUSIONS AND IMPORTANCE Conjunctival hemangiopericytoma should be considered in patients with conjunctival lesions unresponsive to medical management. Surgical excision is diagnostic and therapeutic and is the strongest predictor of clinical course. Incompletely excised lesions are at a greater risk of local recurrence and subsequent metastasis. Given the neoplasm's malignant potential, patients should be followed in the outpatient setting.
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Affiliation(s)
- William Edwards
- University of South Alabama College of Medicine, 2451 USA Medical Center Dr, Mobile, AL, USA
| | - Caroline Craven
- Emory Eye Center, Emory University School of Medicine, 1365 Clifton Rd B, Atlanta, GA, USA
| | - Joseph Ryan Turner
- University of South Alabama College of Medicine, 2451 USA Medical Center Dr, Mobile, AL, USA
| | - Hans Grossniklaus
- Emory Eye Center, Emory University School of Medicine, 1365 Clifton Rd B, Atlanta, GA, USA
| | - Jill Wells
- Emory Eye Center, Emory University School of Medicine, 1365 Clifton Rd B, Atlanta, GA, USA
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Amorim Filho FS, Gripp FM, Faria GS, Capuzzo Gonçalves M, Miyahira L. Hemangiopericytoma: Conducts and perioperative management of an extent sinonasal tumor in a Jehovah's Witnesses patient - Case report. Cancer Rep (Hoboken) 2022; 5:e1609. [PMID: 35194976 PMCID: PMC9458489 DOI: 10.1002/cnr2.1609] [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: 07/25/2021] [Revised: 01/02/2022] [Accepted: 01/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background Hemangiopericytomas (HPCs) are rare tumors derived from mesenchymal cells with pericyte differentiation. About 5% of head and neck HPCs occur in the nasal cavity and paranasal sinuses. Due to its rarity, rich vascularity and variable biological behavior, its management is a challenge in itself. Case We report a case of sinonasal HPC in a Jehovah's Witness patient and discuss the obstacles and care related to the restrictions and therapeutic challenges involved in the approach to the patient. The patient was successfully treated by endoscopic endonasal approach with all per‐operative care and restrictions being respected and attended. Conclusions The management of HPC by itself involves challenges and when associated with other restrictive conditions attention and care are required.
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Affiliation(s)
- Francisco S Amorim Filho
- Head and Neck Surgery and Otorhinolaryngology Service, Instituto da Tireoide e Laringe, Goiânia, Brazil.,Department of Otorhinolaryngology and Head and Neck Surgery, Hospital das Clínicas de Goiânia (HC-UFG), Goiânia, Brazil
| | - Flávio M Gripp
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Campinas (UNICAMP), Campinas, Brazil
| | - Guilherme S Faria
- Head and Neck Surgery and Otorhinolaryngology Service, Instituto da Tireoide e Laringe, Goiânia, Brazil
| | - Mateus Capuzzo Gonçalves
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital das Clínicas de Goiânia (HC-UFG), Goiânia, Brazil
| | - Lincoln Miyahira
- Head and Neck Surgery and Otorhinolaryngology Service, Instituto da Tireoide e Laringe, Goiânia, Brazil
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Novel Therapeutic Options for Solitary Fibrous Tumor: Antiangiogenic Therapy and Beyond. Cancers (Basel) 2022; 14:cancers14041064. [PMID: 35205812 PMCID: PMC8870479 DOI: 10.3390/cancers14041064] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 01/10/2023] Open
Abstract
SFT is an ultrarare mesenchymal ubiquitous tumor, with an incidence rate <1 case/million people/year. The fifth WHO classification published in April 2020 subdivided SFT into three categories: benign (locally aggressive), NOS (rarely metastasizing), and malignant. Recurrence can occur in up to 10-40% of localized SFTs, and several risk stratification models have been proposed to predict the individual risk of metastatic relapse. The Demicco model is the most widely used and is based on age at presentation, tumor size, and mitotic count. Total en bloc resection is the standard treatment of patients with a localized SFT; in case of advanced disease, the clinical efficacy of conventional chemotherapy remains poor. In this review, we discuss new insights into the biology and the treatment of patients with SFT. NAB2-STAT6 oncogenic fusion, which is the pathognomonic hallmark of SFT, is supposedly involved in the overexpression of vascular endothelial growth factor (VEGF). These specific biological features encouraged the successful assessment of antiangiogenic drugs. Overall, antiangiogenic therapies showed a significant activity toward SFT in the advanced/metastatic setting. Nevertheless, these promising results warrant additional investigation to be validated, including randomized phase III trials and biological translational analysis, to understand and predict mechanisms of efficacy and resistance. While the therapeutic potential of immunotherapy remains elusive, the use of antiangiogenics as first-line treatment should be considered.
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Allen P. My time with Franz Enzinger at the Armed Forces Institute of Pathology. Ann Diagn Pathol 2022; 58:151914. [DOI: 10.1016/j.anndiagpath.2022.151914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/08/2022] [Indexed: 11/29/2022]
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15
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Large hemangiopericytoma of the shoulder: A case report. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp200530073a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction. Hemangiopericytoma is a rare tumour derived from the pericytes, contractile spindle cells that surround the capillaries and postcapillary venules. The tumour is found equally among males and females. Case report. We reported a case of a 63-year-old female who presented a giant painful mass on her right shoulder that occurred one year before admission. Limited range of motion and a sense of tingling along the affected arm was present also. An irregular, oval-shaped mass, dark red in colour, with signs of necrosis, was 14 cm in maximum diameter. Routine laboratory analysis showed results within the range of referenced values. Lung X-ray and ultrasonographic examination of the abdomen showed no signs of secondary tumour deposits, and no osteomuscular lesions in the affected region. Ultrasonographic examination of the neck and right axillary region showed no signs of regional metastases. The surgical excision of the entire tumour was performed, with the associated subcutaneous tissue and a part of fascia underneath. Results of the histopathological analysis confirmed the diagnosis of hemangiopericytoma. The specimen showed no signs or elements of the neoplastic tissue on the edges of the resection lines. Three years after the operation, there were no signs of tumour relapses, regional or systemic metastases. Conclusion. Considering that there are no official clinical guides and protocols for hemangiopericytoma management, as well as the occurrence of cutaneous and subcutaneous heman-giopericytomas is exceptionally rare, more extensive research in this field and more described cases are needed to gain a better understanding of the issue.
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Alexiev BA, Finkelman BS, Streich L, Bautista MM, Pollack SM, Jennings LJ, Brat DJ. Solitary fibrous tumor of thoracic cavity, extra-thoracic sites and central nervous system: Clinicopathologic features and association with local recurrence and metastasis. Pathol Res Pract 2021; 224:153531. [PMID: 34171600 DOI: 10.1016/j.prp.2021.153531] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 01/13/2023]
Abstract
Published risk stratification models of solitary fibrous tumor (SFT) have been associated with distant metastases outside the central nervous system (CNS), but have not been studied for tumors occurring in the CNS. In a retrospective review, we identified 72 cases of solitary fibrous tumor or hemangiopericytoma (HPC) diagnosed between January 2011 and December 2020 at our institution. The tumors involved the central nervous system (N = 17), thoracic cavity (N = 28), and extrathoracic sites (N = 27). The risk of local recurrence, distant metastasis, or death at 5 years was 57% (95% CI 23%, 76%) in the CNS, 24% (95% CI 2%, 41%) in the thoracic cavity, and 13% (95% CI 0%, 25%) in extrathoracic sites. By contrast, the risk of distant metastasis or death at 5 years was 13% (95% CI 0%, 29%) in CNS primaries, 5% (95% CI 0%, 14%) in thoracic primaries, and 14% (95% CI 0%, 27%) in extrathoracic primaries. Using the published 3- and 4-variable risk stratification models by Demicco et al., we retrospectively assessed our cases for risk of local recurrence, distant metastasis, and death. For tumors outside the CNS, we show that three- and four-variable risk stratification models were associated with recurrence-free survival in addition to the previously known association with distant metastasis (all P < 0.05). In contrast, inside the CNS, we show that neither risk model is a significantly associated with clinical behavior, and that WHO grade is likely the best available prognostic tool, though none of the differences were significant. The lack of significant differences can be likely explained by the younger median age (47 years vs 61 years) and smaller median tumor size (3.5 cm vs 5.6 cm), downgrading the risk stratification scores in CNS compared to non-CNS primaries. In conclusion, existing risk stratification models of SFT are not associated with clinical behavior for tumors arising inside the CNS, but are associated with local recurrence in addition to distant metastasis outside the CNS.
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Affiliation(s)
- Borislav A Alexiev
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 251 East Huron St, Feinberg 7-342A, Chicago, IL 60611, USA.
| | - Brian S Finkelman
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 251 East Huron St, Feinberg 7-342A, Chicago, IL 60611, USA
| | - Lukas Streich
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 251 East Huron St, Feinberg 7-342A, Chicago, IL 60611, USA
| | - Melissa Mejia Bautista
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 251 East Huron St, Feinberg 7-342A, Chicago, IL 60611, USA
| | - Seth M Pollack
- Department of Medicine, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 676N St Clair St, Arkes Pavilion Ste 850, Chicago, IL 60611, USA
| | - Lawrence J Jennings
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 251 East Huron St, Feinberg 7-342A, Chicago, IL 60611, USA
| | - Daniel J Brat
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, 303 East Chicago Ave, Ward 3-140, Chicago, IL 60611, USA
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Yamada Y, Kohashi K, Kinoshita I, Yamamoto H, Iwasaki T, Yoshimoto M, Ishihara S, Toda Y, Ito Y, Kuma Y, Yamada-Nozaki Y, Koga Y, Hashisako M, Kiyozawa D, Kitahara D, Narutomi F, Kuboyama Y, Nakamura T, Inoue T, Mukai M, Honda Y, Toyokawa G, Tsuchihashi K, Fushimi F, Taguchi K, Nishiyama K, Tamiya S, Oshiro Y, Furue M, Nakashima Y, Suzuki S, Iwaki T, Oda Y. Histological background of dedifferentiated solitary fibrous tumour. J Clin Pathol 2021; 75:397-403. [PMID: 33975913 DOI: 10.1136/jclinpath-2020-207311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 11/03/2022]
Abstract
AIMS Dedifferentiation is a histological phenomenon characterised by abrupt transition of histology to a sarcomatous component with high-grade malignant potential in solitary fibrous tumour (SFT). The authors histologically reviewed SFT cases to reveal the histological background of dedifferentiated SFTs. METHODS Clinicopathological and histopathological findings of 145 SFT cases were reviewed. Immunohistochemical staining and genetic analysis were also performed. RESULTS The non-dedifferentiated components showed a cellular component in 45 of 145 (31%), high mitotic rate (≥4/10 high-powered field) in 12 of 145 (8.2%) tumours, necrosis in 7 of 145 (4.8%) tumours, multinodular growth pattern in 39 of 132 (29.5%) available tumours and intratumoural fibrous septa in 37 of 131 (28.2%). Immunohistochemically, the non-dedifferentiated components were positive for CD34 in 128 of 141 (90.7%), bcl-2 in 101 of 133 (75.9%), nuclear pattern of β-catenin in 64 of 127 (50.3%) and p16 in 22 of 140 (15.7%). Loss of Rb protein expression was detected in 17 of 110 (15.4%) cases. Statistically, cellular component, multinodular structure, p16 overexpression and Rb protein loss were significantly associated with dedifferentiation. Moreover, cellular component and multinodular structure were significantly associated with p16 overexpression and Rb protein loss. All the non-deddifferentiated components showed wild type of p53 expression. The dedifferentiated components of all 10 dedifferentiated tumours presented positivity for p16 in 9 of 10 (90%) and mutational type of p53 in 5 of 10 (50%). Loss of Rb protein expression was detected in 6 of 10 (60%). CONCLUSIONS The authors propose that cellular or multinodular transformation may be associated with dedifferentiation. They also suggest that cellular and multinodular transformation may be associated with p16 overexpression and Rb downregulation.
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Affiliation(s)
- Yuichi Yamada
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Izumi Kinoshita
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeshi Iwasaki
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masato Yoshimoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shin Ishihara
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yu Toda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Ito
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuki Kuma
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yui Yamada-Nozaki
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yutaka Koga
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mikiko Hashisako
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Kiyozawa
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daichi Kitahara
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Fumiya Narutomi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Kuboyama
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takahito Nakamura
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeshi Inoue
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Munenori Mukai
- Department of Pathology, Koseiren Takaoka Hospital, Takaoka, Toyama, Japan
| | - Yumi Honda
- Department of Surgical Pathology, Kumamoto University Hospital, Kumamoto, Japan
| | - Gouji Toyokawa
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenji Tsuchihashi
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Fumiyoshi Fushimi
- Department of Pathology, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - Kenichi Taguchi
- Department of Pathology, National Kyushu Cancer Center, Fukuoka, Japan
| | | | - Sadafumi Tamiya
- Department of Pathology, Kitakyushu Municipal Medical Center, Kitakyushu, Fukuoka, Japan
| | - Yumi Oshiro
- Department of Pathology, Matsuyama Red Cross Hospital, Matsuyama, Ehime, Japan
| | - Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Suzuki
- Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Iwaki
- Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Tariq MU, Din NU, Abdul-Ghafar J, Park YK. The many faces of solitary fibrous tumor; diversity of histological features, differential diagnosis and role of molecular studies and surrogate markers in avoiding misdiagnosis and predicting the behavior. Diagn Pathol 2021; 16:32. [PMID: 33879215 PMCID: PMC8059036 DOI: 10.1186/s13000-021-01095-2] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/12/2021] [Indexed: 12/17/2022] Open
Abstract
Background Solitary Fibrous Tumor (SFT) is a distinct soft tissue neoplasm associated with NAB2-STAT6 gene fusion. It can involve a number of anatomic sites and exhibits a wide spectrum of histological features. Main body Apart from diversity in morphological features seen even in conventional SFT, two histologic variants (fat-forming and giant cell-rich) are also recognized. In addition, a malignant form and dedifferentiation are well recognized. Owing to diverse histological features and involvement of diverse anatomic locations, SFT can mimic other soft tissue neoplasms of different lineages including schwannoma, spindle cell lipoma, dermatofibrosarcoma protuberans, liposarcoma, gastrointestinal stromal tumor (GIST), malignant peripheral nerve sheath tumor (MPNST), and synovial sarcoma. SFT is classified as an intermediate (rarely metastasizing) tumor according to World Health Organization Classification of Tumors of Soft tissue and Bone, 5th edition. The management and prognosis of SFT differs from its malignant mimics and correct diagnosis is therefore important. Although SFT expresses a distinct immunohistochemical (IHC) profile, the classic histomorphological and IHC profile is not seen in all cases and diagnosis can be challenging. NAB2-STAT6 gene fusion has recently emerged as a sensitive and specific molecular marker and its IHC surrogate marker signal transducer and activator of transcription 6 (STAT6) has also shown significant sensitivity and specificity. However, few recent studies have reported STAT6 expression in other soft tissue neoplasms. Conclusion This review will focus on describing the diversity of histological features of SFT, differential diagnoses and discussing the features helpful in distinguishing SFT from its histological mimics.
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Affiliation(s)
- Muhammad Usman Tariq
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Nasir Ud Din
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Jamshid Abdul-Ghafar
- Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan.
| | - Yong-Koo Park
- Emeritus Professor, Kyung Hee University, School of Medicine Vice President of Asia, International Academy of Pathology, U2Labs, Jangwon Medical Foundation 68 Geoma-ro, Songpa-gu, Seoul, 05755, South Korea
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19
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Tong J, Athayde J, MacKenzie S, Ho M. Successful multidisciplinary treatment of Doege-Potter syndrome: hypoglycaemia caused by paraneoplastic IGF-2 production by a metastatic haemangiopericytoma. BMJ Case Rep 2021; 14:14/4/e241724. [PMID: 33858901 PMCID: PMC8055102 DOI: 10.1136/bcr-2021-241724] [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: 11/04/2022] Open
Abstract
Hypoglycaemia due to insulin-like growth factor (IGF)-2 secretion is a paraneoplastic complication of malignancy with significant morbidity that can often go unrecognised due to its uncommon presentation. We report on a case of a 51-year-old man with metastatic haemangiopericytoma presenting with refractory hypoglycaemia, requiring continuous dextrose 10% infusion while in hospital. IGF-2 levels were significantly elevated, in keeping with a rare entity associated with solitary fibrous tumours, known as Doege-Potter syndrome. The patient was managed using uncooked cornstarch in conjunction with debulking of the hepatic tumour burden with bland IR-guided transarterial embolisation, and eventual surgical resection to treat his non-islet cell tumour hypoglycaemia (NICTH). The case highlights this rare paraneoplastic phenomenon that should be included in the differential for hypoglycaemia, especially if a history of a solitary fibrous tumour is elicited. Our case is the first to document a successful approach to treating the hypoglycaemia using preoperative transarterial bland embolisation.
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Affiliation(s)
- Jeffery Tong
- Department of Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Jonathan Athayde
- Department of Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Shawn MacKenzie
- Department of Surgery, The University of British Columbia Faculty of Medicine, New Westminster, British Columbia, Canada
| | - Meghan Ho
- Department of Medicine, The University of British Columbia Faculty of Medicine, New Westminster, British Columbia, Canada
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20
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Gonzalez JA, Sanchez E, Messa Botero O, Cervera-Bonilla S. Solitary Fibrous Tumor in the Perianal Region: Report of Two Cases With an Atypical Location. Cureus 2021; 13:e12887. [PMID: 33643733 PMCID: PMC7901715 DOI: 10.7759/cureus.12887] [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: 11/24/2022] Open
Abstract
A solitary fibrous tumor (SFT) is a mesenchymal neoplasm of spindle cells, initially described in the pleura. The World Health Organization (WHO) classifies the solitary fibrous tumor as a neoplasm with intermediate biological potential. Diagnostic images are essential for the diagnostic and therapeutic approach in this entity. The standard of treatment for this type of lesion is surgical resection with oncological margins larger than 1 cm. The solitary fibrous tumors located in the perianal, perineal, and pelvic regions are infrequent and represent a challenge in the clinical approach, mainly because the manifestations are nonspecific. Given the low incidence of this type of neoplasm, we present two cases of SFT in the perianal region managed in a high-complexity hospital.
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Affiliation(s)
| | - Elio Sanchez
- Surgical Oncology, Instituto Nacional de Cancerología, Bogota, COL
| | | | - Sergio Cervera-Bonilla
- Breast and Soft Tissue Surgery, Hospital Universitario San Ignacio, Bogota, COL.,Breast and Soft Tissue Surgery, Instituto Nacional de Cancerología, Bogota, COL
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21
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Guo YC, Yao LY, Tian ZS, Shi B, Liu Y, Wang YY. Malignant solitary fibrous tumor of the greater omentum: A case report and review of literature. World J Clin Cases 2021; 9:445-456. [PMID: 33521114 PMCID: PMC7812880 DOI: 10.12998/wjcc.v9.i2.445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/28/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Malignant solitary fibrous tumors (SFTs) account for 15%-20% of all SFTs, and malignant SFTs arising from the greater omentum are extremely rare. Most malignant SFTs of the greater omentum are diagnosed via pathological examinations after surgery. In this study, we report a case of malignant omental SFT and review the published literature on this rare malignancy.
CASE SUMMARY A 64-year-old female presented with an abdominal mass, and underwent exploratory surgery, during which a huge tumor originating from the greater omentum and intraperitoneal implants were identified and resected. The results of the pathological examination, immunohistochemistry staining, and gene sequencing led to the diagnosis of malignant SFT of the greater omentum. The patient died one and a half years later due to tumor recurrence and metastasis.
CONCLUSION This is the first report of the application of gene sequencing in the diagnosis of malignant SFTs of the greater omentum.
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Affiliation(s)
- Yu-Chen Guo
- Department of Gastrointestinal Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Li-Yu Yao
- Department of Pediatric Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Zhi-Sen Tian
- Department of Spine Surgery, China-Japan Union Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Bing Shi
- Department of Gastroenterology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Ying Liu
- Department of Spine Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Yuan-Yi Wang
- Department of Spine Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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22
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Outani H, Kobayashi E, Wasa J, Saito M, Takenaka S, Hayakawa K, Endo M, Takeuchi A, Kobayashi H, Kito M, Morii T, Imanishi J, Ueda T. Clinical Outcomes of Patients with Metastatic Solitary Fibrous Tumors: A Japanese Musculoskeletal Oncology Group (JMOG) Multiinstitutional Study. Ann Surg Oncol 2020; 28:3893-3901. [PMID: 33146837 DOI: 10.1245/s10434-020-09306-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/15/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although the unpredictable malignant behavior of solitary fibrous tumors (SFTs) has been recognized, the clinical features and prognosis of metastatic SFTs have not been well documented due to the extreme rarity of these cases. The aim of this study is to investigate the clinical features, prognostic factors, and optimal management of patients with metastatic SFTs. PATIENTS AND METHODS Sixty patients with metastatic SFT were retrospectively reviewed. Univariate and multivariate analyses were performed to identify the factors associated with survival. Time to next treatment (TNT) was used to evaluate the effects of various chemotherapy regimens. RESULTS A total of 34 male and 26 female patients (median age 55 years, range, 23-87 years) were included in the study. The median follow-up period after metastasis was 32 months (range 1-126 months). Tumor location and local recurrence were correlated with late metastasis. The 3- and 5-year overall survival rates were 72.7% and 49.2%, respectively. Primary tumor location, number of metastases, and metastasectomy were significantly associated with survival. Metastasectomy was the only significant variable on multivariate analysis. The TNT was significantly different among the various regimens. CONCLUSIONS Patients with metastatic SFTs had relatively longer survival periods compared with those with other metastatic soft-tissue sarcomas. Tumor location and number of metastases was associated with survival. Surgical resection of the metastatic lesions offers the best chance of survival, however further studies are warranted to define patients who would benefit from metastasectomy, and the most effective chemotherapeutic regimen for patients with metastatic SFTs remains unknown.
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Affiliation(s)
- Hidetatsu Outani
- Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
| | - Eisuke Kobayashi
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Junji Wasa
- Department of Orthopedic Oncology, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Masato Saito
- Department of Orthopedic Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Satoshi Takenaka
- Department of Musculoskeletal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Keiko Hayakawa
- Department of Orthopedic Surgery, Cancer Institute Hosipital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makoto Endo
- Department of Orthopedic Surgery, Kyushu University, Fukuoka, Japan
| | - Akihiko Takeuchi
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hiroshi Kobayashi
- Department of Orthopedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Munehisa Kito
- Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takeshi Morii
- Department of Orthopedic Surgery, Kyorin University, Tokyo, Japan
| | - Jungo Imanishi
- Department of Orthopedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Takafumi Ueda
- Department of Orthopedic Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
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Hemangiopericytoma: Incidence, Treatment, and Prognosis Analysis Based on SEER Database. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2468320. [PMID: 33204688 PMCID: PMC7655240 DOI: 10.1155/2020/2468320] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022]
Abstract
Background Hemangiopericytomas are rare tumors derived from pericytes surrounding the blood vessels. The clinicopathological characteristics and prognosis of hemangiopericytoma patients remain mostly unknown. In this retrospective cohort study, we assessed the clinicopathological characteristics of hemangiopericytoma patients, as well as the clinical usefulness of different treatment modalities. Material and Methods. We collected the clinicopathological data (between 1975 and 2016) of hemangiopericytoma and hemangioendothelioma patients from the Surveillance, Epidemiology, and End Results (SEER) database. Incidence, treatment, and patient prognosis were assessed. Results Data from 1474 patients were analyzed in our study cohort (hemangiopericytoma: n = 1243; hemangioendothelioma: n = 231). The incidence of hemangiopericytoma in 2016 was 0.060 per 100,000 individuals. The overall survival (OS) and cancer-specific survival (CSS) did not differ between patients with hemangioendothelioma and those with hemangiopericytoma (P = 0.721, P = 0.544). The tumor grade had no effect on the OS of hemangiopericytoma patients. Multivariate analysis revealed the clinical usefulness of surgery in hemangiopericytoma patients (HR = 0.15, 95% confidence interval: 0.05-0.41, P < 0.001). In contrast, radiotherapy did not improve OS (P = 0.497) or CSS (P = 0.584), and chemotherapy worsened patient survival (P < 0.001). Additionally, the combination of surgery and radiotherapy had a similar effect with surgery alone on hemangiopericytoma patient survival (OS: P = 0.900; CSS: P = 0.156). Surgery plus chemotherapy provided a worse clinical benefit than surgery alone (P < 0.001). Conclusions Our findings suggested that hemangiopericytoma had a similar prognosis with hemangioendothelioma. Surgery was the only effective treatment that provided survival benefits in hemangiopericytoma patients, while the clinical usefulness of adjuvant chemotherapy or radiotherapy was limited.
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24
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Bakhshwin A, Berry RS, Cox RM, Li R, Reynolds JP, Rubin BP, McKenney JK. Malignant solitary fibrous tumour of the prostate: four cases emphasising significant histological and immunophenotypical overlap with sarcomatoid carcinoma. Pathology 2020; 52:643-648. [PMID: 32758370 DOI: 10.1016/j.pathol.2020.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/27/2020] [Accepted: 06/03/2020] [Indexed: 12/12/2022]
Abstract
Solitary fibrous tumour (SFT) is well-described in the urinary tract, but malignant examples are rare. We studied our experience with high grade malignant SFT of the prostate to address the degree of histological and immunophenotypical overlap with sarcomatoid carcinoma and prostatic stromal sarcoma. Four cases were identified from the surgical pathology consultation archives. All available H&E stained sections were reviewed. Immunostains for STAT6, CAM5.2, NKX3.1, PAX-8, GATA3, high molecular weight cytokeratin (34BE12), p40, and p63 were performed on available material. Each case was evaluated by three separate SFT prognostic risk models based on clinicopathological features, and for features of 'dedifferentiated SFT'. The patient's ages were 49, 55, 69, and 73 years. Three presented with symptoms of benign prostatic hyperplasia and one with haematuria. Tumour sizes were 5, 9, 13, and 13 cm. Mitotic rate ranged from 6 to 20 mitoses per 10 high power fields, and two cases showed abrupt transition from conventional SFT to areas with marked nuclear pleomorphism/anaplasia (i.e., 'de-differentiation'). Immunophenotypically, all four cases had strong and diffuse nuclear reactivity for STAT6. For other markers, three of three had both focal PR and GATA3 nuclear expression (up to 30% of cells). One case with 'dedifferentiated' features showed expression of multiple epithelial markers, including EMA (focal), high molecular weight cytokeratin (focal), p63, and p40. In summary, malignant SFT may rarely occur in the prostate and may closely mimic sarcomatoid carcinoma or prostatic stromal sarcoma, both histologically and immunophenotypically. Consideration of the diagnostic possibility of malignant SFT, recognition of unexpected GATA3 and PR expression, and utilisation of monoclonal STAT6 immunohistochemistry facilitate appropriate diagnosis at this unusual anatomical site.
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Affiliation(s)
- Ahmed Bakhshwin
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ryan S Berry
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Roni M Cox
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Roger Li
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Jordan P Reynolds
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Brian P Rubin
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jesse K McKenney
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
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Lee M, Song JS, Hong SM, Jang SJ, Kim J, Song KB, Lee JH, Cho KJ. Sarcoma metastasis to the pancreas: experience at a single institution. J Pathol Transl Med 2020; 54:220-227. [PMID: 32311873 PMCID: PMC7253956 DOI: 10.4132/jptm.2020.03.04] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/04/2020] [Indexed: 12/17/2022] Open
Abstract
Background Reports of metastatic sarcoma to the pancreas are limited. We reviewed the clinicopathologic characteristics of such cases. Methods We reviewed 124 cases of metastatic tumors to the pancreas diagnosed at Asan Medical Center between 2000 and 2017. Results Metastatic tumors to the pancreas consisted of 111 carcinomas (89.5%), 12 sarcomas (9.6%), and one melanoma (0.8%). Primary sarcoma sites were bone (n=4); brain, lung, and soft tissue (n=2 for each); and the uterus and pulmonary vein (n=1 for each). Pathologically, the 12 sarcomas comprised 2 World Health Organization grade III solitary fibrous tumors/hemangiopericytomas, and one case each of synovial sarcoma, malignant solitary fibrous tumor, undifferentiated pleomorphic sarcoma, osteosarcoma, mesenchymal chondrosarcoma, intimal sarcoma, myxofibrosarcoma, myxoid liposarcoma, rhabdomyosarcoma, subtype uncertain, and high-grade spindle-cell sarcoma of uncertain type. The median interval between primary cancer diagnosis and pancreatic metastasis was 28.5 months. One case manifested as a solitary pancreatic osteosarcoma metastasis 15 months prior to detection of osteosarcoma in the femur and was initially misdiagnosed as sarcomatoid carcinoma of the pancreas. Conclusions The metastatic sarcoma should remain a differential diagnosis when spindle-cell malignancy is found in the pancreas, even for solitary lesions or in patients without prior history.
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Affiliation(s)
- Miseon Lee
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon Seon Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Mo Hong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Se Jin Jang
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jihun Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki Byung Song
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hoon Lee
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Ja Cho
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Solitary fibrous tumor involving the pancreas: report of the cytologic features and first report of a primary pancreatic solitary fibrous tumor diagnosed by fine-needle aspiration biopsy. J Am Soc Cytopathol 2020; 9:272-277. [PMID: 32423685 DOI: 10.1016/j.jasc.2020.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/09/2020] [Accepted: 02/13/2020] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Solitary fibrous tumor (SFT) of the pancreas is rare, with only 16 reported cases in English studies. The cytologic features of pancreatic SFT have not been well described. We report 2 cases of SFT (1 primary and 1 metastatic) involving the pancreas and discuss the cytomorphologic findings, including the first primary SFT of the pancreas specifically diagnosed using cytology. MATERIALS AND METHODS The cases of 2 patients with a diagnosis of SFT of the pancreas from material obtained via fine needle aspiration (FNA) are reported. Clinical information was retrieved from the patients' medical records. The FNA cytology slides, previous relevant surgical pathologic findings, and findings from subsequent pancreatic resections were reviewed. RESULTS Of the 2 patients, 1 had had secondary involvement of the pancreas from a primary central nervous system SFT, and 1 had had a primary pancreatic SFT diagnosed by FNA. Immunohistochemistry for STAT6 was crucial for establishing the diagnosis using FNA. CONCLUSIONS We have reported 2 cases of SFT involving the pancreas, including the first reported case of primary pancreatic SFT diagnosed preoperatively using FNA. Metastatic SFT from central nervous system primaries should be considered when diagnosing SFT of the pancreas.
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Mian MA, Gilliland GD. Managing a long-recurring primary orbital hemangiopericytoma. Proc (Bayl Univ Med Cent) 2020; 33:108-109. [DOI: 10.1080/08998280.2019.1664221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 10/25/2022] Open
Affiliation(s)
- Madeeha A. Mian
- College of Medicine, Texas A&M Health Sciences Center, Dallas, Texas
| | - Grant D. Gilliland
- Department of Ophthalmology, Baylor University Medical Center, Dallas, Texas
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“Hey! Whatever happened to hemangiopericytoma and fibrosarcoma?” An update on selected conceptual advances in soft tissue pathology which have occurred over the past 50 years. Hum Pathol 2020; 95:113-136. [DOI: 10.1016/j.humpath.2019.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/09/2019] [Indexed: 12/29/2022]
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Cimadamore A, Montironi R, Serni S, Campi R. Seminal Vesicle Tumor Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1296:309-318. [PMID: 34185301 DOI: 10.1007/978-3-030-59038-3_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Primary diseases of the seminal vesicles (SV) are very rare entities.Nonneoplastic lesions of the seminal vesicles include amyloidosis, inflammation, calcification and calculi, radiation-induced changes, and basal cell proliferation.Seminal vesicles are frequently involved by tumors originating elsewhere, in particular by prostatic adenocarcinoma, urothelial carcinoma, and rectal adenocarcinoma. On the contrary, primary tumors of the seminal vesicles are rare. Among these, the most common is seminal vesicle adenocarcinoma. To date, less than 100 cases have been reported in literature. Morphologically, primary SV adenocarcinoma is described as a papillary or sheetlike growth architecture, with trabecular and glandular patterns, composed by hobnail tumor cells, frequently with mucinous differentiation. On the contrary, mesenchymal tumors include benign lesions such as leiomyoma, schwannoma, fibroma, paraganglioma, solitary fibrous tumor, cystadenoma, and mixed epithelial and stromal tumors (MEST).Cystadenoma is a rare benign tumor, while MESTs are biphasic tumors with stromal and benign epithelial components. Histological features such as stromal atypia, mitotic activity, nuclear pleomorphism, and tumor necrosis distinct MEST in low-, intermediate-, and high-grade tumors.In recent years, multiple studies reported a link between tumorigenesis and tumor microenvironment. In this regard, the molecular mechanisms connecting prostate cancer (PCa) progression and the host microenvironment have been described and include extracellular matrix (ECM), myofibroblasts, cancer-associated fibroblasts (CAFs), neuroendocrine cells, adipose tissue, and the immune-modulatory cells. Of note, only one study evaluated the influence of seminal vesicle's tumor microenvironment (SVME) on prostate cancer cells so far. Besides, in vivo experiments in NOD/SCID mice clarified the influence of SVME on PCa progression. As such, the injection of PC3 cells into the prostate or the SV resulted in different tumor aggressiveness, and the incidence of retroperitoneal lymph node metastases was significantly higher in mice models receiving SV injection. These findings demonstrated that SVs (rather than the prostate) offer a stimulating tumor microenvironment for growth and invasion of prostate cancer cells.
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Affiliation(s)
- Alessia Cimadamore
- Institute of Pathological Anatomy and Histopathology, Polytechnic University of the Marche Region (Ancona), Ancona, Italy
| | - Rodolfo Montironi
- Institute of Pathological Anatomy and Histopathology, Polytechnic University of the Marche Region (Ancona), Ancona, Italy
| | - Sergio Serni
- Department of Urologic Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Careggi Hospital, Florence, Italy
| | - Riccardo Campi
- Department of Urologic Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy. .,Department of Experimental and Clinical Medicine, University of Florence, Careggi Hospital, Florence, Italy.
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Avallone G, Stefanello D, Ferrari R, Roccabianca P. The controversial histologic classification of canine subcutaneous whorling tumours: The path to perivascular wall tumours. Vet Comp Oncol 2019; 18:3-8. [DOI: 10.1111/vco.12559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 11/19/2019] [Accepted: 11/19/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Giancarlo Avallone
- Department of Veterinary Medical sciences (DIMEVET)University of Bologna Ozzano dell'Emilia Italy
| | - Damiano Stefanello
- Dipartimento di Medicina VeterinariaUniversità degli Studi di Milano Milan Italy
| | - Roberta Ferrari
- Dipartimento di Medicina VeterinariaUniversità degli Studi di Milano Milan Italy
| | - Paola Roccabianca
- Dipartimento di Medicina VeterinariaUniversità degli Studi di Milano Milan Italy
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Histological and molecular features of solitary fibrous tumor of the extremities: clinical correlation. Virchows Arch 2019; 476:445-454. [PMID: 31463729 DOI: 10.1007/s00428-019-02650-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/13/2019] [Accepted: 08/13/2019] [Indexed: 12/21/2022]
Abstract
Solitary fibrous tumor is a rare mesenchymal neoplasm that exhibits a broad spectrum of biological behaviors. Few studies relative to clinical-pathologic features and predictive factors have been reported, all involving a mixed population of tumors occurring at different anatomic sites. In this study, we described a cohort of 41 patients with solitary fibrous tumor of the extremities and evaluated the prognostic role of clinical and histological features, presence of C228T and C250T mutations at the TERT promoter region, and NAB2-STAT6 fusion variants. Patients were stratified according to the latest risk stratification model proposed by Demicco. The two patients with metastasis at presentation were in the high-risk group; the one with metastasis after surgery was classified in the intermediate-risk group. TERT promoter mutations were detected in 9 out of 38 DNA available. All patients with metastasis were characterized by a TERT promoter mutation. TERT promoter mutation was associated with mitoses > 4 per high-power field (p = 0.001), necrosis (p = 0.049), and size > 10 cm (p = 0.031). NAB2-STAT6 fusion variants were detected in 27 out of 41 cases without any prognostic value. In conclusion, we confirmed that the patients with solitary fibrous tumor of the limbs have a better prognosis than other solitary fibrous tumors, with a very low percentage of metastatic events. Besides, our data support an association between TERT promoter mutations and histologically malignant features, suggesting a possible molecular role in stratifying patients into intermediate- to high-risk tumor.
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Yamada Y, Kohashi K, Kinoshita I, Yamamoto H, Iwasaki T, Yoshimoto M, Ishihara S, Toda Y, Itou Y, Koga Y, Hashisako M, Nozaki Y, Kiyozawa D, Kitahara D, Inoue T, Mukai M, Honda Y, Toyokawa G, Tsuchihashi K, Matsushita Y, Fushimi F, Taguchi K, Tamiya S, Oshiro Y, Furue M, Nakashima Y, Suzuki S, Iwaki T, Oda Y. Clinicopathological review of solitary fibrous tumors: dedifferentiation is a major cause of patient death. Virchows Arch 2019; 475:467-477. [PMID: 31392468 DOI: 10.1007/s00428-019-02622-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 07/08/2019] [Accepted: 07/11/2019] [Indexed: 12/19/2022]
Abstract
Solitary fibrous tumor (SFT) is a soft-tissue neoplasm of intermediate malignant potential, presenting a wide histopathological spectrum. Poorer prognosis of hemangiopericytoma of the central nervous system (CNS), hypoglycemic SFT, and dedifferentiation are well-known characters of SFT, but their clinical significance were not demonstrated enough by large-sized study. Here, the clinicopathological features of SFTs are reviewed and the relationship between genetics and clinicopathological features is examined using 145 SFT cases. All cases were STAT6 IHC-positive and/or NAB2-STAT6 fusion gene-positive. Tumor location was classified into three categories: 30 pleuropulmonary, 96 non-pleuropulmonary/non-central nervous system (CNS), and 18 CNS tumors. The tumor developed recurrence in 21 of 93 available cases (22.5%), metastasis in 11 of 93 (11.8%), and tumor death in 9 of 93 (9.6%). Hypoglycemia occurred in 2 primary tumors and 1 metastatic tumor among 63 reviewable cases, and dedifferentiation occurred in 10 cases (6.8%) including 6 primary tumors, 2 recurrent tumors, and 2 metastatic tumors. Recurrence was positively associated with CNS location (p = 0.0109) and hypoglycemia (p = 0.001); metastasis was positively associated with CNS location (p = 0.0231), hypoglycemia (p < 0.0001), and dedifferentiation (p < 0.0001), while metastasis was negatively correlated with pleural location (p = 0.0471). Tumor death was positively associated with male sex (p = 0.0154), larger size (p = 0.0455), hypoglycemia (p < 0.0001), and dedifferentiation (p < 0.0001). Multivariate analysis revealed independent statistical significance of dedifferentiation for overall survival (p = 0.0467). Exon variant of the fusion gene had no statistical correlation with clinical outcome. In conclusion, dedifferentiation is a major prognostic factor of SFT, and specific location such as cerebromeningeal and intra-abdominal site and hypoglycemia also had a high risk for unfavorable prognosis.
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Affiliation(s)
- Yuichi Yamada
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Izumi Kinoshita
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Takeshi Iwasaki
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Masato Yoshimoto
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Shin Ishihara
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Yu Toda
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Yoshihiro Itou
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Yutaka Koga
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Mikiko Hashisako
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Yui Nozaki
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Daisuke Kiyozawa
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Daichi Kitahara
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Takeshi Inoue
- Department of Pathology, Osaka City General Hospital, 2-13-22 Miyakojima-Hondori, Miyakojima-ku, Osaka-shi, Osaka-fu, 534-0021, Japan
| | - Munenori Mukai
- Department of Pathology, Kouseiren Takaoka Hospital, 5-10 Eiraku-machi, Takaoka-shi, Toyama-ken, 933-8555, Japan
| | - Yumi Honda
- Department of Surgical Pathology, Kumamoto University Hospital, 2-39-1 Kurokami, Chuo-ku, Kumamoto-shi, Kumamoto-ken, 860-8555, Japan
| | - Gouji Toyokawa
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Kenji Tsuchihashi
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Yoshifumi Matsushita
- Department of Pathology, Chidoribashi Hospital, 5-18-1 Chiyo, Hakata-ku, Fukuoka-shi, Fukuoka-ken, 812-0044, Japan
| | - Fumiyoshi Fushimi
- Department of Pathology, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, 3-23-1 Shiobaru, Minami-ku, Fukuoka-shi, Fukuoka-ken, 815-8588, Japan
| | - Kenichi Taguchi
- Department of Pathology, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka-shi, Fukuoka-ken, 811-1395, Japan
| | - Sadafumi Tamiya
- Department of Pathology, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu-shi, Fukuoka-ken, 802-0077, Japan
| | - Yumi Oshiro
- Department of Pathology, Matsuyama Red Cross Hospital, 1 Bunkyomachi, Matsuyama-shi, Ehime-ken, 790-8524, Japan
| | - Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Satoshi Suzuki
- Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Toru Iwaki
- Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka-shi, Fukuoka-ken, 812-8582, Japan.
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Mishra S, Mohanty N, Routray S, Misra S. Haemangiopericytoma/Solitary Fibrous Tumour of Mandible: An Uncommonness in the Oral Cavity. J Maxillofac Oral Surg 2019; 20:42-46. [PMID: 33584040 DOI: 10.1007/s12663-019-01263-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/22/2019] [Indexed: 10/26/2022] Open
Abstract
Among the bewildering variety of neoplasms occurring in the head and neck region, few are unique to the oral cavity which are quite challenging to diagnose. Due to the rarity of these tumours, it is the practicing oral pathologists' accountability to confirm some of these neoplasms with or without special investigative modalities to rule out the differential diagnosis histopathologically. One in the group of such tumour prevails haemangiopericytoma aka. solitary fibrous tumour (HPC/SFT). The management of these tumours is purely histopathologically driven, since the surgical procedure is dependent on the histological diagnosis. This neoplasm is histologically very difficult to confirm as benign or malignant without the use of immunohistochemical markers. We report such a rare case of a 54-year-old female patient, histopathologically confirmed diagnosis of HPC/SFT with CD34 positivity for documentation in the literature.
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Affiliation(s)
- Sobhan Mishra
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be University), Sector-8, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha 751003 India
| | - Neeta Mohanty
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be University), Sector-8, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha 751003 India
| | - Samapika Routray
- All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019 India
| | - Satyaranjan Misra
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be University), Sector-8, Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha 751003 India
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Minamiyama S, Hirota M, Iwai T, Ozawa T, Udaka N, Mitsudo K. Hemangiopericytoma/solitary fibrous tumor of the buccal mucosa: A case report. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2019. [DOI: 10.1016/j.ajoms.2019.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Boyett D, Kinslow CJ, Bruce SS, Sonabend AM, Rae AI, McKhann GM, Sisti MB, Bruce JN, Cheng SK, Wang TJC. Spinal location is prognostic of survival for solitary-fibrous tumor/hemangiopericytoma of the central nervous system. J Neurooncol 2019; 143:457-464. [PMID: 31054100 PMCID: PMC7311186 DOI: 10.1007/s11060-019-03177-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/25/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prior studies have highlighted infratentorial tumor location as a prognostic factor for solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) of the central nervous system (CNS), and spinal location is considered a positive prognostic factor for other tumors of the CNS. While SFT/HPC of the CNS is known to frequently arise from the spinal meninges, there are no case series that report outcomes for spinally located CNS tumors, and their prognosis in relation to intracranial and other CNS-located tumors is unknown. OBJECTIVE To investigate outcomes for patients with SFT/HPC of the spinal meninges. METHODS The Surveillance, Epidemiology, and End-Results Program was used to identify patients with SFT/HPC within the CNS from 1993-2015. We retrospectively analyzed the relationship between tumor location (spinal vs. Brain and other CNS) and survival. RESULTS We identified 551 cases of CNS SFT/HPC, 64 (11.6%) of which were primary tumors of the spinal meninges. Spinal tumors were more likely than brain and other CNS tumors to be SFT vs. HPC (37.5 vs. 12%, p < 0.001), benign (42.2 vs. 20.3%, p < 0.001), and less than 5 cm (53.1 vs. 35.7%, p < 0.001). The 10-year survival rates for spinal and brain/other CNS tumors were 85 and 58%, respectively. Median survival time was significantly longer for spinal tumors (median survival not reached vs. 138 months, p = 0.03, HR = 0.41 [95% CI 0.18-0.94]). On multivariable analysis, spinal tumor location was associated with improved survival over tumors located in the brain and other CNS (HR = 0.36 [95% CI 0.15-0.89], p = 0.03). CONCLUSION Spinal tumor location is associated with improved survival in patients with SFT/HPC of the CNS. Larger institutional studies are necessary to characterize the relationship between tumor location and other relevant factors such as presentation and amenability to gross-total resection and adjuvant radiotherapy. Future studies exploring optimal management of spinally located tumors are also needed.
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Affiliation(s)
- Deborah Boyett
- Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Connor J Kinslow
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 622 West 168th Street, BNH B011, New York, NY, 10032, USA
| | - Samuel S Bruce
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Adam M Sonabend
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL, 60611, USA
| | - Ali I Rae
- Department of Neurological Surgery, Oregon Health & Sciences University, 3181 SW Sam Jackson Pkwy, Portland, OR, 97239, USA
| | - Guy M McKhann
- Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA
| | - Michael B Sisti
- Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA
| | - Jeffrey N Bruce
- Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA
| | - Simon K Cheng
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 622 West 168th Street, BNH B011, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA
| | - Tony J C Wang
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 622 West 168th Street, BNH B011, New York, NY, 10032, USA.
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA.
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Du H, Dreier JR, Zarei M, Wu CL, Bronson RW, Kwiatkowski DJ. A novel mouse model of hemangiopericytoma due to loss of Tsc2. Hum Mol Genet 2019; 27:4169-4175. [PMID: 30124871 DOI: 10.1093/hmg/ddy289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 08/06/2018] [Indexed: 01/01/2023] Open
Abstract
Hemangiopericytoma (HPC) is a rare vascular tumor, which is thought to originate from pericytes. However, no direct evidence for the cell of origin has been found, and the mechanism of HPC tumorigenesis is poorly understood. Here we report that loss of the tumor suppressor gene Tsc2 in pericytes using a FoxD1 promoter driven cre allele (Foxd1tm1(GFP/cre) Amc, FoxD1GC) leads to the formation of HPC in multiple sites. Tsc2ffFoxD1GC mice had stunted growth with seizures and tail and hind limb tremor with a median survival of 110 days. They also showed recombination in brain, spinal cord, tongue, liver, intestine and skeletal muscle. Distinctive perivascular tumors consisting of cells with oval nuclei and scant cytoplasm were identified in multiple sites in all Tsc2ffFoxD1GC mice. Immunohistochemistry staining showed a high expression of phospho-S6-S240/244, a hallmark of activated mTORC1, as well as pericyte markers NG2 and vimentin in these tumors. In summary, we demonstrate that loss of Tsc2 in pericytes generates HPC, the first mouse model of HPC reported.
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Affiliation(s)
- Heng Du
- Division of Pulmonary Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - John R Dreier
- Division of Pulmonary Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mahsa Zarei
- Division of Pulmonary Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Veterinary Physiology and Pharmacology, Texas A & M University, College Station, TX
| | - Chin-Lee Wu
- Departments of Pathology and Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - David J Kwiatkowski
- Division of Pulmonary Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Gupta A, Sharma SD, Bansal P, Sikka S. Hemangiopericytoma of Gingiva in a 4-Year-Old Child: A Rare Case Report. J Maxillofac Oral Surg 2019; 18:52-56. [PMID: 30728692 PMCID: PMC6328836 DOI: 10.1007/s12663-018-1086-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/17/2018] [Indexed: 10/17/2022] Open
Abstract
A hemangiopericytoma is a type of soft tissue sarcoma that originates in the pericytes in the walls of capillaries which was characterized in 1942. It is commonly seen in the age group of 5th-6th decades of adults and only 5-10% of cases occur in children with extreme rare occurrence in head and neck region (16%). A rare case of hemangiopericytoma in a 4-year-old female patient is presented here and its clinical, histopathological and immunohistochemically features are discussed. Though surgical resection remains the mainstay, excisional biopsy was primarily performed to reach the final diagnosis. Even in the follow-up phase of 1 year, no recurrence or no metastatic changes were observed.
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Affiliation(s)
- Ashish Gupta
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences & Research, Faridabad, Haryana India
- Present Address: Faridabad, India
| | - Sneha D. Sharma
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences & Research, Faridabad, Haryana India
| | - Pankaj Bansal
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences & Research, Faridabad, Haryana India
| | - Seema Sikka
- Department of Oral & Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences & Research, Faridabad, Haryana India
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Kimmel J, Dikman A, Hajdu C. Gastric Solitary Fibrous Tumor Causing Upper Gastrointestinal Bleeding. ACG Case Rep J 2019; 6:e00005. [PMID: 31616714 PMCID: PMC6657998 DOI: 10.14309/crj.0000000000000005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/15/2018] [Indexed: 12/17/2022] Open
Abstract
We present an 81-year-old woman with remote breast cancer who presented with melena and hemorrhagic shock requiring intensive care hospitalization. Endoscopic evaluation showed a 5-cm pedunculated gastric mass with ulceration and friability. She underwent sleeve gastrectomy for definitive treatment of her bleeding. Pathology was consistent with a solitary fibrous tumor (SFT). There are only a few reported cases of gastric SFTs presenting with gastrointestinal bleeding. If a large brown/tan bleeding mass is identified on upper endoscopy, SFT should be considered.
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Affiliation(s)
- Jessica Kimmel
- Department of Medicine, Division of Gastroenterology, New York University School of Medicine, New York, NY
| | - Andrew Dikman
- Department of Medicine, Division of Gastroenterology, New York University School of Medicine, New York, NY
| | - Cristina Hajdu
- Department of Pathology, New York University School of Medicine, New York, NY
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39
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Wu PH, Lu HE. Solitary fibrous tumor of rectus sheath. JOURNAL OF MEDICAL SCIENCES 2019. [DOI: 10.4103/jmedsci.jmedsci_174_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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40
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Hatfield BS, Mochel MC, Smith SC. Mesenchymal Neoplasms of the Genitourinary System: A Selected Review with Recent Advances in Clinical, Diagnostic, and Molecular Findings. Surg Pathol Clin 2018; 11:837-876. [PMID: 30447845 DOI: 10.1016/j.path.2018.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mesenchymal neoplasms of the genitourinary (GU) tract often pose considerable diagnostic challenges due to their wide morphologic spectrum, relative rarity, and unexpected incidence at GU sites. Soft tissue tumors arise throughout the GU tract, whether from adventitia surrounding or connective tissues within the kidneys, urinary bladder, and male and female genital organs. This selected article focuses on a subset of these lesions, ranging from benign to malignant and encompassing a range of patterns of mesenchymal differentiation, where recent scholarship has lent greater insight into their clinical, molecular, or diagnostic features.
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Affiliation(s)
- Bryce Shawn Hatfield
- Department of Pathology, VCU School of Medicine, 1200 East Marshall Street, PO Box 980662, Richmond, VA 23298, USA
| | - Mark Cameron Mochel
- Department of Pathology, VCU School of Medicine, 1200 East Marshall Street, PO Box 980662, Richmond, VA 23298, USA
| | - Steven Christopher Smith
- Departments of Pathology and Urology, VCU School of Medicine, 1200 East Marshall Street, PO Box 980662, Richmond, VA 23298, USA.
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41
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Very rare localization of a retroperitoneal hemangiopericytoma revealed by lumbosciatalgia: A case report. Int J Surg Case Rep 2018; 53:127-131. [PMID: 30391737 PMCID: PMC6216087 DOI: 10.1016/j.ijscr.2018.10.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 10/13/2018] [Indexed: 01/26/2023] Open
Abstract
Hemangiopericytoma is a rare vascular tumor representing about 1% of all vascular tumors and approximatively 5% of all soft tissues sarcomas. Retroperitoneal hemangiopericytoma is a rare location. The radiologic feature suggests the diagnosis but the pathologic findings associated to immune histochemistery remain the only tool to confirm the diagnosis. Surgical excision is the most preferred treatment as it helps in relieving the symptoms as well as confirm the diagnosis.
Introduction: Hemangiopericytoma is a rare vascular tumor representing about 1% of all vascular tumors and approximatively 5% of all soft tissues sarcomas that arises from the pericytes of Zimmerman surrounding capillaries and postcapillaries vessels. Retroperitoneal hemangiopericytomas are rare among the localisations as it usually occurs in lower and upper extremities. Presentation of case: We present a case of 31-year-old man with a well-defined retro peritoneal mass measuring about 105 × 73 × 83 mm at right lower quadrant of the abdomen anterior to right psoas muscle. Intraoperatively, an large mass measuring 10 × 8 cm was found arising from the retro peritoneum. A monobloc excision was performed. The postoperative course was uneventful. Histopathological examination with immune histochemistry revealed that tumoral cells were positive for desmin, CD34, smooth muscular antigen. Final diagnosis of hemangiopericytoma was made. On the last follow up at one year, he was symptom free. Discussion: Hemangiopericytoma is a rare tumor. It takes origin from pericytes presenting as intervals along the walls of capillaries and post-capillary venules. Retroperitoneal hemangiopericytoma is a rare location. It is often discovered at late course, and can be revealed by various symptoms with the compression of the adjacent organs by the tumor Surgical resection should be considered in symptomatic cases or in case of diagnostic dilemma. Conclusion: Retroperitoneal hemangiopericytoma can be benign but it should be treated the same way as aggressive tumors. It requires a careful and long term follow up.
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Lerut J, Iesari S. Vascular tumours of the liver: a particular story. Transl Gastroenterol Hepatol 2018; 3:62. [PMID: 30363746 DOI: 10.21037/tgh.2018.09.02] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 09/03/2018] [Indexed: 12/12/2022] Open
Abstract
Vascular tumours of the liver represent an underrated chapter of medical and surgical hepatology. These tumours cover a wide spectrum ranging from the frequent and most benign hepatic haemangioma (HH), via the rare and intermediately aggressive hepatic epithelioid haemangioendothelioma (HEHE) to the rare and most malignant hepatic haemangiosarcoma (HHS). In contrast to the treatment algorithms for hepatocellular and cholangiocellular cancer, the diagnostic and therapeutic approaches to HEHE and HHS are not well developed. The related uncertainty is explained by their rare occurrence and their protean clinical, morphological (imaging) and histopathological presentation and behaviour. This article gives an update about these particular tumours based on the analysis of the recent literature and of the studies on vascular tumours published by the European Liver Intestine Transplantation Association (ELITA)-European Liver Transplant Registry (ELTR). It focuses also on the place of liver transplantation (LT) in the respective therapeutic algorithms. The differential diagnosis between these vascular and other tumour types may be very difficult. Correct diagnosis is of utmost importance and is based on a high index of clinical suspicion and on the integration of clinical, radiological, histological [including immunohistochemistry (IHC) and molecular biology findings]. Surgery, be it partial or total hepatectomy (LT), should be proposed whenever possible, because it is the therapeutic mainstay. In HEHE, LT provides excellent results, with long-term disease-free survivals (DFS) reaching 75%. Good results can be obtained even in case of (frequent) extrahepatic spread. Based on the extensive ELITA-ELTR study a HEHE-LT prognostic score has been proposed in order to estimate the risk of recurrence after LT. In contrast, results of surgery and LT are extremely poor for HHS, for the almost invariably rapid recurrence (within 6 months) and related death within 2 years. LT remains a contraindication for HHS. Due to the still important recurrence rate after surgical resection (25% in HEHE and almost 100% in HHS), there is an urgent need to develop pharmacological treatments targeting angiogenic and non-VEGF angiogenic pathways. To date, some prospective pilot studies and case reports have shown some short-term stabilisation of the disease in small groups of patients. In order to make progress, combination of surgery, anti-angiogenic and immunotherapy seems worthwhile. To complete the panel of vascular liver tumours, infantile haemangioendothelioma, haemangiopericytoma, nodular regenerative hyperplasia (NRH) and hepatic small vessel neoplasms (HSVN) are also discussed.
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Affiliation(s)
- Jan Lerut
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain (UCL), Brussels, Belgium
| | - Samuele Iesari
- Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain (UCL), Brussels, Belgium.,Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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43
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Ehman EC, Torbenson MS, Wells ML, Welch BT, Thompson SM, Garg I, Venkatesh SK. Hepatic tumors of vascular origin: imaging appearances. Abdom Radiol (NY) 2018; 43:1978-1990. [PMID: 29159525 DOI: 10.1007/s00261-017-1401-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
A number of benign and malignant neoplasms may arise from the vascular elements within the liver parenchyma. Lesions discussed in this article include angiosarcoma, epithelioid hemangioendothelioma, solitary fibrous tumor (hemangiopericytoma), infantile, and cavernous hemangiomas. Despite a common theme of vascular origin, the pathologic and imaging appearance of these entities can be heterogeneous. Angiosarcomas are bizarrely enhancing, highly aggressive tumors, which often present with metastatic disease. When solitary, epithelioid hemangioendothelioma lesions can exhibit a concentric ring or target appearance on contrast-enhanced CT and at MR and when numerous may be indistinguishable from angiosarcoma except for a more slowly advancing course. Primary solitary fibrous tumors of the liver are exceedingly rare solid masses and most often initially diagnosed on imaging as other entities such as cholangiocarcinoma. Infantile hemangiomas consist of benign proliferation of the vascular endothelium and in the absence of flow-related complications, are usually clinically silent, and may be detected incidentally as T1 hypointense, T2 hyperintense, centripetally enhancing lesions. Cavernous hemangiomas are extremely common hepatic lesions and when classic rarely offer a challenge in diagnosis, though atypical variants may mimic more serious diseases. The purpose of this review is to provide an overview of important vascular tumors of the liver in order to aid the radiologist in providing a broad differential diagnosis for focal liver lesions, and when classic, suggest specific uncommonly seen diagnoses in order to more accurately guide clinical management.
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44
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45
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Tan SY, Szymanski LJ, Galliani C, Parham D, Zambrano E. Solitary Fibrous Tumors in Pediatric Patients: A Rare and Potentially Overdiagnosed Neoplasm, Confirmed by STAT6 Immunohistochemistry. Pediatr Dev Pathol 2018; 21:389-400. [PMID: 29228868 DOI: 10.1177/1093526617745431] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pathological diagnosis of solitary fibrous tumor (SFT) in the pediatric population is challenging, as it occurs uncommonly in this age-group and resembles other spindle cell neoplasms. SFT contains a NAB2-STAT6 fusion gene, which can be reliably detected using STAT6 immunohistochemistry. Positive staining is highly sensitive and specific. We sought to investigate the utility of STAT6 immunohistochemistry, to show how commonly SFT was historically recognized at 3 academic pediatric institutions, to reclassify them when appropriate, and to demonstrate features of major mimics of SFT. Our series included cases with a previous diagnosis of SFT or for which SFT was among key considerations, from 3 major academic pediatric hospitals seen over the past 30 years. Of 18 tumors identified, only 3 tumors from 2 patients demonstrated positive STAT6 staining as well as the typical histology and immunophenotype seen in SFT. The remaining 15 tumors were reclassified based on morphology, additional immunohistochemistry and fluorescence in situ hybridization as desmoid-type fibromatosis (3 tumors), nerve sheath/neural tumors (3 tumors), low-grade fibromyxoid sarcoma, medallion-like dermal fibroma, poorly differentiated Sertoli cell tumor, nodular/proliferative fasciitis, calcifying fibrous tumor, aneurysmal bone cyst of soft tissue, STAT6-negative SFT with adipocytic differentiation, undifferentiated small round blue cell tumor, and scar (1 tumor each). Our study confirms that SFT is rare in the pediatric population and that it is potentially overdiagnosed. STAT6 immunohistochemistry is recommended to confirm the diagnosis of SFT in the pediatric population.
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Affiliation(s)
- Serena Y Tan
- 1 Department of Pathology, Stanford University Medical Center, Stanford, California
| | - Linda J Szymanski
- 2 Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Carlos Galliani
- 3 Department of Pathology, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota
| | - David Parham
- 2 Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Eduardo Zambrano
- 1 Department of Pathology, Stanford University Medical Center, Stanford, California
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46
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Eshraghi B, Ghadimi H, Nozarian Z. Unusual occurrence of orbital hemangiopericytoma in the zygomatic bone of an adolescent: a case report. EYE AND VISION 2018; 5:10. [PMID: 29785407 PMCID: PMC5950185 DOI: 10.1186/s40662-018-0105-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 04/27/2018] [Indexed: 11/28/2022]
Abstract
Background Hemangiopericytoma and solitary fibrous tumor are considered related variants on the same spectrum and both may essentially be the same tumor. They are infrequently encountered in the orbital region while the zygomatic bone is an extremely rare location for these neoplasms to occur. Case presentation A 14-year-old boy presented with complaint of deformity of left infraorbital area and a firm, regular mass in the region. Orbital CT scan revealed a well-defined round isodense intraosseous lesion in the lowermost portion of the lateral orbital wall (zygomatic bone), expanding the bone and protruding anteriorly and medially. MRI showed the mass to be heterogenous and strongly enhancing with contrast medium. Inferior transconjunctival orbitotomy was performed and the mass was removed. The histopathologic examination and immunohistochemistry staining results (positive for CD34, CD31 and smooth muscle actin, but negative for CD99, S100, B-cell lymphoma 2 (bcl-2) and desmin) confirmed the diagnosis of hemangiopericytoma. The postoperative course was uneventful, with no evidence of recurrence after 5 years follow up. Conclusions This case represents the second hemangiopericytoma reported in the zygomatic bone. Although extremely rare, hemangiopericytoma/solitary fibrous tumor might be considered in the differential diagnosis of intraosseous lesions of the orbital and zygomatic region.
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Affiliation(s)
- Bahram Eshraghi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Sq, Tehran, 1336616351 Iran
| | - Hadi Ghadimi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Sq, Tehran, 1336616351 Iran
| | - Zohreh Nozarian
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Sq, Tehran, 1336616351 Iran
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47
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Macagno N, Vogels R, Appay R, Colin C, Mokhtari K, Küsters B, Wesseling P, Figarella-Branger D, Flucke U, Bouvier C. Grading of meningeal solitary fibrous tumors/hemangiopericytomas: analysis of the prognostic value of the Marseille Grading System in a cohort of 132 patients. Brain Pathol 2018; 29:18-27. [PMID: 29600523 DOI: 10.1111/bpa.12613] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/12/2018] [Indexed: 12/18/2022] Open
Abstract
The finding that meningeal solitary fibrous tumors (SFTs) and meningeal hemangiopericytomas (HPCs) are both characterized by NAB2-STAT6 gene fusion has pushed their inclusion in the WHO 2016 Classification of tumors of the central nervous system (CNS) as different manifestations of the same entity. Given that the clinical behavior of the CNS SFT/HPC spectrum ranges from benign to malignant, it is presently unclear whether the grading criteria are still adequate. Here, we present the results of a study that analyzed the prognostic value of an updated version of the Marseille Grading System (MGS) in a retrospectively assembled cohort of 132 primary meningeal SFTs/HPCs with nuclear overexpression of STAT6. The median patient follow-up was 64 months (range 4-274 months); 73 cases (55%) were MGS I, 50 cases (38%) MGS II and 9 cases (7%) were MGS III. Progression-free survival (PFS) and disease-specific survival (DSS) were investigated using univariate analysis: the prognostic factors for PFS included MGS, extent of surgery, radiotherapy, chemotherapy and mitotic activity ≥5/10 high-power field (HPF). Moreover, MGS, radiotherapy, mitotic activity ≥5/10 HPF, and necrosis were the prognostic factors measured for DSS. In multivariate analysis, extent of surgery, mitotic activity ≥5/10 HPF, MGS I and MGS III were the independent prognostic factors measured for PFS while necrosis, MGS III and radiotherapy were the independent prognostic factors for DSS. In conclusion, our results show that assessing the malignancy risk of SFT/HPC should not rely on one single criterion like mitotic activity. Therefore, MGS is useful as it combines the value of different criteria. In particular, the combination of a high mitotic activity and necrosis (MGS III) indicates a particularly poor prognosis.
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Affiliation(s)
- Nicolas Macagno
- Department of Pathology and Neuropathology, Timone Hospital, Marseille, France.,INSERM UMR911, Aix-Marseille University (AMU), Marseille, France
| | - Rob Vogels
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Pathology, Stichting PAMM, Eindhoven, The Netherlands
| | - Romain Appay
- Department of Pathology and Neuropathology, Timone Hospital, Marseille, France.,INSERM UMR911, Aix-Marseille University (AMU), Marseille, France
| | - Carole Colin
- INSERM UMR911, Aix-Marseille University (AMU), Marseille, France
| | - Karima Mokhtari
- Department of Neuropathology, Pitié-Salpêtrière Hospital, Paris, France
| | | | | | - Benno Küsters
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Pathology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Pieter Wesseling
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.,Department of Pathology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,University Medical Center, Utrecht, The Netherlands
| | - Dominique Figarella-Branger
- Department of Pathology and Neuropathology, Timone Hospital, Marseille, France.,INSERM UMR911, Aix-Marseille University (AMU), Marseille, France
| | - Uta Flucke
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Pathology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,University Medical Center, Utrecht, The Netherlands
| | - Corinne Bouvier
- Department of Pathology and Neuropathology, Timone Hospital, Marseille, France.,INSERM UMR911, Aix-Marseille University (AMU), Marseille, France
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48
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Salas S, Resseguier N, Blay JY, Le Cesne A, Italiano A, Chevreau C, Rosset P, Isambert N, Soulie P, Cupissol D, Delcambre C, Bay JO, Dubray-Longeras P, Krengli M, De Bari B, Villa S, Kaanders JHAM, Torrente S, Pasquier D, Thariat JO, Myroslav L, Sole CV, Dincbas HF, Habboush JY, Zilli T, Dragan T, Khan R K, Ugurluer G, Cena T, Duffaud F, Penel N, Bertucci F, Ranchere-Vince D, Terrier P, Bonvalot S, Macagno N, Lemoine C, Lae M, Coindre JM, Bouvier C. Prediction of local and metastatic recurrence in solitary fibrous tumor: construction of a risk calculator in a multicenter cohort from the French Sarcoma Group (FSG) database. Ann Oncol 2018; 28:1979-1987. [PMID: 28838212 DOI: 10.1093/annonc/mdx250] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Solitary fibrous tumors (SFT) are rare unusual ubiquitous soft tissue tumors that are presumed to be of fibroblastic differentiation. At present, the challenge is to establish accurate prognostic factors. Patients and methods A total of 214 consecutive patients with SFT diagnosed in 24 participating cancer centers were entered into the European database (www.conticabase.org) to perform univariate and multivariate analysis for overall survival (OS), local recurrence incidence (LRI) and metastatic recurrence incidence (MRI) by taking competing risks into account. A prognostic model was constructed for LRI and MRI. Internal and external validations of the prognostic models were carried out. An individual risk calculator was carried out to quantify the risk of both local and metastatic recurrence. Results We restricted our analysis to 162 patients with local disease. Twenty patients (12.3%) were deceased at the time of analysis and the median OS was not reached. The LRI rates at 10 and 20 years were 19.2% and 38.6%, respectively. The MRI rates at 10 and 20 years were 31.4% and 49.8%, respectively. Multivariate analysis retained age and mitotic count tended to significance for predicting OS. The factors influencing LRI were viscera localization, radiotherapy and age. Mitotic count, tumor localization other than limb and age had independent values for MRI. Three prognostic groups for OS were defined based on the number of unfavorable prognostic factors and calculations were carried out to predict the risk of local and metastatic recurrence for individual patients. Conclusion LRI and MRI rates increased between 10 and 20 years so relapses were delayed, suggesting that long-term monitoring is useful. This study also shows that different prognostic SFT sub-groups could benefit from different therapeutic strategies and that use of a survival calculator could become standard practice in SFTs to individualize treatment based on the clinical situation.
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Affiliation(s)
- S Salas
- Department of Medicine, Timone Hospital, Marseille.,Aix Marseille University, Marseille
| | - N Resseguier
- Support Unit for Clinical Research and Economic Evaluatin, Timone Hospital, Marseille
| | - J Y Blay
- Department of Medicine, Leon Berard Center, Lyon
| | - A Le Cesne
- Department of Medicine, Gustave Roussy Institute, Villejuif
| | - A Italiano
- Department of Medicine, Bergonié Institute, Bordeaux
| | - C Chevreau
- Department of Medicine, Claudius Regaud Institute, Toulouse
| | - P Rosset
- Department of Medicine, CHU, Tours
| | - N Isambert
- Department of Medicine, Georges-François Leclerc Institute, Dijon
| | - P Soulie
- Department of Medicine, Paul Papin Institute, Angers
| | - D Cupissol
- Department of Medicine, Val d'Aurelle Institute, Montpellier
| | - C Delcambre
- Department of Medicine, François-Baclesse Institute, Caen
| | - J O Bay
- Department of Medicine, Jean Perrin Institute, Clermont-Ferrand, France
| | - P Dubray-Longeras
- Department of Medicine, Jean Perrin Institute, Clermont-Ferrand, France
| | - M Krengli
- Department of Radiotherapy, University Hospital, Novara, Italy
| | - B De Bari
- Department of Radiotherapy, CHU Vaudois, Lausanne, Switzerland
| | - S Villa
- Department of Radiotherapy, Catalan Institute of Oncology, Badalona Catalonia, Spain
| | - J H A M Kaanders
- Department of Radiotherapy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - S Torrente
- Department of Radiotherapy, University Hospital, Novara, Italy
| | - D Pasquier
- Department of Radiotherapy, Centre Oscar Lambret, Lille
| | - J O Thariat
- Department of Radiotherapy, Centre Antoine-Lacassagne, Nice, France
| | - L Myroslav
- Department of Radiotherapy, Rambam HCC, Haifa, Israel
| | - C V Sole
- Department of Radiotherapy, Clinica Instituto de Radiomedicina (IRAM), Santiago, Chile
| | - H F Dincbas
- Department of Radiotherapy, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - J Y Habboush
- Department of Radiotherapy, Mayo Clinic, Jacksonville, USA
| | - T Zilli
- Department of Radiotherapy, HUG, Geneva, Switzerland
| | - T Dragan
- Department of Radiotherapy, Institut J. Bordet Brussels, Brussels, Belgium
| | - K Khan R
- Department of Radiotherapy, CHVR, Sion, Switzerland
| | - G Ugurluer
- Department of Radiotherapy, Adana Hospital, Adana, Turkey
| | - T Cena
- Department of Medical Statistics, University of Piemonte Orientale, Novara, Italy
| | - F Duffaud
- Department of Medicine, Timone Hospital, Marseille
| | - N Penel
- Department of Medicine, Oscar Lambret Institute, Lille
| | - F Bertucci
- Department of Medicine, Paoli Calmette Institute, Marseille
| | | | - P Terrier
- Department of Pathology, Gustave Roussy Institute, Villejuif
| | - S Bonvalot
- Department of Surgery, Institut Curie, PSL University, Paris
| | - N Macagno
- Department of Pathology, Timone Hospital, Marseille
| | - C Lemoine
- Support Unit for Clinical Research and Economic Evaluatin, Timone Hospital, Marseille
| | - M Lae
- Department of Pathology, Curie Institute, Paris
| | - J M Coindre
- Department of Pathology, Bergonié Institute, Bordeaux.,University Victor Ségalen, Bordeaux, France
| | - C Bouvier
- Aix Marseille University, Marseille.,Department of Pathology, Timone Hospital, Marseille
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49
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Hughes KV, Bard MC, Lewis JE, Kasperbauer JL, Facer GW. Hemangiopericytoma of the Nasal Cavity: A Review of 15 Cases over a 40-Year Period. ACTA ACUST UNITED AC 2018. [DOI: 10.2500/105065892781976655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hemangiopericytomas are rare tumors of vascular origin most commonly found in the extremities or retroperitoneal area. When they originate from the nasal cavity and paranasal sinuses, they tend to be less aggressive and generally do not metastasize. The term “hemangiopericytoma-like lesion” has been coined for sinonasal hemangiopericytomas that display more benign histologic and growth characteristics than do those located elsewhere. Fifteen cases of hemangiopericytoma of the nasal cavity and paranasal sinuses were reviewed over the period 1951 to 1990; included are follow-up data on cases reported earlier from this institution. The clinical course, management, and outcome was evaluated and correlated with the histologic characteristics of the tumors. The recurrence rate in our series was 13.3%; the mean follow-up was 11 years. No patients died of their disease or had evidence of metastatic disease. This clinicopathologic review suggests that sinonasal hemangiopericytomas should not be classified as “hemangiopericytoma-like” lesions; rather, they should be expected to have significant local recurrence rates with low rates of distant metastasis and mortality. Long-term follow-up is essential as there can be local recurrence after many years.
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Affiliation(s)
- Kenneth V. Hughes
- Departments of Otorhinolaryrology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
| | - Michael C. Bard
- Departments of Otorhinolaryrology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
| | - Jean E. Lewis
- Departments of Surgical Pathology, Mayo Clinic, Rochester, MN
| | - Jan L. Kasperbauer
- Departments of Otorhinolaryrology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
| | - George W. Facer
- Departments of Otorhinolaryrology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
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50
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Yasui R, Minatogawa T, Kanoh N, Nakata Y, Kubota A. Nasal Septal Hemangiopericytoma-like Tumor: A Case Report with an Immunohistochemical Study. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/194589240101500409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nasal hemangiopericytoma-like (HPCL) tumor is a rare vascular tumor and should be differentiated from typical hemangiopericytomas (HPCs). This study reports the case of an HPCL tumor in a 77-year-old man with histological and immunohistochemical features. After preoperative evaluation of the blood supply, the dark-red right intranasal tumor was resected completely via the right maxillary sinus. The final histopathological diagnosis was HPCL tumor based on several stains: vimentin (+), α-SMA (+), etc. Moreover, there were few p53 (+) cells and the Ki-67 and topoisomerase IIα labeling indices were both under 5%. These findings indicated that this tumor was a low-grade malignancy. The immunohistochemical investigations used are useful for making the diagnosis of HPCL tumor and determining the treatment, malignancy, and prognosis. (American Journal of Rhinology 15 267–270, 2001)
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Affiliation(s)
- Rie Yasui
- Department of Otolaryngology, Chibune Hospital, Nishiyodogawa-ku, Osaka, Japan
| | - Toru Minatogawa
- Department of Otolaryngology, Chibune Hospital, Nishiyodogawa-ku, Osaka, Japan
| | - Naoyuki Kanoh
- Departments of Otolaryngology and Hyogo College of Medicine, Nishinomiya, Japan
| | - Yasuo Nakata
- Departments of Pathology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Akira Kubota
- Departments of Pathology, Hyogo College of Medicine, Nishinomiya, Japan
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