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Geng J, Chen D, Wang L, Liu X, Chen W, Gao H, Xiao S. Infantile fibrosarcoma of the perineum with dorsal metastasis in a neonate: a case report original. BMC Pediatr 2023; 23:327. [PMID: 37386422 PMCID: PMC10308727 DOI: 10.1186/s12887-023-04129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/12/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Infantile fibrosarcoma is a rare pediatric soft tissue tumor and usually appears in children before one year of age. Distal extremities constitute the most frequently affected locations, and other tissues such as the trunk, head and neck, gut, sacrococcygeal region, and viscera are uncommon sites. CASE PRESENTATION We describe a rare case of infantile fibrosarcoma arising from the perineum. First, a cystic mass was detected using prenatal ultrasonography, and then an echo was changed in serial ultrasound examinations. A solid cystic lesion was found at term; a hypoechoic lesion occurred in the back. The tumor became so large that massive bleeding occurred, which then underwent surgical resection. Pathological examination confirmed infantile fibrosarcoma. CONCLUSION Our report demonstrates not all ultrasonographic findings in cases of infantile fibrosarcoma exhibit a solid mass during the initial examination - an early-stage lesion may reveal a cystic echo. Infantile fibrosarcoma has a good prognosis and surgery constitute the main treatment, with adjuvant chemotherapy being received if necessary.
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Affiliation(s)
- Juan Geng
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Dan Chen
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Limin Wang
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Xiangjiao Liu
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Wenjing Chen
- Department of Pathology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Hongyi Gao
- Department of Pathology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Shangjie Xiao
- Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China.
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2
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Orly J, Bisdorff A, Joly A, Edee AE, Tavernier E, Herbreteau D, Boccara O, Wassef M, Maruani A. Characteristics, Natural Course and Treatment of Intramuscular Capillary-type Haemangioma: A Systematic Literature Review. Acta Derm Venereol 2023; 103:adv00893. [PMID: 36939537 PMCID: PMC10041649 DOI: 10.2340/actadv.v103.4432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/29/2022] [Indexed: 03/21/2023] Open
Abstract
Intramuscular capillary-type haemangiomas (ICTH) are rare vascular anomalies that can easily be misdiagnosed as other entities. A systematic review was performed of all cases of ICTH in the literature since its first description in 1972. An adjudication committee reviewed cases to include only ICTHs. Among 1,143 reports screened, 43 were included, involving 75 patients. The most frequent differential diagnosis was intramuscular venous malformations. The mean age of patients at diagnosis was 21.2 years. ICTH was mainly described as a gradually increasing mass (81.8%), painless (73.9%), that could occur anywhere in the body but most frequently on the head and neck (44.0%). Magnetic resonance imaging (MRI) was mainly used for diagnosis (69.1%) and displayed specific features. The most frequent treatment was complete surgical removal (73.9%), which could be preceded by embolization, and led to complete remission without recurrence in all but 1 case.
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Affiliation(s)
- Jordan Orly
- CHRU Tours, Department of Dermatology, Unit of Pediatric dermatology, Tours, France; Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours.
| | - Annouk Bisdorff
- 3Reference center for vascular anomalies FAVA-multi, University Hospital of Lariboisière; Coordinator of the constitutive center for superficial arteriovenous malformations in children and adults; AP-HP, Department of Neuroradiology, Paris, France
| | - Aline Joly
- Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours, France; Reference center for vascular anomalies FAVA-multi, University Hospital of Lariboisière; Coordinator of the constitutive center for superficial arteriovenous malformations in children and adults; AP-HP, Department of Neuroradiology, Paris, France; CHRU Tours, Department of Maxillo-facial surgery, Tours, France
| | - Afi-Emiliène Edee
- Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours, France
| | - Elsa Tavernier
- University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France; CHRU Tours, Clinical Investigation Center INSERM 1415, Tours, France
| | | | - Olivia Boccara
- Department of Dermatology and Reference center for genodermatoses and rare skin diseases (MAGEC-Necker), University Hospital Necker-Enfants Malades, Paris, France
| | - Michel Wassef
- Department of Pathology, University Hospital of Lariboisière, AP-HP, Paris, France
| | - Annabel Maruani
- CHRU Tours, Department of Dermatology, Unit of Pediatric dermatology, Tours, France; Reference center for genodermatoses and rare skin diseases (MAGEC-Tours), Tours, France; University of Tours, University of Nantes, INSERM 1246-SPHERE, Tours, France
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3
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Update of pediatric soft tissue tumors with review of conventional MRI appearance-part 2: vascular lesions, fibrohistiocytic tumors, muscle tumors, peripheral nerve sheath tumors, tumors of uncertain differentiation, and undifferentiated small round cell sarcomas. Skeletal Radiol 2022; 51:701-725. [PMID: 34297167 DOI: 10.1007/s00256-021-03837-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/22/2021] [Accepted: 06/02/2021] [Indexed: 02/02/2023]
Abstract
There are numerous soft tissue tumors and tumor-like conditions in the pediatric population. Magnetic resonance imaging is the most useful modality for imaging these lesions. Although certain soft tissue lesions exhibit magnetic resonance features characteristic of a specific diagnosis, most lesions are indeterminate, and a biopsy is necessary for diagnosis. We provide a detailed update of soft tissue tumors and tumor-like conditions that occur in the pediatric population, emphasizing each lesion's conventional magnetic resonance imaging appearance, using the recently released 5th edition of the World Health Organization Classification of Soft Tissue and Bone Tumors as a guide. In part one of this review, pediatric tumor-like lesions, adipocytic tumors, fibroblastic and myofibroblastic tumors, and perivascular tumors are discussed. In part two, vascular lesions, fibrohistiocytic tumors, muscle tumors, peripheral nerve sheath tumors, tumors of uncertain differentiation, and undifferentiated small round cell sarcomas are reviewed. Per the convention of the WHO, these lesions involve the connective, subcutaneous, and other non-parenchymatous organ soft tissues, as well as the peripheral and autonomic nervous system.
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4
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Eleti S, Meshaka R, McHugh K, Sebire N, Tahir N. Imaging characteristics of infantile fibrosarcoma. Clin Radiol 2022; 77:e532-e539. [DOI: 10.1016/j.crad.2022.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/31/2022] [Indexed: 11/03/2022]
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5
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Porrino J, Al-Dasuqi K, Irshaid L, Wang A, Kani K, Haims A, Maloney E. Update of pediatric soft tissue tumors with review of conventional MRI appearance-part 1: tumor-like lesions, adipocytic tumors, fibroblastic and myofibroblastic tumors, and perivascular tumors. Skeletal Radiol 2022; 51:477-504. [PMID: 34191084 DOI: 10.1007/s00256-021-03836-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/22/2021] [Accepted: 06/02/2021] [Indexed: 02/02/2023]
Abstract
There are numerous soft tissue tumors and tumor-like conditions in the pediatric population. Magnetic resonance imaging is the most useful modality for imaging these lesions. Although certain soft tissue lesions exhibit magnetic resonance features characteristic of a specific diagnosis, most lesions are indeterminate, and a biopsy is necessary for diagnosis. We provide a detailed update of soft tissue tumors and tumor-like conditions that occur in the pediatric population, emphasizing each lesion's conventional magnetic resonance imaging appearance, using the recently released 5th edition of the World Health Organization Classification of Soft Tissue and Bone Tumors as a guide. In part one of this review, pediatric tumor-like lesions, adipocytic tumors, fibroblastic and myofibroblastic tumors, and perivascular tumors are discussed. In part two, vascular lesions, fibrohistiocytic tumors, muscle tumors, peripheral nerve sheath tumors, tumors of uncertain differentiation, and undifferentiated small round cell sarcomas are reviewed. Per the convention of the WHO, these lesions involve the connective, subcutaneous, and other non-parenchymatous-organ soft tissues, as well as the peripheral and autonomic nervous system.
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Affiliation(s)
- Jack Porrino
- Yale Radiology and Biomedical Imaging, 330 Cedar Street, New Haven, CT, 06520, USA.
| | - Khalid Al-Dasuqi
- Yale Radiology and Biomedical Imaging, 330 Cedar Street, New Haven, CT, 06520, USA
| | - Lina Irshaid
- Yale School of Medicine Department of Pathology, 333 Cedar Street, New Haven, CT, 06520, USA
| | - Annie Wang
- Yale Radiology and Biomedical Imaging, 330 Cedar Street, New Haven, CT, 06520, USA
| | - Kimia Kani
- Department of Radiology, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD, 21201, USA
| | - Andrew Haims
- Yale Radiology and Biomedical Imaging, 330 Cedar Street, New Haven, CT, 06520, USA
| | - Ezekiel Maloney
- Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA
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6
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Ha DL, Lee GW, Shin K, Ko HC, Kim BS, Kim MB, Kim HS. Deeply Located Infantile Hemangioma with Rapid Growth Resembles Malignancy. Ann Dermatol 2021; 33:390-391. [PMID: 34341647 PMCID: PMC8273315 DOI: 10.5021/ad.2021.33.4.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/11/2020] [Accepted: 08/17/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dae-Lyong Ha
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.,Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Gi-Wook Lee
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kihyuk Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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7
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Al-Qassab S, Lalam R, Botchu R, Bazzocchi A. Imaging of Pediatric Soft Tissue Tumors and Tumor-like Conditions. Semin Musculoskelet Radiol 2021; 25:39-56. [PMID: 34020467 DOI: 10.1055/s-0041-1723966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Lumps and bumps are frequently seen in children, and the vast majority are a result of trauma, infection, or inflammation. True soft tissue neoplastic lesions are rare; however, their wide and complex classifications make these lesions challenging to manage. Imaging features are usually nonspecific, and a reasonable list of differential diagnoses can be generated following consideration of the clinical presentation, age, and anatomical location of the lesion. In this article, we offer a practical approach to diagnosing such lesions by discussing the most common three benign and malignant lesions in different anatomical regions stratified by age with emphasis on certain features that might aid in the diagnosis such as depth, multiplicity, calcification, or other specific imaging feature.
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Affiliation(s)
- Sinan Al-Qassab
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, United Kingdom
| | - Radhesh Lalam
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, United Kingdom
| | - Rajesh Botchu
- The Royal Orthopaedic Hospital, Birmingham, United Kingdom
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8
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Tsukamoto S, Mavrogenis AF, Tanaka Y, Errani C. Imaging of Soft Tissue Tumors. Curr Med Imaging 2021; 17:197-216. [PMID: 32660406 DOI: 10.2174/1573405616666200713183400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/08/2020] [Accepted: 06/20/2020] [Indexed: 02/07/2023]
Abstract
Differentiation of malignant from benign soft tissue tumors is challenging with imaging alone, including that by magnetic resonance imaging and computed tomography. However, the accuracy of this differentiation has increased owing to the development of novel imaging technology. Detailed patient history and physical examination remain essential for differentiation between benign and malignant soft tissue tumors. Moreover, measurement only of tumor size based on Response Evaluation Criteria In Solid Tumors criteria is insufficient for the evaluation of response to chemotherapy or radiotherapy. Change in metabolic activity measured by 18F-fluorodeoxyglucose positron emission tomography or dynamic contrast enhanced-derived quantitative endpoints can more accurately evaluate treatment response compared to change in tumor size. Magnetic resonance imaging can accurately evaluate essential factors in surgical planning such as vascular or bone invasion and "tail sign". Thus, imaging plays a critical role in the diagnosis and treatment of soft tissue tumors.
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Affiliation(s)
- Shinji Tsukamoto
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan
| | - Costantino Errani
- Department Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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9
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Chen X, Huang Y, He L, Zhang T, Zhang L, Ding H. CT-Based Radiomics to Differentiate Pelvic Rhabdomyosarcoma From Yolk Sac Tumors in Children. Front Oncol 2020; 10:584272. [PMID: 33330062 PMCID: PMC7732637 DOI: 10.3389/fonc.2020.584272] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/20/2020] [Indexed: 12/19/2022] Open
Abstract
Background The purpose of this study was to investigate the role of CT radiomics features combined with a support vector machine (SVM) model in potentially differentiating pelvic rhabdomyosarcoma (RMS) from yolk sac tumors (YSTs) in children. Methods A total of 94 patients with RMS (n = 49) and YSTs (n = 45) were enrolled. Non-enhanced phase (NP), arterial phase (AP), and venous phase (VP) images were retrieved for analysis. The volumes of interest (VOIs) were constructed by segmenting tumor regions on CT images to extract radiomics features. Datasets were randomly divided into two sets including a training set and a test set. In the training set, the least absolute shrinkage and selection operator (LASSO) algorithm was used to screen out the optimal radiomics features that could distinguish RMS from YSTs, and the features were combined with the SVM algorithm to build the classifier model. In the testing set, the areas under the receiver operating characteristic (ROC) curves (AUCs), accuracy, specificity, and sensitivity of the model were calculated to evaluate its diagnostic performance. The clinical factors (including age, sex, tumor site, tumor volume, AFP level) were collected. Results In total, 1,321 features were extracted from the NP, AP, and VP images. The LASSO regression algorithm was used to screen out 23, 26, and 17 related features, respectively. Subsequently, to prevent model overfitting, the 10 features with optimal correlation coefficients were retained. The SVM classifier achieved good diagnostic performance. The AUCs of the NP, AP, and VP radiomics models were 0.937 (95% CI: 0.862, 0.978), 0.973 (95% CI: 0.913, 0.996), and 0.855 (95% CI: 0.762, 0.922) in the training set, respectively, which were confirmed in the test set by AUCs of 0.700 (95% CI: 0.328, 0.940), 0.800 (95% CI: 0.422, 0.979), and 0.750 (95% CI: 0.373, 0.962), respectively. The difference in sex, tumor volume, and AFP level were statistically significant (P < 0.05). Conclusions The CT-based radiomics model can be used to effectively distinguish RMS and YST, and combined with clinical features, which can improve diagnostic accuracy and increase the confidence of radiologists in the diagnosis of pelvic solid tumors in children.
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Affiliation(s)
- Xin Chen
- Department of Radiology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yan Huang
- Department of Radiology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Ling He
- Department of Radiology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Zhang
- Department of Radiology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Li Zhang
- Department of Radiology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Ding
- Department of Radiology, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
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10
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Reid C, Saifuddin A. A review of paediatric soft tissues masses referred to a tertiary musculoskeletal sarcoma centre. Br J Radiol 2020; 94:20200790. [PMID: 33156715 DOI: 10.1259/bjr.20200790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To determine the differential diagnosis of musculoskeletal soft tissue masses in children referred to a specialist musculoskeletal oncology unit. METHODS All children (0-18 y) referred to a specialist musculoskeletal oncology unit over a 20-month period (September 2018-May 2020) were retrospectively reviewed. Demographic data and referral diagnoses were obtained from the electronic patient notes. MRI findings and histopathological results were recorded. The comparison of non-neoplastic, benign neoplastic and malignant diagnoses at the point of referral and final diagnosis was determined. RESULTS 116 patients were included, 60 (51.7%) males and 56 (48.3%) females with mean age of 10.6 years (3 months-18 years). 69 (59.5%) patients were referred with a suspected sarcoma, 29 (25.0%) with a suspected benign tumour and 18 (15.5%) with a non-neoplastic lesion. A diagnosis was achieved by histological assessment in 61 (52.6%) cases, microbiological assessment in 3 (2.6%) or clinical and imaging assessment in 52 (44.8%). 67 (57.8%) cases had non-neoplastic pathology, 39 (33.6%) a benign tumour, 4 (3.4%) an intermediate-grade tumour, 6 (5.2%) a malignant tumour. CONCLUSIONS Although over half of children referred to a specialist musculoskeletal oncology unit were suspected of having a soft tissue sarcoma at referral, only 5.2% were diagnosed with a malignant tumour. ADVANCES IN KNOWLEDGE Approximately, 6 of 69 (8.7%) children referred to a specialist musculoskeletal oncology unit with a suspected soft tissue sarcoma will have a malignant lesion. Most paediatric soft tissue masses are non-neoplastic, the commonest diagnosis being a vascular malformation.
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Affiliation(s)
- Catriona Reid
- Department of Radiology, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.,Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Asif Saifuddin
- Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, UK
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11
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Hickson M, McHugh K, McCarville B. Primary synovial sarcomas in the paediatric and young adult population: A pictorial review. Eur J Radiol 2020; 133:109376. [PMID: 33166832 DOI: 10.1016/j.ejrad.2020.109376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To present a pictorial essay of paediatric primary synovial sarcomas from common and less documented anatomical locations. To review the literature for the imaging characteristics and prognostic factors of this rare but important childhood malignancy. METHOD 24 primary synovial sarcoma cases (17 male, 7 female with an age range 4-21 years) were reviewed in a collaborative effort between St Jude Children's Research Hospital and Great Ormond Street Hospital for Children. Images from 19 cases were selected for inclusion, to demonstrate the spectrum of appearances across imaging modalities, in a range of different anatomical locations (upper limb, lower limb, chest/abdomen/pelvis, and head and neck). A literature review depicting the typical radiological features and the prognostic significance of these features, was also conducted. RESULTS AND CONCLUSIONS Primary synovial sarcoma can occur in any anatomical location, but typically within the extremities and often in close association with joints. Rarer anatomical locations described in our essay include the gastrohepatic ligament and femoral nerve sheath. We detail the salient imaging characteristics, including the T2 'triple signal' pattern which is believed to be highly specific for this particular sarcoma and in many cases predicts a poor outcome. Other poor prognostic factors include haemorrhage, lack of calcification and tumour size >10 cm. A broad range of radiological appearances are described, and in some cases related to anatomical position and size, however the presence of a soft tissue mass close to a joint in a young patient are suggestive of this diagnosis.
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Affiliation(s)
- Melissa Hickson
- The Whittington Hospital, Magdala Avenue, London N19 5NF, UK.
| | - Kieran McHugh
- Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK.
| | - Beth McCarville
- St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105-3678, USA.
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12
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Elledge CR, Krasin MJ, Ladra MM, Alcorn SR, Han P, Gibbs IC, Hiniker SM, Laack NN, Terezakis SA. A multi-institutional phase 2 trial of stereotactic body radiotherapy in the treatment of bone metastases in pediatric and young adult patients with sarcoma. Cancer 2020; 127:739-747. [PMID: 33170960 DOI: 10.1002/cncr.33306] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/28/2020] [Accepted: 09/27/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Metastasectomy is standard of care for pediatric patients with metastatic sarcoma with limited disease. For patients with unresectable disease, stereotactic body radiotherapy (SBRT) may serve as an alternative. Herein, the authors report the results of a prospective, multi-institutional phase 2 trial of SBRT in children and young adults with metastatic sarcoma. METHODS Patients aged >3 years and ≤40 years with unresected, osseous metastatic nonrhabdomyosarcoma sarcomas of soft tissue and bone were eligible. Patients received SBRT to a dose of 40 Gray (Gy) in 5 fractions. Local control (LC), progression-free survival (PFS), and overall survival (OS) were calculated using the Kaplan-Meier method. RESULTS Fourteen patients with a median age of 17 years (range, 4-25 years) were treated to 37 distinct metastatic lesions. With a median follow-up of 6.8 months (30.5 months in surviving patients), the Kaplan-Meier patient-specific and lesion-specific LC rates at 6 months were 89% and 95%, respectively. The median PFS was 6 months and the median OS was 24 months. In a post hoc analysis, PFS (median, 9.3 months vs 3.7 months; log-rank P = .03) and OS (median not reached vs 12.7 months; log-rank P = .02) were improved when all known sites of metastatic disease were consolidated with SBRT compared with partial consolidation. SBRT was well tolerated, with 2 patients experiencing grade 3 toxicities. CONCLUSIONS SBRT achieved high rates of LC in pediatric patients with inoperable metastatic nonrhabdomyosarcoma sarcomas of soft tissue and bone. These results suggest that the ability to achieve total consolidation of metastatic disease with SBRT is associated with improved PFS and OS.
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Affiliation(s)
- Christen R Elledge
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthew J Krasin
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Matthew M Ladra
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sara R Alcorn
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Peijin Han
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Iris C Gibbs
- Department of Radiation Oncology, Stanford University, Palo Alto, California
| | - Susan M Hiniker
- Department of Radiation Oncology, Stanford University, Palo Alto, California
| | - Nadia N Laack
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Stephanie A Terezakis
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota
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13
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Unusual Case of Concurrent Retroperitoneal Congenital Infantile Fibrosarcoma and Cellular Type Congenital Mesoblastic Nephroma. J Pediatr Hematol Oncol 2020; 42:e801-e806. [PMID: 31343481 DOI: 10.1097/mph.0000000000001567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although congenital infantile fibrosarcoma (cIFS) is a rare soft tissue sarcoma among children, it constitutes one of the most common soft tissue sarcomas during the first year of life. Congenital mesoblastic nephroma (CMN) is the most common benign renal tumor usually developing during the first 3 months of life. cIFS and cellular type CMN (cCMN) share not only similar histopathologic features but identical molecular genetic abnormality including the ETV6/NTRK3 fusion gene. Here, we report an unusual case of cIFS occurring with cCMN. CASE PRESENTATION An 18-month-old girl presented with a 1-month history of abdominal distension and a few days' history of a palpable abdominal mass. A large heterogenous mass sized 9.0×11.2×11.6 cm on the right side of the abdomen and an isolated heterogenous lesion sized 4×4.5 cm within the right kidney were noted from the imaging study. Pathologic findings were consistent with cIFS and cCMN of the right kidney. In addition, both pathologic specimens contained the ETV6/NTRK3 fusion gene. CONCLUSION Although cIFS and cCMN share similar histopathologic features and molecular genetic abnormality, simultaneous occurrence of these 2 types of tumor is exceedingly rare. To our knowledge, this is the first unusual case report of concurrent cIFS and cCMN.
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Inarejos Clemente EJ, Navallas M, Barber Martínez de la Torre I, Suñol M, Munuera Del Cerro J, Torner F, Garraus M, Navarro OM. MRI of Rhabdomyosarcoma and Other Soft-Tissue Sarcomas in Children. Radiographics 2020; 40:791-814. [PMID: 32243230 DOI: 10.1148/rg.2020190119] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Soft-tissue sarcomas in children comprise a heterogeneous group of entities with variable manifestation depending on the age of the patient and the location of the tumor. MRI is the modality of choice for evaluating musculoskeletal soft-tissue tumors and plays a paramount role in both initial diagnosis and assessment of tumor response during and after treatment. Conventional MRI sequences, such as T1- and T2-weighted imaging, offer morphologic information, which is important for localizing the lesion and describing anatomic relationships but not accurate for determining its malignant or benign nature and may be limited in differentiating tumor response from therapy-related changes. Advanced multiparametric MRI offers further functional information that can help with these tasks by using different imaging sequences and biomarkers. The authors present the role of MRI in rhabdomyosarcoma and other soft-tissue sarcomas in children, emphasizing a multiparametric approach with focus on the utility and potential added value of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI in characterization and staging, determination of pretreatment extent, and evaluation of tumor response and recurrence after treatment. ©RSNA, 2020.
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Affiliation(s)
- Emilio J Inarejos Clemente
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., I.B.M.d.l.T., J.M.d.C.), Pathology (M.S.), Orthopaedics (F.T.), and Oncology and Haematology (M.G.), Hospital Sant Joan de Déu, Av Sant Joan de Déu 2, 08950 Esplugues de Llobregat (Barcelona), Spain; Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ont, Canada (O.M.N.)
| | - María Navallas
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., I.B.M.d.l.T., J.M.d.C.), Pathology (M.S.), Orthopaedics (F.T.), and Oncology and Haematology (M.G.), Hospital Sant Joan de Déu, Av Sant Joan de Déu 2, 08950 Esplugues de Llobregat (Barcelona), Spain; Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ont, Canada (O.M.N.)
| | - Ignasi Barber Martínez de la Torre
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., I.B.M.d.l.T., J.M.d.C.), Pathology (M.S.), Orthopaedics (F.T.), and Oncology and Haematology (M.G.), Hospital Sant Joan de Déu, Av Sant Joan de Déu 2, 08950 Esplugues de Llobregat (Barcelona), Spain; Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ont, Canada (O.M.N.)
| | - Mariona Suñol
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., I.B.M.d.l.T., J.M.d.C.), Pathology (M.S.), Orthopaedics (F.T.), and Oncology and Haematology (M.G.), Hospital Sant Joan de Déu, Av Sant Joan de Déu 2, 08950 Esplugues de Llobregat (Barcelona), Spain; Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ont, Canada (O.M.N.)
| | - Josep Munuera Del Cerro
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., I.B.M.d.l.T., J.M.d.C.), Pathology (M.S.), Orthopaedics (F.T.), and Oncology and Haematology (M.G.), Hospital Sant Joan de Déu, Av Sant Joan de Déu 2, 08950 Esplugues de Llobregat (Barcelona), Spain; Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ont, Canada (O.M.N.)
| | - Ferran Torner
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., I.B.M.d.l.T., J.M.d.C.), Pathology (M.S.), Orthopaedics (F.T.), and Oncology and Haematology (M.G.), Hospital Sant Joan de Déu, Av Sant Joan de Déu 2, 08950 Esplugues de Llobregat (Barcelona), Spain; Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ont, Canada (O.M.N.)
| | - Moira Garraus
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., I.B.M.d.l.T., J.M.d.C.), Pathology (M.S.), Orthopaedics (F.T.), and Oncology and Haematology (M.G.), Hospital Sant Joan de Déu, Av Sant Joan de Déu 2, 08950 Esplugues de Llobregat (Barcelona), Spain; Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ont, Canada (O.M.N.)
| | - Oscar M Navarro
- From the Departments of Diagnostic Imaging (E.J.I.C., M.N., I.B.M.d.l.T., J.M.d.C.), Pathology (M.S.), Orthopaedics (F.T.), and Oncology and Haematology (M.G.), Hospital Sant Joan de Déu, Av Sant Joan de Déu 2, 08950 Esplugues de Llobregat (Barcelona), Spain; Department of Medical Imaging, University of Toronto, Toronto, Ont, Canada (O.M.N.); and Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ont, Canada (O.M.N.)
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Özşen M, Yalçınkaya U, Yazıcı Z, Sarısözen MB. Lipomatous Tumors in Pediatric Patients: A Retrospective Analysis of 50 cases. Turk Patoloji Derg 2020; 36:1-10. [PMID: 31282548 PMCID: PMC10512668 DOI: 10.5146/tjpath.2019.01464] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/01/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Although lipomatous tumors are the most common type of mesenchymal tumors in adults, they account for less than 10% of all soft tissue lesions in pediatric patients. In this descriptive study, we aim to present our series of pediatric lipomatous tumors consisting of lipoma, neural fibrolipoma, lipoblastoma, atypical lipomatous tumor, myxoid liposarcoma and pleomorphic liposarcoma, and to evaluate the clinicopathological characteristics of these tumors in reference to the literature. MATERIAL AND METHOD In this study, pediatric lipomatous tumor cases diagnosed between 2002 and 2018 were screened from pathological archives and retrospectively evaluated. RESULTS A total of 50 cases were diagnosed with lipomatous tumor within the mentioned period. Of the total cases, 24 were female (48%) and 26 were male (52%), with age distribution ranging from 1 to 204 months. Histopathological examination revealed lipoma in 26 cases (52%), lipoblastoma in 19 (38%), atypical lipomatous tumor in 2 (4%), myxoid liposarcoma in 2 (4%), and pleomorphic liposarcoma in 1 case (2%). CONCLUSION Although lipomatous tumors are the most common type of mesenchymal tumors; they rarely occur in children. Since there is a limited number of studies on pediatric lipomatous tumors in the literature, there is insufficient data on the prevalence and incidence of these tumors. These tumors may slowly enlarge to greater sizes, especially those localized in deep tissues, and may cause various clinical symptoms by compressing surrounding tissues. Local recurrences may occur, even after total excision, and require close monitoring.
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Affiliation(s)
- Mine Özşen
- Department of Pathology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Ulviye Yalçınkaya
- Department of Pathology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Zeynep Yazıcı
- Department of Radiology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Mehmet Bartu Sarısözen
- Department of Orthopedics and Traumatology, Uludag University Faculty of Medicine, Bursa, Turkey
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Peng A, Zhang L, Zhao H, Zhou L. Case report: neonatal giant forehead hemangiopericytoma with a 5-year follow-up. Medicine (Baltimore) 2019; 98:e17888. [PMID: 31764783 PMCID: PMC6882637 DOI: 10.1097/md.0000000000017888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/23/2019] [Accepted: 10/09/2019] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Hemangiopericytoma (HPC) is a rare pediatric neoplasm with a high risk of bleeding, aggressive growth and high early relapse rates. Surgical excision remains the mainstream treatment, while the functions of chemotherapy and radiotherapy remain controversial. In particular, an infantile giant extracranial HPC located in the forehead has never been reported. PATIENT CONCERNS A 3-day-old girl was delivered normally with a giant tumor localized mainly in the right frontal region. The surface of the mass was filled with vascularity. DIAGNOSIS According to the results of imaging and pathological examinations, the diagnosis was HPC grade II. INTERVENTIONS Gross total resection of the tumor and the invading partial frontal bone followed by skin scalp reconstruction was carried out without any blood transfusion. OUTCOMES No recurrence was identified during 5 years of follow-up. And better outcomes can be achieved without adjuvant therapy. LESSONS Multimodality imaging and a collaborative multidisciplinary approach are indispensable for the successful surgical management of infantile HPC, especially for giant tumors and their potential risk of life-threatening bleeding. Gross total resection is the optimal option for infantile HPC, and even without adjuvant therapy, it achieves better outcomes.
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Affiliation(s)
- AiJun Peng
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan province
| | - LiBing Zhang
- Department of Pediatrics, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu province, China
| | - Hai Zhao
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan province
| | - LiangXue Zhou
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan province
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Kim CH, Son J, Kim DH, Lee SK, Son BS. Surgical resection of a congenital hemangiopericytoma involving the thoracic spine. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2019. [DOI: 10.1016/j.epsc.2019.101262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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18
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Ypsilantis P, Meditskou S, Lambropoulou M, Papamitsou T, Simopoulos C. Spontaneous pancreatic undifferentiated pleomorphic sarcoma in a laboratory rat: A case report. Animal Model Exp Med 2019; 2:222-225. [PMID: 31773099 PMCID: PMC6762044 DOI: 10.1002/ame2.12078] [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: 05/31/2019] [Revised: 07/17/2019] [Accepted: 07/31/2019] [Indexed: 11/26/2022] Open
Abstract
We present a case of spontaneous undifferentiated/unclassified sarcoma, of a pleomorphic subtype formerly known as malignant fibrous histiocytoma (UPS/MFH), arising from the pancreas of a laboratory rat. The mass was excised after laparotomy from a 6-month-old female laboratory Wistar rat. It presented a giant multilobulated mass of irregular shape, which had arisen from the pancreas and occupied almost the entire peritoneal cavity. Histologically the tumor was characterized by a highly variable morphological pattern, with frequent transitions from storiform to pleomorphic areas. An extensive immunohistochemical examination revealed no specific lines of differentiation. Immunohistochemical positivity was observed only to MIB-1 (high Ki-67 proliferation index), vimentin and CD68 antibodies. The diagnosis was compatible with UPS/MFH. To the best of our knowledge, the present case is the first report of a spontaneous primary UPS/MFH arising from the pancreas of a laboratory rat.
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Affiliation(s)
- Petros Ypsilantis
- Laboratory of Experimental Surgery and Surgical ResearchSchool of MedicineDemocritus University of ThraceAlexandroupolisGreece
| | - Soultana Meditskou
- Laboratory of Histology and EmbryologyAristotle University of ThessalonikiThessalonikiGreece
| | - Maria Lambropoulou
- Laboratory of Histology and EmbryologySchool of MedicineDemocritus University of ThraceAlexandroupolisGreece
| | - Theodora Papamitsou
- Laboratory of Histology and EmbryologyAristotle University of ThessalonikiThessalonikiGreece
| | - Constantinos Simopoulos
- Laboratory of Experimental Surgery and Surgical ResearchSchool of MedicineDemocritus University of ThraceAlexandroupolisGreece
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19
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[Imaging of abdominal tumors in childhood and adolescence : Part II: relevant intra-abdominal and retroperitoneal tumor entities]. Radiologe 2019; 58:673-686. [PMID: 29947934 DOI: 10.1007/s00117-018-0410-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abdominal and pelvic tumors in children and adolescents can be manifested intra-abdominally and also often in the retroperitoneum. The most important pediatric primary retroperitoneal space-occupying lesions are nephroblastoma (Wilms' tumor) and neuroblastoma, whereby imaging plays a decisive role in the diagnostics and differentiation of the two entities. Benign tumors of the mesentery and gastrointestinal tract occur more frequently in children than malignant lesions. The benign entities include lipoma, polyps and vascular tumors, such as lymphatic malformations. Of the malignant sarcomas, abdominal rhabdomyosarcomas (RMS) occur relatively often in childhood and adolescence. The most frequent pediatric abdominal lymphoma is Burkitt's lymphoma, an aggressive subtype of non-Hodgkin's lymphoma. Relevant tumor entities in childhood are also germ cell tumors, which originate from the genitals (gonadal) or can be extragonadally manifested. The benignancy or malignancy of germ cell tumors ranges from benign teratomas to highly malignant entities, such as yolk sac tumors. The germ cell tumors, just as all pediatric abdominal mass lesions, show a broad spectrum of tumor aggressiveness, malignancy and therefore also prognosis and mortality for the affected children and adolescents.
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20
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Atypical Teratoid Rhabdoid Tumor of the Cauda Equina in a Child: Report of a Very Unusual Case. Appl Immunohistochem Mol Morphol 2018; 28:e58-e62. [PMID: 29346182 DOI: 10.1097/pai.0000000000000620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Atypical teratoid/rhabdoid tumors (AT/RT) are highly aggressive malignant primitive neoplasms that commonly occur in children younger than 2 years of age. The prognosis is generally dismal with a median survival time of <1 year. The majority of AT/RT occur in the posterior fossa and less frequently the supratentorium. Primary pediatric spinal AT/RT are exceedingly rare and only 15 cases have been reported to date. Here we report a very unusual case of primary spinal AT/RT extensively involving the spinal cord from T11 down to the cauda equina. In this patient, the tumor was highly aggressive and resulted in extensive dissemination into the nerve roots and paraspinal soft tissue rapidly resulting in the patient's death 1 month after diagnosis. to the best of our knowledge, this degree of involvement of the spine by a primary AT/RT has not been described before.
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21
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Abstract
BACKGROUND Congenital infantile fibrosarcoma (CIF) is rare and represents less than 1% of all childhood cancers. It is a tumor that originates in the connective fibrous tissue found at the ends of long bones and then spreads to other surrounding soft tissues. These lesions are typically large, grow rapidly, and can often be mistaken for teratomas. Diagnosis is confirmed by pathology, where cellular proliferation of fibroblasts occurs. Imaging is an important part of the diagnosis, which includes the use of magnetic resonance imaging and/or computed tomography scan. Although surgical resection is the primary treatment, chemotherapeutic agents may be used as adjuvant therapy. PURPOSE To describe modalities for accurate diagnosis and treatment of CIF. METHODS/SEARCH STRATEGY PubMed was searched using terms "congenital infantile fibrosarcoma" and "infantile fibrosarcoma." Eleven relevant, English language articles were identified and utilized in the preparation of this case presentation. FINDINGS/RESULTS Complications addressed in this case presentation are prenatal diagnostic challenges, pharmacologic interventions in the setting of prematurity, immunosuppression, and acute liver and renal failure. Pharmacologic treatments will include chemotherapy agents, antimicrobial agents, as well as granulocyte colony-stimulating factor for immunosuppression. Nursing challenges included positioning and integumentary disturbances. IMPLICATIONS FOR PRACTICE Utilization of diagnostic imaging and pathology to accurately identify and diagnose CIF is essential. IMPLICATIONS FOR RESEARCH Safety and efficacy of chemotherapeutic agents in premature infants with CIF need to be established.
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22
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Leonard L, Meyer HJ, Surov A. [Imaging characteristics of malignant and benign lesions of skeletal muscle]. Radiologe 2017; 57:1059-1070. [PMID: 29181716 DOI: 10.1007/s00117-017-0323-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There are many different tumors and tumor-like lesions with variable biological behavior that may affect the skeletal musculature. The aim of this study was to review the different intramuscular lesions and to provide a classification based on their radiological patterns. Intramuscular lesions can present as solid, liquid, semiliquid or fat equivalent manifestations and also as diffuse muscle enlargement and muscle calcification. Additionally, lesions with mixed patterns of the aforementioned alterations can also occur. Benign and malignant muscle lesions can often manifest with identical radiological patterns, which is why a certain differentiation is often difficult. A systematic radiological description and when possible assignment with respect to etiology and dignity depending on the patient history is necessary in order to recommend a subsequent histological confirmation or to avoid unnecessary confirmation.
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Affiliation(s)
- L Leonard
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland
| | - H J Meyer
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland
| | - A Surov
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland.
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Abstract
RATIONALE Alveolar soft part sarcoma (ASPS) is a rare, malignant neoplasm, which mostly occurs in the upper and lower extremities. This article presents an unusual case of ASPS involving the penis of a 3-year-old boy. To our knowledge, this is the first case of ASPS in the penis of a child. PATIENT CONCERNS The patient complained of slight penile pain for 1 year and a soft tissue mass could be palpated in his penis. DIAGNOSES Imaging was performed on the penis. The pathological feature of the mass was evaluated through biopsy examination. It was found that the mass was an alveolar soft tissue sarcoma, which was then confirmed by immunohistochemistry. INTERVENTIONS The patient only underwent a partial penectomy because his parents wished to keep the penis. Conventional chemotherapy has been performed for 6 months after the surgery. OUTCOMES At 28-month follow-up the mass did not increase apparently, and no signs of metastasis were found. LESSONS ASPS may occur originally in the penis.
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Affiliation(s)
- Linli Qiu
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuman Li
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shima Ibrahim Ali
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Radiological Science And Medical Imaging Department, Alzaiem Alazhari University, Khartoum, Sudan
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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24
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Guilmette J, Laverdière C, Soulières D, Patey N, Soucy G, Trudel D, Bouron-Dal Soglio D. Malignant Rhabdoid Tumor of Soft Tissue. Pediatr Dev Pathol 2017; 20:262-266. [PMID: 28429647 DOI: 10.1177/1093526617706814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction Malignant rhabdoid tumor (MRT) is defined as a high-grade sarcoma derived from an uncertain cell of origin. Its diagnosis is associated with poor prognosis and patient's life expectancy is greatly reduced. Material and method Here, we describe a unique case of 9-month-old boy who presented with a large MRT arising from the soft tissue of the neck. Following intensive multimodal treatment, the patient benefited from a 25 years' remission until the discovery of multiple liver metastases. Conclusion MRT of soft tissue needs to be distinguished from other soft tissue neoplasms, as MRT is highly aggressive and is usually associated with a poor outcome. In addition, this is the longest remission time reported in a patient with soft tissue MRT and this might be related to the use of early intensive multimodal treatments.
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Affiliation(s)
- Julie Guilmette
- 1 Department of Anatomo-Pathology, University of Montreal Heath Care Center, Montreal, Quebec, Canada
| | - Caroline Laverdière
- 2 Hematology-Oncology Division, Department of Pediatrics, Ste-Justine Hospital, Montreal, Quebec, Canada
| | - Denis Soulières
- 3 Department of Hematoly-Oncology, Notre-Dame Hospital, Montreal, Quebec, Canada
| | - Natasha Patey
- 4 Department of Pathology, Ste-Justine Hospital, Montreal, Quebec, Canada
| | - Geneviève Soucy
- 1 Department of Anatomo-Pathology, University of Montreal Heath Care Center, Montreal, Quebec, Canada
| | - Dominique Trudel
- 1 Department of Anatomo-Pathology, University of Montreal Heath Care Center, Montreal, Quebec, Canada
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Sargar KM, Sheybani EF, Shenoy A, Aranake-Chrisinger J, Khanna G. Pediatric Fibroblastic and Myofibroblastic Tumors: A Pictorial Review. Radiographics 2016; 36:1195-214. [DOI: 10.1148/rg.2016150191] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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26
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McCarville MB. What MRI can tell us about neurogenic tumors and rhabdomyosarcoma. Pediatr Radiol 2016; 46:881-90. [PMID: 27229505 DOI: 10.1007/s00247-016-3572-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 12/03/2015] [Accepted: 02/04/2016] [Indexed: 12/21/2022]
Abstract
This review focuses on the MRI features of neurogenic tumors and rhabdomyosarcoma in children. Neurogenic tumors include those arising from a nerve sheath and neuroblastic tumors that arise from the sympathetic nervous system. Nerve sheath tumors can be benign or malignant and occur sporadically or in association with neurofibromatosis type 1. Neuroblastic tumors comprise a spectrum of tumors ranging from highly malignant neuroblastoma to the benign ganglioneuroma. These neurogenic tumors arise in typical locations within the chest, abdomen and pelvis and have distinctive and characteristic imaging features that should suggest their diagnosis. Rhabdomyosarcoma encompasses a variety of histological subtypes that exhibit varying degrees of aggressiveness and biological behavior. While some abdominal and pelvic locations are well known to give rise to rhabdomyosarcoma, this tumor can arise in any tissue in the body except bone. The paper reviews the MRI and clinical features of neurogenic tumors and rhabdomyosarcoma and the imaging findings that can aid in clinical management.
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Affiliation(s)
- M Beth McCarville
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, MS 220, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
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27
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Amdani SM, Mendez M. Visual Diagnosis: 7-year-old Girl With Swelling in the Arm. Pediatr Rev 2015; 36:e14-7. [PMID: 25934915 DOI: 10.1542/pir.36-5-e14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Shahnawaz M Amdani
- Department of Pediatrics, Lincoln Medical and Mental Health Center, Bronx, NY
| | - Magda Mendez
- Department of Pediatrics, Lincoln Medical and Mental Health Center, Bronx, NY
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28
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BCOR-CCNB3 fusions are frequent in undifferentiated sarcomas of male children. Mod Pathol 2015; 28:575-86. [PMID: 25360585 PMCID: PMC4385430 DOI: 10.1038/modpathol.2014.139] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 08/09/2014] [Accepted: 08/10/2014] [Indexed: 11/25/2022]
Abstract
The BCOR-CCNB3 fusion gene, resulting from a chromosome X paracentric inversion, was recently described in translocation-negative 'Ewing-like' sarcomas arising in bone and soft tissue. Genetic subclassification of undifferentiated unclassified sarcomas may potentially offer markers for reproducible diagnosis and substrates for therapy. Using whole transcriptome paired-end RNA sequencing (RNA-seq) we unexpectedly identified BCOR-CCNB3 fusion transcripts in an undifferentiated spindle-cell sarcoma. RNA-seq results were confirmed through direct RT-PCR of tumor RNA and cloning of the genomic breakpoints from tumor DNA. Five additional undifferentiated sarcomas with BCOR-CCNB3 fusions were identified in a series of 42 pediatric and adult unclassified sarcomas. Genomic breakpoint analysis demonstrated unique breakpoint locations in each case at the DNA level even though the resulting fusion mRNA was identical in all cases. All patients with BCOR-CCNB3 sarcoma were males diagnosed in mid childhood (7-13 years of age). Tumors were equally distributed between axial and extra-axial locations. Five of the six tumors were soft-tissue lesions with either predominant spindle-cell morphology or spindle-cell areas interspersed with ovoid to round cells. CCNB3 immunohistochemistry showed strong nuclear positivity in five tumors before oncologic therapy, but was patchy to negative in post-treatment tumor samples. An RT-PCR assay developed to detect the fusion transcript in archival formalin-fixed tissue was positive in all six cases, with high sensitivity and specificity in both pre- and post-treated samples. This study adds to recent reports on the clinicopathologic spectrum of BCOR-CCNB3 fusion-positive sarcomas, a newly emerging entity within the undifferentiated unclassified sarcoma category and describes a simple RT-PCR assay that in conjunction with CCNB3 immunohistochemistry can be useful in diagnosing these tumors.
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29
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Chung EM, Biko DM, Arzamendi AM, Meldrum JT, Stocker JT. Solid Tumors of the Peritoneum, Omentum, and Mesentery in Children: Radiologic-Pathologic Correlation:From the Radiologic Pathology Archives. Radiographics 2015; 35:521-46. [DOI: 10.1148/rg.352140273] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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30
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Imaging features of alveolar soft-part sarcoma: a report from Children's Oncology Group Study ARST0332. AJR Am J Roentgenol 2015; 203:1345-52. [PMID: 25415714 DOI: 10.2214/ajr.14.12462] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE There are few studies in the literature regarding the imaging features of alveolar soft-part sarcoma (ASPS). We performed a comprehensive assessment of the imaging characteristics of this rare tumor to determine whether there are features that suggest the diagnosis. MATERIALS AND METHODS Twenty-two subjects with ASPS underwent pretherapy imaging as part of enrollment in Children's Oncology Group protocol ARST0332 for the treatment of nonrhabdomyosarcoma soft-tissue sarcomas: 16 patients underwent MRI; three, CT; and three, both MRI and CT. Two radiologists retrospectively reviewed the imaging studies by consensus and recorded tumor location, size, contour, internal architecture, signal characteristics, presence of flow voids, and enhancement patterns. RESULTS The 12 females and 10 males in the study group ranged in age from 8 to 23 years 7 months (mean, 15 years 8 months). The most common anatomic site was the lower extremity (12/22, 55%) followed by the upper extremity (4/22, 18%). The maximal tumor diameter ranged from 2.3 to 20.0 cm (median, 5.9 cm). All tumors imaged with MRI had flow voids (19/19, 100%), and 19 (19/22, 86%) had large peripheral vessels, lobulated margins, and nodular internal architecture. Unenhanced T1-weighted MRI was available for 18 tumors: 14 (14/18, 78%) appeared slightly hyperintense to muscle. Of the 16 tumors imaged with contrast material, 11 (11/16, 69%) showed intense enhancement and five (5/16, 31%), moderate enhancement. Six tumors (6/16, 38%) had a thick enhancing peripheral rim with a nonenhancing center consistent with necrosis. CONCLUSION The imaging features of ASPS include flow voids, large peripheral vessels, internal nodularity, and lobulated margins. Contrast administration produces intense to moderate enhancement, sometimes with a thick enhancing peripheral rim around central necrosis. Extremity tumors with these imaging features in a child or young adult should suggest the diagnosis of ASPS.
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Alcorn KM, Pollock AN, Kazahaya K, Solot CB, Jackson O. Epidermoid cyst of the soft palate in a 2-year-old: a case report and review of literature of pediatric soft palate lesions. Clin Pediatr (Phila) 2014; 53:1399-402. [PMID: 25031319 DOI: 10.1177/0009922814543325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kaitlyn M Alcorn
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA University of Pennsylvania Perelman School of Medicine, Philadelphia, Philadelphia, PA, USA
| | - Avrum N Pollock
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA University of Pennsylvania Perelman School of Medicine, Philadelphia, Philadelphia, PA, USA
| | - Ken Kazahaya
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA University of Pennsylvania Perelman School of Medicine, Philadelphia, Philadelphia, PA, USA
| | - Cynthia B Solot
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Oksana Jackson
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA University of Pennsylvania Perelman School of Medicine, Philadelphia, Philadelphia, PA, USA
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Ainsworth KE, Chavhan GB, Gupta AA, Hopyan S, Taylor G. Congenital infantile fibrosarcoma: review of imaging features. Pediatr Radiol 2014; 44:1124-9. [PMID: 24706181 DOI: 10.1007/s00247-014-2957-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 02/26/2014] [Accepted: 02/26/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Fibrosarcoma is a rare tumor in children with limited information on imaging features of these tumors in the literature. OBJECTIVE To retrospectively review the imaging features of histologically proven congenital infantile fibrosarcoma. MATERIALS AND METHODS The list of histologically confirmed congenital infantile fibrosarcomas between November 1999 and June 2013 was obtained from the oncology-pathology database. Imaging features and pathology reports of these tumors were reviewed. Patient charts were reviewed and clinical features, management and outcomes were recorded. RESULTS During the study period, 13 children (9 girls and 4 boys; age range: 0 day-16 months, median age: 2.5 months) with congenital infantile fibrosarcomas were available for complete radiological review. The translocation (t[12;15]) was present in 11/13 (84.6%) and absent in 2/13. Eight/thirteen (61.5%) tumors were located in extremities (5 in lower and 3 in upper), 3/13 in thoracolumbar paraspinal regions, and one each in abdomen and sternocleidomastoid muscle. Imaging features included iso- to hyperintensity on T1-W, hyperintensity on T2-W as compared to skeletal muscles and heterogeneous enhancement. Six (37.5%) tumors showed hemorrhagic components and 2 (15.4%) showed low intensity foci. None of the patients had evidence of regional or distant metastases at diagnosis. Management included surgical resection only (1/13) and combined surgery and chemotherapy (10/13). Overall survival was 100% with a median follow-up of 49.3 months. CONCLUSION Congenital infantile fibrosarcoma has nonspecific imaging characteristics but should be high on the differential diagnosis in a soft-tissue tumor presenting in infancy, located in an extremity and showing tumoral hemorrhage. Patients have a favorable outcome.
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Affiliation(s)
- Kelly E Ainsworth
- Department of Diagnostic Imaging, McMaster University Medical Centre and McMaster University, Hamilton, ON, Canada
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Intramuscular diffuse-type tenosynovial giant cell tumor of the deltoid muscle in a child. Skeletal Radiol 2014; 43:1179-83. [PMID: 24676801 DOI: 10.1007/s00256-014-1854-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 02/07/2014] [Accepted: 02/19/2014] [Indexed: 02/02/2023]
Abstract
Tenosynovial giant cell tumors (GCTs) typically form in the joints or extra-articular soft tissues such as the tendon sheath, and are benign tumors that commonly occur in the hands or wrists in the third to fifth decades of life. However, the diffuse type of extra-articular GCT arising within muscle is a rare soft tissue tumor, especially in a pediatric patient. In this report, we describe the magnetic resonance imaging and sonographic findings of a rare case of intramuscular diffuse-type GCT in the deltoid muscle of a 9-year-old boy.
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Abstract
There are several tumors and tumorlike conditions with variable biological behavior that may involve the skeletal musculature. The aim of this work was to review different intramuscular lesions and to provide a classification of muscle lesions based on their radiological patterns as well as to provide as a pictorial essay the imaging characteristics of typical muscle lesions. Radiologically, intramuscular lesions can manifest as solid masses, liquid or semiliquid masses, fat-containing lesions, diffuse muscle enlargement, and muscle calcifications. Additionally, lesions with mixed patterns can also occur. It is noteworthy that different malignant or benign muscle lesions can manifest with identical radiological patterns.
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Affiliation(s)
- Alexey Surov
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
| | - Marc-André Weber
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
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Intramuscular capillary-type hemangioma: radiologic-pathologic correlation. Pediatr Radiol 2014; 44:558-65. [PMID: 24487677 DOI: 10.1007/s00247-014-2876-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 11/08/2013] [Accepted: 01/06/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Infantile hemangiomas demonstrate a pattern of proliferative growth in infancy followed by a slow phase of involution. In contrast a rare type of vascular tumor, intramuscular capillary-type hemangioma, usually presents beyond the period of infancy with nonspecific symptoms and no evidence of involution. OBJECTIVE The purpose of this study was to characterize the clinical, imaging, histopathological characteristics and management of intramuscular capillary-type hemangioma. MATERIALS AND METHODS We performed a retrospective review of a 20-year period to identify children diagnosed with intramuscular capillary-type hemangioma. Patient demographics, imaging and histopathological findings were recorded. RESULTS We included 18 children (10 boys, 8 girls) with histologically proven intramuscular capillary-type hemangioma - and adequate imaging. The mean age at presentation was 8.1 years (range 1 day to 19 years). Twelve lesions involved muscles of the extremities, 4 were located in the trunk and 2 were in the head and neck. MRI had been performed in all children and demonstrated a soft-tissue mass with flow voids, consistent with fast flow. The lesion was well-circumscribed in 16 children and intralesional fat was seen in 14. Doppler US demonstrated a heterogeneous lesion, predominantly isoechoic to surrounding muscle, with enlarged arterial feeders. Enlarged feeding arteries, inhomogeneous blush and lack of arteriovenous shunting were noted on angiography (n = 5). The most common histopathological findings were lobules of capillaries with plump endothelium and at least some adipose tissue. The lesions were excised in six children. Two children were lost to follow-up. In the remaining 10, follow-up MRI studies ranging from 3 months to 10 years showed that the lesion enlarged in proportion to the child (n = 7), demonstrated slow growth (n = 2) or remained stable (n = 1). There was no change in imaging characteristics on follow-up. CONCLUSION Intramuscular capillary-type hemangioma is a rare benign vascular tumor of skeletal muscle. The most typical imaging features show a heterogeneous intramuscular mass with fast flow, and intralesional fat. Although the lesion is relatively stable in appearance over time, imaging does not obviate the need for a biopsy to rule out sarcoma. The diagnosis can usually be established by typical findings on histopathology.
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A 22-month-old male child with a painless arm mass presenting to the emergency department. Pediatr Emerg Care 2014; 30:221-3. [PMID: 24589816 DOI: 10.1097/pec.0000000000000116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Erickson BP, Tse DT. Management of neonatal proptosis: a systematic review. Surv Ophthalmol 2013; 59:378-92. [PMID: 24929905 DOI: 10.1016/j.survophthal.2013.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/04/2013] [Accepted: 11/12/2013] [Indexed: 11/30/2022]
Abstract
Gross proptosis presenting at birth is an uncommon manifestation of a variety of lesions that can compromise vision and result in disfigurement or even loss of life. Notably, many disease entities have different presentations and prognoses in neonates compared to older children. A structured mental framework is essential to an efficient and coordinated response. We present three challenging cases of neonatal proptosis and discuss the clinical presentation and biological behavior of the lesions that are most often implicated.
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Affiliation(s)
| | - David T Tse
- Bascom Palmer Eye Institute, Miami, Florida, United States.
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Viry F, Orbach D, Klijanienko J, Fréneaux P, Pierron G, Michon J, Neuenschwander S, Brisse HJ. Alveolar soft part sarcoma-radiologic patterns in children and adolescents. Pediatr Radiol 2013; 43:1174-81. [PMID: 23681452 DOI: 10.1007/s00247-013-2667-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 01/17/2013] [Accepted: 01/27/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Alveolar soft part sarcoma is a rare but highly malignant tumour and little is known about its radiologic pattern in children. OBJECTIVE To describe the radiologic features of alveolar soft part sarcoma in children and adolescents. MATERIALS AND METHODS We retrospectively analysed the clinical and imaging data of six children age 7-17 years at diagnosis, with histologically or genetically proven alveolar soft part sarcoma. RESULTS The tumours were located deep within muscles of the limbs (n = 4), in chest wall muscle (n = 1) and in the orbit (n = 1). High-flow feeding arteries, large drainage veins and intense enhancement were consistent findings by all imaging modalities. At MRI, all tumours demonstrated high signal intensity on T2-weighted images and high or iso-intense signal on T1-W imaging compared to muscle. In tumours larger than 70 mm in one dimension (n = 3/6), large vessels converging toward the tumour centre led to a highly vascularised central stellar area pattern. Five children demonstrated synchronous (n = 4/5) and metachronous (n = 1/5) lung metastases. CONCLUSION Alveolar soft part sarcoma should be suggested when a highly vascularised, intramuscular mass demonstrating large feeding and drainage vessels converging toward a central stellar area is seen in children, especially if synchronous lung metastases are present.
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Affiliation(s)
- Flore Viry
- Department of Radiology, Institut Curie, Paris, France.
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Kaliki S, Eagle RC, Shields CL, Shields JA. Ciliochoroidal metastasis as the initial manifestation of an occult soft-tissue extraosseous sarcoma in a 10-year-old girl. J AAPOS 2013; 17:217-20. [PMID: 23622454 DOI: 10.1016/j.jaapos.2012.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 11/16/2012] [Accepted: 11/19/2012] [Indexed: 10/26/2022]
Abstract
Uveal metastases are rare in children and metastasis from sarcoma is rare at any age. We report a purportedly healthy 10-year-old girl who developed ciliochoroidal metastasis from an occult primary extraosseous sarcoma of the ankle region. The patient died from widespread metastases 6 months after enucleation despite intensive chemotherapy.
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Affiliation(s)
- Swathi Kaliki
- Department of Pathology, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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van Bommel A, Aslam R, Brundler MA, Hobin D, Jester A. Early tendon transfer after wide resection of an undifferentiated sarcoma of the forearm in a neonate: a case report. J Plast Reconstr Aesthet Surg 2013; 66:1287-90. [PMID: 23395150 DOI: 10.1016/j.bjps.2013.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 11/26/2012] [Accepted: 01/03/2013] [Indexed: 11/30/2022]
Abstract
A 1-month-old female baby was diagnosed with an undifferentiated sarcoma of her forearm after incisional biopsy. She received five cycles of chemotherapy before a wide resection of her extensor muscles including the radial nerve was undertaken, resulting in a complete drop of wrist and fingers. At this stage, primary tendon transfer of the brachioradialis to extensor carpi radial brevis muscle was performed, which proved to be not sufficient. Five months after resection of the tumour, restoration of the extensor function was achieved by flexor tendon transfers to provide wrist, finger and thumb extension. After 2 years, the patient did not show any signs of recurrence and she has a good wrist, finger and thumb extension and flexion. The diagnosis of an undifferentiated sarcoma is one per exclusion. Treatment includes chemotherapy and complete resection of the tumour with a wide margin. We discuss the diagnosis of undifferentiated sarcoma as well as early restoration of hand function in neonates.
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Affiliation(s)
- Annelotte van Bommel
- Department of Plastic Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
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