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Kuntz T, Grimm A, Hofmann SC, Michalowitz AL, Schaller J, Hellmich M, Assaf C, Oellig F, Kreuter A. Hydrochlorothiazide and increased risk of atypical fibroxanthoma and pleomorphic dermal sarcoma. J Dtsch Dermatol Ges 2024; 22:513-519. [PMID: 38483049 DOI: 10.1111/ddg.15379] [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: 07/28/2023] [Accepted: 01/11/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND AND OBJECTIVES Previous work has demonstrated that hydrochlorothiazide (HCTZ) is a risk factor for squamous cell carcinomas (SCC) and basal cell carcinomas (BCC) due to pro-photocarcinogenic effects. Atypical fibroxanthoma (AFX) and pleomorphic sarcoma (PDS), both ultraviolet-induced cancers, display a rare but rising cutaneous tumor entity. This study aimed to evaluate if the use of HCTZ is higher in patients with AFX/PDS than in patients with SCC/BCC and subsequently may be a risk factor for AFX/PDS-development. PATIENTS AND METHODS In a retrospective study of four German skin cancer centers, AFX/PDS cases and SCC/BCC controls were sex and age matched (1:3) over a time-period of 7 years (2013-2019) to evaluate the use of HCTZ, immunosuppressive medication, second malignancies, and presence of diabetes mellitus. RESULTS Overall, 146 AFX/PDS and 438 controls (SCC/BCC) were included in the study. The use of HCTZ was significantly higher in patients with AFX/PDS (44.5%) compared to patients with SCC/BCC (25.3%). Additionally, the presence of diabetes mellitus was significantly higher in AFX/PDS patients. CONCLUSIONS This study demonstrates a significantly higher use of HCTZ in patients with AFX/PDS compared to SCC/BCC. This result suggests that HCTZ may be a risk factor for AFX/PDS. Additionally, diabetes mellitus or its comorbidities may be associated with an increased risk for AFX/PDS.
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Affiliation(s)
- Thomas Kuntz
- Department of Dermatology and Venereology, University of Cologne, Cologne, Germany
- Department of Dermatology, Venereology, and Allergology, Helios St. Elisabeth Hospital Oberhausen, University of Witten-Herdecke, Oberhausen, Germany
| | - Alexander Grimm
- Department of Dermatology, Venereology, and Allergology, Helios St. Elisabeth Hospital Oberhausen, University of Witten-Herdecke, Oberhausen, Germany
| | - Silke C Hofmann
- Department of Dermatology, Allergology, und Dermatosurgery, Helios University Hospital Wuppertal, University of Witten-Herdecke, Wuppertal, Germany
| | - Alena-Lioba Michalowitz
- Department of Dermatology, Venereology, and Allergology, Helios St. Elisabeth Hospital Oberhausen, University of Witten-Herdecke, Oberhausen, Germany
| | - Jörg Schaller
- Department of Dermatology, Venereology, and Allergology, Helios St. Johannes Hospital Duisburg, Duisburg, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Chalid Assaf
- Department of Dermatology and Venereology, Helios Klinikum Krefeld, Krefeld, Germany
| | - Frank Oellig
- Institute of Pathology, Mülheim an der Ruhr, Germany
| | - Alexander Kreuter
- Department of Dermatology, Venereology, and Allergology, Helios St. Elisabeth Hospital Oberhausen, University of Witten-Herdecke, Oberhausen, Germany
- Department of Dermatology, Venereology, and Allergology, Helios St. Johannes Hospital Duisburg, Duisburg, Germany
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2
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Kuntz T, Grimm A, Hofmann SC, Michalowitz AL, Schaller J, Hellmich M, Assaf C, Oellig F, Kreuter A. Hydrochlorothiazid: Erhöhtes Risiko für atypisches Fibroxanthom und pleomorphes dermales Sarkom. J Dtsch Dermatol Ges 2024; 22:513-520. [PMID: 38574023 DOI: 10.1111/ddg.15379_g] [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: 07/28/2023] [Accepted: 01/11/2024] [Indexed: 04/06/2024]
Abstract
ZusammenfassungHintergrund und ZieleBisherige Arbeiten haben gezeigt, dass Hydrochlorothiazid (HCT) aufgrund seiner photokarzinogenen Wirkung einen Risikofaktor für Plattenepithelkarzinome (SCC) und Basalzellkarzinome (BCC) darstellt. Atypische Fibroxanthome (AFX) und pleomorphe dermale Sarkome (PDS), beides UV‐induzierte Tumoren, stellen eine seltene, aber zunehmende Tumorentität der Haut dar. In dieser Studie soll untersucht werden, ob die Einnahme von HCT bei Patienten mit AFX/PDS höher ist als bei Patienten mit SCC/BCC und ob dies ein Risikofaktor für die Entwicklung von AFX/PDS sein könnte.Patienten und MethodikIn einer retrospektiven Studie an vier deutschen Hautkrebszentren wurden AFX/PDS‐Fälle und SCC/BCC‐Kontrollen über einen Zeitraum von sieben Jahren (2013‐2019) geschlechts‐ und alters‐gematcht (1:3) auf die Einnahme von HCT und immunsuppressiven Medikamenten sowie auf Zweitmalignome und Diabetes mellitus untersucht.ErgebnisseInsgesamt wurden 146 AFX/PDS und 438 Kontrollen (SCC/BCC) in die Studie eingeschlossen. Die Einnahme von HCT war bei Patienten mit AFX/PDS (44,5%) im Vergleich zu Patienten mit SCC/BCC (25,3%) signifikant häufiger. Außerdem war Diabetes mellitus bei AFX/PDS‐Patienten signifikant häufiger.SchlussfolgerungenDiese Studie zeigt eine signifikant höhere Einnahme von HCT bei Patienten mit AFX/PDS im Vergleich zu SCC/BCC. Dies legt nahe, dass HCT ein Risikofaktor für AFX/PDS sein könnte. Darüber hinaus könnten ein Diabetes mellitus oder dessen Begleiterkrankungen mit einem erhöhten Risiko für AFX/PDS assoziiert sein.
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Affiliation(s)
- Thomas Kuntz
- Klinik für Dermatologie und Venerologie, Universität Köln
- Klinik für Dermatologie und Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten-Herdecke, Oberhausen
| | - Alexander Grimm
- Klinik für Dermatologie und Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten-Herdecke, Oberhausen
| | - Silke C Hofmann
- Klinik für Dermatologie, Venerologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal
| | - Alena-Lioba Michalowitz
- Klinik für Dermatologie und Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten-Herdecke, Oberhausen
| | - Jörg Schaller
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Johannes Klinik Duisburg
| | - Martin Hellmich
- Institut für Medizinische Statistik und Bioinformatik, Medizinische Fakultät der Universität Köln
| | - Chalid Assaf
- Klinik für Dermatologie und Venerologie, Helios Klinikum Krefeld
| | | | - Alexander Kreuter
- Klinik für Dermatologie und Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Universität Witten-Herdecke, Oberhausen
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Johannes Klinik Duisburg
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3
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Gualdi G, La Rosa G, Di Buduo A, Paradisi A, Soglia S, Calzavara-Pinton P, Amerio P. Conventional surgery compared with formalin-fixed tissue Mohs surgery (slow Mohs) for DFSP: A comparative analysis of 83 cases. J Eur Acad Dermatol Venereol 2023; 37:e1393-e1395. [PMID: 37458274 DOI: 10.1111/jdv.19336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Giulio Gualdi
- Department of Medicine and Aging Science, Dermatologic Clinic, University G D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Giuseppe La Rosa
- Dermatologic Clinic, Spedali Civili, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Andrea Di Buduo
- Department Medical Sciences, and Public Health, Dermatology Clinic, University of Cagliari, Cagliari, Italy
| | - Andrea Paradisi
- Dermatology. Department of Medicine and translational surgery, Catholic University of Sacred Heart, Rome, Italy
- UOC of Dermatology, Department of medical and surgical sciences, A. Gemelli University Polyclinic Foundation - IRCCS, Rome, Italy
| | - Simone Soglia
- Dermatologic Clinic, Spedali Civili, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | | | - Paolo Amerio
- Department of Medicine and Aging Science, Dermatologic Clinic, University G D'Annunzio Chieti-Pescara, Chieti, Italy
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Helbig D, Dippel E, Erdmann M, Frisman A, Kage P, Leiter U, Mentzel T, Seidel C, Weishaupt C, Ziemer M, Ugurel S. S1-Leitlinie dermales und subkutanes Leiomyosarkom. J Dtsch Dermatol Ges 2023; 21:555-564. [PMID: 37183752 DOI: 10.1111/ddg.14989_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Doris Helbig
- Klinik und Poliklinik für Dermatologie und Venerologie, Universitätsklinikum Köln
| | - Edgar Dippel
- Klinik für Dermatologie und Venerologie, Klinikum der Stadt Ludwigshafen
| | - Michael Erdmann
- Hautklinik, Universitätsklinikum Erlangen, CCC Erlangen EMN, Erlangen
| | - Alexander Frisman
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Leipzig
| | - Paula Kage
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig
| | - Ulrike Leiter
- Zentrum für Dermatoonkologie, Universitäts-Hautklinikum, Eberhard-Karls-Universität Tübingen
| | - Thomas Mentzel
- MVZ Dermatopathologie Friedrichshafen/Bodensee, Friedrichshafen
| | - Clemens Seidel
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Leipzig
| | | | - Mirjana Ziemer
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig
| | - Selma Ugurel
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen
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Li Y, Chen Z, Nie S, Wu Z. Atrophic dermatofibrosarcoma protuberans: Two case reports and literature review. Front Oncol 2023; 13:1100398. [PMID: 36845717 PMCID: PMC9948607 DOI: 10.3389/fonc.2023.1100398] [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: 11/16/2022] [Accepted: 01/27/2023] [Indexed: 02/11/2023] Open
Abstract
Dermatofibrosarcoma protuberans is a rare, locally aggressive, slowly growing cutaneous fibroblastic sarcoma with a high recurrence rate and low metastatic potential. Atrophic dermatofibrosarcoma protuberans is a rare variant usually presents as atrophic plaques, easily neglected and misdiagnosed as benign lesions by patients and dermatologists. Here we report two cases of atrophic dermatofibrosarcoma protuberans, one of which was accompanied by pigment, and review other cases have been reported in the literature. Understanding the most up-to-date literature and early identification of these dermatofibrosarcoma protuberans variants can help clinicians avoid delayed diagnosis and improve prognosis.
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Affiliation(s)
| | | | - Shu Nie
- Department of Dermatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kumari J, Das K, Patil A, Babaei M, Cockerell CJ, Goldust M. Clinical update on cutaneous and subcutaneous sarcomas. J Cosmet Dermatol 2023; 22:402-409. [PMID: 36074118 DOI: 10.1111/jocd.15369] [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: 06/26/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cutaneous sarcomas are uncommon cancers that can have a wide range of clinical symptoms and lead to considerable cutaneous as well as systemic morbidity. AIM The objective of this review article is to discuss epidemiology, clinical features, diagnosis, and therapy of different types of cutaneous sarcomas. MATERIAL AND METHODS Literature was screened to retrieve articles from PubMed/Medline and Google Scholar and related websites. Cross-references from the relevant articles were also considered for review. Review articles, clinical studies, systematic reviews, meta-analyses, and relevant information from selected websites were included. RESULTS AND DISCUSSION Cutaneous sarcomas have a negative effect on the quality of life. In their diagnosis, clinical presentation and histological evaluation are crucial. Complete surgical removal is the solution for more or less all cutaneous and subcutaneous sarcomas. The prognosis for cutaneous sarcomas is generally favorable since they tend to recur locally with distant metastases only on rare occasions. Patients having advanced disease should be treated in the setting of clinical trials if possible; choices include radiation therapy and systemic medicines. The value of innovative immunotherapy cannot be determined decisively at this time due to a paucity of relevant trials. CONCLUSION As cutaneous sarcomas are rarely diagnosed based on clinical findings, histology plays an important role in the diagnosis. They have a relatively favorable prognosis if treated properly. Patients should be treated at specialized centres.
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Affiliation(s)
- Jyoti Kumari
- Silchar Medical College and Hospital, Silchar, Assam, India
| | - Kinnor Das
- Department of Dermatology Venereology and Leprosy, Silchar Medical College, Silchar, Assam, India
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Mahsa Babaei
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Clay J Cockerell
- Departments of Dermatology and Pathology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Cockerell Dermatopathology, Dallas, Texas, USA
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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7
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Kuntz T, Siebdrath J, Hofmann SC, Baltaci M, Schaller J, Hellmich M, von Goltzheim LS, Assaf C, Oellig F, Michalowitz AL, Helbig D, Kreuter A. Zunahme des atypischen Fibroxanthoms und pleomorphen dermalen Sarkoms: eine retrospektive Analyse vier deutscher Hauttumorzentren. J Dtsch Dermatol Ges 2022; 20:1581-1588. [PMID: 36508370 DOI: 10.1111/ddg.14911_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/14/2022] [Indexed: 12/14/2022]
Abstract
HINTERGRUND UND ZIELE In den letzten Jahren konnten umfassende Erkenntnisse über die Pathogenese, Diagnostik und Behandlung von kutanen Sarkomen, insbesondere des atypischen Fibroxanthoms (AFX) und pleomorphen dermalen Sarkoms (PDS) gesammelt werden. Beide Entitäten zeigten innerhalb der letzten Dekade steigende Inzidenzraten. Die vorliegende Studie diente der Untersuchung, welchen Einfluss die neuen Erkenntnisse auf die Fallzahlen von AFX/PDS im Vergleich zu anderen Sarkom-Entitäten haben. PATIENTEN UND METHODIK Diese retrospektive Studie wurde an vier deutschen Hauttumorzentren durchgeführt und alle von zertifizierten Dermatopathologen bestätigten histopathologischen Befunde von kutanen Sarkomen (AFX, PDS, Dermatofibrosarcoma protuberans, kutanes Leiomyosarkom, Angiosarkom und Kaposi-Sarkom) in einem Zeitraum von sieben Jahren (2013-2019) evaluiert. Zusätzlich wurde der Einsatz von immunhistochemischen Markern als diagnostische Hilfe (Panzytokeratin, S100, Desmin, CD34, CD10, Prokollagen-1, CD99, CD14 und CD68) erfasst. ERGEBNISSE Insgesamt konnten 255 kutane Sarkome in die vorliegende Studie eingeschlossen werden. Die Zahl der kutanen Sarkome nahm kontinuierlich von 2013 bis 2019 zu (von 16 auf 52 Fälle im Jahr). Die Diagnose eines AFX/PDS konnte in 2019 4,6-mal häufiger als in 2013 gestellt werden. Das AFX stellte mit 49,3 % aller kutanen Sarkome den häufigsten Sarkom-Subtypen dar. Zusätzlich war der Anstieg von AFX/PDS mit dem Einsatz von Immunhistochemie assoziiert. Der Einsatz von spezifischen Immunhistochemischen Markern stieg von 57,1 % im Jahr 2013 auf 100 % in 2019. SCHLUSSFOLGERUNGEN Diese retrospektive Studie von vier deutschen Hauttumorzentren demonstriert eine substanzielle Zunahme von AFX/PDS, wahrscheinlich infolge kürzlich etablierter beziehungsweise verbesserter diagnostischer und terminologischer Standards. Dieser Anstieg ist vermutlich mit dem vermehrten Einsatz von bestimmten immunhistochemischen Markern assoziiert. AFX/PDS treten wahrscheinlich häufiger auf als bisher vermutet und repräsentieren möglicherweise den häufigsten kutanen Sarkom-Subtyp.
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Affiliation(s)
- Thomas Kuntz
- Klinik für Dermatologie, Venerologie und Allergologie, Universität zu Köln.,Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Krankenhaus Oberhausen, Universität Witten-Herdecke, Oberhausen
| | - Julian Siebdrath
- Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Krankenhaus Oberhausen, Universität Witten-Herdecke, Oberhausen
| | - Silke C Hofmann
- Klinik für Dermatologie, Allergologie und Dermatochirurgie, HELIOS Universitätsklinikum Wuppertal, Universität Witten-Herdecke, Wuppertal
| | - Mehmet Baltaci
- Klinik für Dermatologie und Venerologie, HELIOS Klinikum Duisburg
| | - Jörg Schaller
- Klinik für Dermatologie und Venerologie, HELIOS Klinikum Duisburg
| | - Martin Hellmich
- Institut für Medizinische Statistik und Bioinformatik, Medizinische Fakultät und Universitätsklinikum Köln, Universität zu Köln
| | - Luise Stach von Goltzheim
- Institut für Medizinische Statistik und Bioinformatik, Medizinische Fakultät und Universitätsklinikum Köln, Universität zu Köln
| | - Chalid Assaf
- Klinik für Dermatologie und Venerologie, HELIOS Klinikum Krefeld
| | | | - Alena-Lioba Michalowitz
- Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Krankenhaus Oberhausen, Universität Witten-Herdecke, Oberhausen
| | - Doris Helbig
- Klinik für Dermatologie, Venerologie und Allergologie, Universität zu Köln
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Krankenhaus Oberhausen, Universität Witten-Herdecke, Oberhausen.,Klinik für Dermatologie und Venerologie, HELIOS Klinikum Duisburg
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8
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Han Q, Chen M, Yang J, Du T, Peng H. Dermatofibrosarcoma protuberans im Gesicht: Klinisch‐pathologische und molekulare Studie mit 34 Fällen. J Dtsch Dermatol Ges 2022; 20:1463-1475. [DOI: 10.1111/ddg.14882_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Qianqian Han
- Department of Pathology West China Hospital Sichuan University Chengdu Sichuan China
| | - Min Chen
- Department of Pathology West China Hospital Sichuan University Chengdu Sichuan China
| | - Jieliang Yang
- Department of Pathology West China Hospital Sichuan University Chengdu Sichuan China
| | - Tianhai Du
- Department of Pathology West China Hospital Sichuan University Chengdu Sichuan China
| | - Heng Peng
- Department of Pathology West China Hospital Sichuan University Chengdu Sichuan China
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9
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Parisi F, Abramo F, Maimone M, Poli A, Millanta F. Skin Photodamage Lesions in a Bilateral Feline Auricular Primary Fibrosarcoma. Vet Sci 2022; 9:vetsci9100548. [PMID: 36288161 PMCID: PMC9611120 DOI: 10.3390/vetsci9100548] [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: 07/29/2022] [Revised: 09/22/2022] [Accepted: 10/03/2022] [Indexed: 11/16/2022] Open
Abstract
As with human species, recent studies also suggest a photoinduced etiopathology for non-epithelial cutaneous tumors in feline species. We report a recent case of a ten-year-old male cat with a white-hair coat and mesenchymal neoplasms of both auricles. Cytology, complete blood count (CBC), serum biochemistry and imaging examinations were performed. After surgery, the samples underwent routinary histopathology and were additionally stained with orcein. A routine analysis yielded values within a normal range and the imaging examination showed no abnormalities, suggesting that the bilateral presentation of neoplasms was primary rather than metastatic. The cytology was inconclusive, but, through histopathology, two well-differentiated fibrosarcomas were diagnosed and histopathological changes related to chronic UV exposure (such as epidermal hyperplasia, stratification disorders, keratinocyte dysplasia and an accumulation of elastotic material) were documented in the skin adjacent to the lesions. An orcein stain succeeded in highlighting elastosis. The elastic fibers lost their regular structure and orientation and appeared to be fragmented, wavy to branched and knotted. A morphometric analysis showed that the amount of elastotic material in the dermis close to the tumors was more than double compared with the more distant areas. Elastosis is considered to be a hallmark of photodamage; thus, an involvement of UV rays in the carcinogenic process of the tumors may be suspected.
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Affiliation(s)
- Francesca Parisi
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge n. 2, 56124 Pisa, Italy
- Correspondence: ; Tel.: +39-05-0221-6982
| | - Francesca Abramo
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge n. 2, 56124 Pisa, Italy
| | - Marco Maimone
- Clinica Veterinaria Foce, via Eugenio Baroni, 26R, 16129 Genova, Italy
| | - Alessandro Poli
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge n. 2, 56124 Pisa, Italy
| | - Francesca Millanta
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge n. 2, 56124 Pisa, Italy
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10
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Malakoutikhah Z, Mohaghegh F, Derakhshan M, Mehdizadeh MJ. Radio‐induced simultaneous development of squamous cell carcinoma and undifferentiated pleomorphic sarcoma of scalp. Clin Case Rep 2022; 10:e6058. [PMID: 35846910 PMCID: PMC9280752 DOI: 10.1002/ccr3.6058] [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: 04/13/2022] [Revised: 05/18/2022] [Accepted: 06/11/2022] [Indexed: 11/08/2022] Open
Abstract
Radiotherapy was commonly applied to treat benign skin diseases such as tinea capitis. Some patients treated with radiation have developed skin malignancies over the years. This article reported a 72‐year‐old man presenting with two distinct non‐melanoma skin tumors on his scalp, including squamous cell carcinoma and metastatic pleomorphic sarcoma.
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Affiliation(s)
- Zahra Malakoutikhah
- Applied Physiology Research Center, Cardiovascular Research Institute Isfahan University of Medical Sciences Isfahan Iran
| | - Fatemeh Mohaghegh
- Department of Dermatology, Skin Disease and Leishmaniasis Research Center Isfahan Medical School, Isfahan University of Medical Sciences Isfahan Iran
| | - Maryam Derakhshan
- Department of Pathology Isfahan Medical School, Isfahan University of Medical Sciences Isfahan Iran
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11
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Auricular Non-Epithelial Tumors with Solar Elastosis in Cats: A Possible UV-Induced Pathogenesis. Vet Sci 2022; 9:vetsci9020034. [PMID: 35202288 PMCID: PMC8874616 DOI: 10.3390/vetsci9020034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023] Open
Abstract
The photoinduced etiopathology of actinic keratosis and squamous cell carcinoma in feline species is well known. This etiology has also been reported for non-epithelial cutaneous tumors in other species. To date, no cases of auricular non-epithelial cutaneous neoplasms erased in a contest of actinic keratosis in cats have been reported. The aim of this study was to describe feline auricular non-epithelial cutaneous neoplasms associated with typical UV-induced cutaneous lesions and solar elastosis. The study was conducted on five feline cases diagnosed with auricular non-epithelial cutaneous tumors (two fibrosarcomas, one mixosarcoma, one epithelioid melanoma and one hemangiosarcoma), selected from the Tumor Registry of the Department of Veterinary Sciences of the University of Pisa (1998–2018). Ten and six feline auricular biopsies of normal skin and skin with actinic keratosis, respectively, were used as controls. Orcein stain was used to investigate solar elastosis. Histological changes related to chronic solar irradiation were documented in the skin adjacent to the neoplastic lesions in the five cats. Considering the anatomical localization and the results of histopathology, this study suggests that non-epithelial cutaneous neoplasms may have a UV-induced etiopathogenesis in the feline species.
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12
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Kirchner A, Sergeyenko A, Keane J, Belinski K, Liu W. Diagnosis of cutaneous mycobacterial spindle cell pseudotumor in the absence of typical inflammatory cells: A case report. J Cutan Pathol 2021; 48:1178-1181. [PMID: 33948982 DOI: 10.1111/cup.14042] [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: 02/15/2021] [Revised: 04/25/2021] [Accepted: 04/28/2021] [Indexed: 11/30/2022]
Abstract
Mycobacterial spindle cell pseudotumor (MSP) is a non-neoplastic condition that is characterized by spindle-shaped histiocytes colonized by mycobacteria. MSP is most commonly diagnosed in the immunocompromised and, while MSP can occur throughout the body, the most common sites of MSP involvement are the lymph nodes and the skin. To diagnose MSP, histopathological analysis typically demonstrates the presence of inflammatory cells, in addition to spindle cells and the unequivocal mycobacteria, which guides the diagnosis away from potential neoplasms. If properly diagnosed and treated with appropriate antibiotic therapy, patients tend to experience almost complete resolution of their symptoms. MSP is a rare condition; to our knowledge, there have only been 11 documented cases of cutaneous MSP, including the one introduced in this report. Here, we present a unique case of a 50-year-old female on chronic immunosuppressive therapy diagnosed with cutaneous MSP in the absence of inflammatory cells on pathology.
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Affiliation(s)
- Allison Kirchner
- University of Illinois College of Medicine, Chicago, Illinois, USA
| | | | | | | | - Wenhua Liu
- Consolidated Pathology Consultants, Libertyville, Illinois, USA
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13
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Maier JC, Kofler K, Forchhammer S, Skardelly M, Mentzel T, Häfner HM, Kofler L. [Infiltration of the skull by dedifferentiated cutaneous leiomyosarcoma]. Hautarzt 2021; 72:1098-1101. [PMID: 33760962 PMCID: PMC8613129 DOI: 10.1007/s00105-021-04800-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 11/30/2022]
Abstract
Wir berichten über einen 81-jährigen Patienten mit bereits mehrfach voroperiertem Tumor der Kopfhaut. In der histologischen erneuten Aufarbeitung ließ sich ein dedifferenziertes Leiomyosarkom nachweisen, das bereits die Schädeldecke infiltriert hatte. In einem interdisziplinären Ansatz mit den Kollegen der Klinik für Neurochirurgie konnte eine Komplettexzision erreicht werden. Kutane Leiomyosarkome sind seltene Tumoren der Haut, die typischerweise als langsam wachsende, erythematöse Knoten imponieren. Aufgrund des Metastasierungspotenzials ist eine komplette, schnittrandkontrollierte Resektion erforderlich.
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Affiliation(s)
- J C Maier
- Universitätshautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland.
| | - K Kofler
- Universitätshautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - S Forchhammer
- Universitätshautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - M Skardelly
- Praxis für Neurochirurgie Reutlingen, Steinenbergstr. 31, 72764, Reutlingen, Deutschland
| | - T Mentzel
- Dermatopathologie Friedrichshafen, Siemensstr. 6/1, 88048, Friedrichshafen, Deutschland
| | - H M Häfner
- Universitätshautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - L Kofler
- Universitätshautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
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14
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Henning A, Banks M, Korman AM, Iwenofu IH, Chung CG. GATA-3 expression in a de-differentiated chondrosarcoma with cutaneous iatrogenic implantation: a diagnostic pitfall with important clinical implications. J Cutan Pathol 2021; 48:932-936. [PMID: 33655510 DOI: 10.1111/cup.13995] [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: 07/25/2020] [Revised: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Abstract
De-differentiated chondrosarcoma (DDCS) is an extremely aggressive tumor of the bone characterized by a high-grade, non-chondroid sarcoma adjacent to a low- or intermediate-grade chondrosarcoma. Adequate tumor sampling demonstrating the biphasic features is necessary to make an accurate diagnosis. The diagnosis may be challenging as histopathology may mimic other neoplasms. We present a case of a 76-year-old woman with a history of breast cancer who presented with a pathologic non-displaced fracture. A bone biopsy demonstrated a high-grade neoplasm composed of pleomorphic spindled and epithelioid cells with focal expression of AE1/3 and GATA3, most likely consistent with metastatic breast carcinoma. After a difficult clinical course, the tumor was resected demonstrating a similar morphology to her prior biopsy, as well as an area of a low-grade cartilaginous neoplasm consistent with chondrosarcoma. The biphasic tumor alongside a low-grade chondrosarcoma allowed for a diagnosis of DDCS. Several days after her procedure, the patient developed violaceous nodules overlying and surrounding the surgical site. Skin biopsy demonstrated a malignant epithelioid neoplasm with identical histomorphologic features identical to her prior bone resection. Given the location of the skin lesions directly within the surgical site right after resection, the clinical-pathological picture was that of sarcomatosis cutis by iatrogenic cutaneous implantation.
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Affiliation(s)
- Ania Henning
- Department of Pathology, Summa Health System, Akron, Ohio, USA
| | - Mackenzie Banks
- The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Abraham M Korman
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - I Hans Iwenofu
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Catherine G Chung
- Division of Dermatology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA.,Department of Pathology, The Ohio State University, Columbus, Ohio, USA
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15
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Soares Queirós C, Filipe P, Soares de Almeida L. Cutaneous leiomyosarcoma: a 20-year retrospective study and review of the literature. An Bras Dermatol 2021; 96:278-283. [PMID: 33775481 PMCID: PMC8178579 DOI: 10.1016/j.abd.2020.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/01/2020] [Accepted: 10/12/2020] [Indexed: 11/29/2022] Open
Abstract
Background Cutaneous leiomyosarcoma is a rare malignant neoplasm with muscular origin, representing 2%-3% of all cutaneous soft tissue sarcomas. Objectives The aim of this study was to characterize clinicopathological features of patients diagnosed with cutaneous leiomyosarcoma in our center over the last 20-years. Methods A retrospective study of patients with a histopathological diagnosis of leiomyosarcoma between 1999 and 2018 was conducted. Results Eleven patients were diagnosed with cutaneous leiomyosarcoma during this period. Most cases occurred in men (n = 7). Age at presentation ranged from 47 to 92 years (mean 64.9 years). Head and neck were the most frequently involved locations (n = 5). Ten leiomyosarcoma were dermal, with one cutaneous metastasis. Immunohistochemical staining was available for 7 patients, demonstrating positivity for smooth muscle actin in all of them. All neoplasms were treated surgically. Mean survival was 32.2-months. Study limitations This was a retrospective study based on medical and pathological records. Conclusions Histopathology is essential for the diagnosis of leiomyosarcoma, usually revealing a dermal or subcutaneous lesion composed of intertwined fascicles of smooth muscle fibers. Immunohistochemistry is then used to adequately differentiate leiomyosarcoma from other spindle cell tumors. When dealing with cutaneous leiomyosarcoma, it is advisable to carefully evaluate the depth of subcutaneous extension, since even minimal subcutaneous involvement may be associated with a poorer prognosis.
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Affiliation(s)
- Catarina Soares Queirós
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar e Universitário de Lisboa Norte, Lisbon, Portugal.
| | - Paulo Filipe
- Faculty of Medicine, Universidade de Lisboa, Lisbon, Portugal
| | - Luís Soares de Almeida
- Dermatology Department, Hospital de Santa Maria, Centro Hospitalar e Universitário de Lisboa Norte, Lisbon, Portugal; Faculty of Medicine, Universidade de Lisboa, Lisbon, Portugal
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16
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Undifferentiated pleomorphic sarcoma of skin in unusual locations: Report of two cases. Jt Dis Relat Surg 2021; 32:253-257. [PMID: 33463447 PMCID: PMC8073439 DOI: 10.5606/ehc.2021.78856] [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: 09/10/2020] [Accepted: 11/02/2020] [Indexed: 11/21/2022] Open
Abstract
Undifferentiated pleomorphic sarcoma (UPS) of the skin is a rare soft tissue sarcoma subtype with a high risk of metastasis and local recurrence. Ultraviolet exposure plays a prominent role in its etiology. Herein, we present two rare cases of UPS of the skin with an occurrence in non-ultraviolet exposed locations and discuss the need of wide resection and the identification of the depth of the tumor. Due to the resection of the skin, resulting defect was undertaken with skin grafting. One case was extending to the fascia and, after the resection, vacuum-assisted closure therapy was used for the formation of granulation tissue. No recurrence was seen after three and four years for either cases. In conclusion, UPS is a rare, aggressive malignant tumor with a high local recurrence and metastasis rate. Suspicion of malignancy in a plaque-like or nodular lesion in the skin is crucial, and local recurrence and metastasis risk is significantly correlated to the success of wide excision.
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17
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Barrios DM, Do MH, Phillips GS, Postow MA, Akaike T, Nghiem P, Lacouture ME. Immune checkpoint inhibitors to treat cutaneous malignancies. J Am Acad Dermatol 2020; 83:1239-1253. [PMID: 32461079 PMCID: PMC7572574 DOI: 10.1016/j.jaad.2020.03.131] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/11/2022]
Abstract
As the incidence of cutaneous malignancies continues to rise and their treatment with immunotherapy expands, dermatologists and their patients are more likely to encounter immune checkpoint inhibitors. While the blockade of immune checkpoint target proteins (cytotoxic T-lymphocyte-associated protein-4, programmed cell death-1, and programmed cell death ligand-1) generates an antitumor response in a substantial fraction of patients, there is a critical need for reliable predictive biomarkers and approaches to address refractory disease. The first article of this Continuing Medical Education series reviews the indications, efficacy, safety profile, and evidence supporting checkpoint inhibition as therapeutics for metastatic melanoma, cutaneous squamous cell carcinoma, and Merkel cell carcinoma. Pivotal studies resulting in the approval of ipilimumab, pembrolizumab, nivolumab, cemiplimab, and avelumab by regulatory agencies for various cutaneous malignancies, as well as ongoing clinical research trials, are discussed.
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Affiliation(s)
- Dulce M Barrios
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mytrang H Do
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medicine, New York, New York
| | - Gregory S Phillips
- State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Michael A Postow
- Weill Cornell Medicine, New York, New York; Melanoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Tomoko Akaike
- Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Paul Nghiem
- Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Mario E Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medicine, New York, New York.
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18
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Li YL, Gao YL, Niu XL, Wu YT, Du YM, Tang MS, Li JY, Guan XH, Song B. Identification of Subtype-Specific Metastasis-Related Genetic Signatures in Sarcoma. Front Oncol 2020; 10:544956. [PMID: 33123466 PMCID: PMC7573283 DOI: 10.3389/fonc.2020.544956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 08/28/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Sarcomas are heterogeneous rare malignancies constituting approximately 1% of all solid cancers in adults and including more than 70 histological and molecular subtypes with different pathological and clinical development characteristics. Method: We identified prognostic biomarkers of sarcomas by integrating clinical information and RNA-seq data from TCGA and GEO databases. In addition, results obtained from cell cycle, cell migration, and invasion assays were used to assess the capacity for Tanespimycin to inhibit the proliferation and metastasis of sarcoma. Results: Sarcoma samples (N = 536) were divided into four pathological subtypes including DL (dedifferentiated liposarcoma), LMS (leiomyosarcoma), UPS (undifferentiated pleomorphic sarcomas), and MFS (myxofibrosarcoma). RNA-seq expression profile data from the TCGA dataset were used to analyze differentially expressed genes (DEGs) within metastatic and non-metastatic samples of these four sarcoma pathological subtypes with DEGs defined as metastatic-related signatures (MRS). Prognostic analysis of MRS identified a group of genes significantly associated with prognosis in three pathological subtypes: DL, LMS, and UPS. ISG15, NUP50, PTTG1, SERPINE1, and TSR1 were found to be more likely associated with adverse prognosis. We also identified Tanespimycin as a drug exerting inhibitory effects on metastatic LMS subtype and therefore can serve a potential treatment for this type of sarcoma. Conclusions: These results provide new insights into the pathogenesis, diagnosis, treatment, and prognosis of sarcomas and provide new directions for further study of sarcoma.
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Affiliation(s)
- Ya-Ling Li
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.,National Health Commission Key Laboratory of Immunodermatology (China Medical University), Shenyang, China.,Key Laboratory of Immunodermatology, Ministry of Education, Shenyang, China
| | - Ya-Li Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.,National Health Commission Key Laboratory of Immunodermatology (China Medical University), Shenyang, China.,Key Laboratory of Immunodermatology, Ministry of Education, Shenyang, China
| | - Xue-Li Niu
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.,National Health Commission Key Laboratory of Immunodermatology (China Medical University), Shenyang, China.,Key Laboratory of Immunodermatology, Ministry of Education, Shenyang, China
| | - Yu-Tong Wu
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.,National Health Commission Key Laboratory of Immunodermatology (China Medical University), Shenyang, China.,Key Laboratory of Immunodermatology, Ministry of Education, Shenyang, China
| | - Yi-Mei Du
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.,National Health Commission Key Laboratory of Immunodermatology (China Medical University), Shenyang, China.,Key Laboratory of Immunodermatology, Ministry of Education, Shenyang, China
| | - Ming-Sui Tang
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.,National Health Commission Key Laboratory of Immunodermatology (China Medical University), Shenyang, China.,Key Laboratory of Immunodermatology, Ministry of Education, Shenyang, China
| | - Jing-Yi Li
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.,National Health Commission Key Laboratory of Immunodermatology (China Medical University), Shenyang, China.,Key Laboratory of Immunodermatology, Ministry of Education, Shenyang, China
| | - Xiu-Hao Guan
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.,National Health Commission Key Laboratory of Immunodermatology (China Medical University), Shenyang, China.,Key Laboratory of Immunodermatology, Ministry of Education, Shenyang, China
| | - Bing Song
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China.,School of Dentistry, Cardiff University, Cardiff, United Kingdom
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ACAR A, YAMAN B, YANMAZ A, YOLDAŞ AH, KARAARSLAN I, AKALIN T, ÖZDEMİR F, GERÇEKER TÜRK B, CANER A, KANDİLOĞLU G, HAYDAROĞLU A, CEYLAN C. Ege Üniversitesi Hastanesinde görülen melanom dışı deri kanserlerinin epidemiyolojik ve demografik özellikleri. EGE TIP DERGISI 2020. [DOI: 10.19161/etd.815373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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20
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Unraveling the Heterogeneity of Sarcoma Survivors' Health-Related Quality of Life Regarding Primary Sarcoma Location: Results from the SURVSARC Study. Cancers (Basel) 2020; 12:cancers12113083. [PMID: 33105807 PMCID: PMC7690571 DOI: 10.3390/cancers12113083] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/16/2022] Open
Abstract
Simple Summary Sarcomas are a rare group of heterogenous tumors that can develop anywhere in the body. Currently, studies on health-related quality of life (HRQoL) focus on sarcomas of the arm and leg or have too small sample sizes to examine the heterogeneity between different sarcoma locations, leading to limited insight into HRQoL of survivors with specific sarcoma locations. The aim of this study was to assess differences in HRQoL and examine treatment-specific HRQoL issues per sarcoma location. We found, in a population of 1099 sarcoma survivors, different patterns of HRQoL according to primary sarcoma location and a high number of additional, unique treatment-specific HRQoL issues per location, which were not captured with the general HRQoL questionnaire used in cancer patients. This indicates that the currently used HRQoL measures are too generic to capture all sarcoma-related issues, emphasizing the necessity for a comprehensive sarcoma-specific HRQoL measurement strategy. Abstract Sarcoma patients experience physical and psychological symptoms, depending on age of onset, subtype, treatment, stage, and location of the sarcoma, which can adversely affect patients’ health-related quality of life (HRQoL). This study aimed to unravel the heterogeneity of sarcoma survivors’ HRQoL regarding primary sarcoma location. A cross-sectional study was conducted among Dutch sarcoma survivors (N = 1099) aged ≥18, diagnosed 2–10 years ago. Primary sarcoma locations were head and neck, chest, abdominal including retroperitoneal, pelvis including urogenital organs, axial skeleton, extremities (upper and lower), breast, skin and other locations. The European Organization for Research and Treatment of Cancer—Quality of Life Questionnaire (EORTC QLQ)-C30 was used to measure HRQoL accompanied by treatment-specific HRQoL questions. Sociodemographic and clinical characteristics were collected from the Netherlands Cancer Registry. Axial skeleton sarcomas had the lowest functioning levels and highest symptoms compared to other locations. Skin sarcomas had the highest functioning levels and lowest symptoms on most scales. Bone sarcomas scored worse on several HRQoL domains compared to soft tissue sarcomas. High prevalence of treatment-specific HRQoL issues were found per location. In conclusion, sarcomas can present everywhere, which is reflected by different HRQoL outcomes according to primary sarcoma location. The currently used HRQoL measure lacks treatment-specific questions and is too generic to capture all sarcoma-related issues, emphasizing the necessity for a comprehensive sarcoma-specific HRQoL measurement strategy.
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21
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Sato N, Arai E, Nakamura Y, Yazawa Y, Yasuda M. Primary cutaneous localized/clearly-outlined true histiocytic sarcoma: Two long-term follow-up cases. J Dermatol 2020; 47:651-653. [PMID: 32180261 DOI: 10.1111/1346-8138.15315] [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: 08/22/2019] [Accepted: 02/18/2020] [Indexed: 12/01/2022]
Abstract
Histiocytic sarcoma (HS) is a rare hematopoietic tumor that mainly involves extranodal sites, including the intestinal tract, skin, soft tissues and other organs. It is well known as an aggressive neoplasm that shows a poor response to therapy. However, a subset of patients with resectable disease has shown a favorable outcome with surgical treatment. Primary cutaneous HS is exceedingly rare and, to date, its long-term prognosis has thus not been well described. Here, we highlight two cases of primary cutaneous HS that showed long-term survival. Case 1 was a healthy 47-year-old woman who found a 12-mm tumor on her forehead. Case 2 was a 66-year-old woman, under follow up of a myxoid liposarcoma in her leg, who presented with a 25-mm tumor in her hypothenar eminence. Histologically, the tumors in both cases had a smooth outline with proliferating atypical tumor cells that showed histiocytic differentiation as revealed by immunohistochemistry with antibodies to CD68 (KP-1) and lysozyme in case 1; and CD68, lysozyme and CD163 in case 2. Tumor cells in case 1 had a monotonous appearance. After complete resection, cases 1 and 2 have survived for 10 and 4 years, respectively, without recurrence. To date, such patients are relatively long follow-up cases of survival from HS and highlight how a clear outline of the primary cutaneous HS tumor may be associated with its resectability and be an important factor in the assessment of its curability.
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Affiliation(s)
- Naoko Sato
- Departments of, Department of, Diagnostic Pathology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Eiichi Arai
- Departments of, Department of, Diagnostic Pathology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Yasuhiro Nakamura
- Department of, Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Yasuo Yazawa
- Department of, Orthopedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Masanori Yasuda
- Departments of, Department of, Diagnostic Pathology, Saitama Medical University International Medical Center, Hidaka, Japan
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22
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Individual multi-catheter mould technique in high-dose-rate brachytherapy - personalized approach in treating multifocal angiosarcoma of the face. J Contemp Brachytherapy 2019; 11:337-342. [PMID: 31523234 PMCID: PMC6737578 DOI: 10.5114/jcb.2019.87144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 07/02/2019] [Indexed: 12/31/2022] Open
Abstract
Purpose The aim of this study was to report individual surface mould multi-catheter high-dose-rate (IMM HDR) application as a salvage treatment for a head and neck angiosarcoma patient, previously treated with surgery followed by external beam radiotherapy. Material and methods A 74-year-old male reported to our center with an uncommon malignant neoplasm of blood vessels. The patient was qualified for a wide local excision (WLE) of tumor with simultaneous reconstruction using a free-flap collected from the patient's thigh. After surgery, the patient was qualified for adjuvant external-beam radiotherapy (EBRT). Volumetric arc therapy (VMAT; RapidArc®, Varian Medical Systems) was used to deliver 52.8 Gy/1.6 Gy in 33 fractions. Overall treatment time was 51 days. Six months after radiotherapy, an incisional biopsy of non-healing ulcer of the nasal bridge revealed angiosarcoma. Wide local excision with skin graft reconstruction was planned. Due to multifocal disease and lack of possibility for further margin, the resection surgery was completed after skin graft reconstruction from the right thigh. Surface IMM HDR was considered as an alternative option for further treatment. Total dose of 48 Gy (12 fractions) was planned. Results One month after surface IMM HDR, healing process of the skin was observed in the treated regions and six months later, the irradiated areas recovered. General condition of the patient deteriorated two years after diagnosis and one year after HDR. He was hospitalized to receive palliative care. Conclusions HDR brachytherapy may be a valuable option for angiosarcoma treatment. Difficult lesion location may yield non-radical surgery. Surface IMM HDR provides highly conformal plan and allow adjusting the dose to individual clinical situation.
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23
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Welsch K, Breuninger H, Metzler G, Sickinger F, Eberle FC, Häfner HM, Schnabl SM. Patterns of infiltration and local recurrences of various types of cutaneous sarcomas following three-dimensional histology. J Dtsch Dermatol Ges 2019; 16:1434-1442. [PMID: 30537312 DOI: 10.1111/ddg.13708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/19/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Cutaneous sarcomas are rare and characterized by pathogenetic heterogeneity. Knowledge about local infiltration patterns and recurrence rates may be useful in improving patient care and outcomes. The objective of the present study was to compare these two characteristics in sarcomas that had been treated using the identical surgical procedure. PATIENTS AND METHODS Between 2006-2010, 84 patients with various types of sarcoma underwent surgery followed by three-dimensional histology. Tumor entities included dermatofibrosarcoma protuberans (DFSP, 54 patients), leiomyosarcoma (ten patients), rhabdomyosarcoma (one patient), angiosarcoma (seven patients) as well as atypical fibroxanthoma (AFX, three patients) and cutaneous undifferentiated pleomorphic sarcoma (UPS, nine patients). Median follow-up was four years (range: 2-6 years). RESULTS Local recurrence rates among patients with primary DFSP were 2.2 %. All patients undergoing re-excision were subsequently tumor free. Patients with leiomyosarcoma, rhabdomyosarcoma, AFX, and cutaneous UPS experienced no local recurrence; however, one individual developed in-transit metastasis (UPS) (8.3 %). Three patients with angiosarcoma developed local recurrence (43 %), two of whom remained tumor free following re-excision. Two angiosarcoma patients died from distant metastases (29 %). Both DFSP and especially angiosarcoma lesions exhibited extensive subclinical growth. CONCLUSIONS Recurrence rates of cutaneous sarcomas following three-dimensional histology are low. Local recurrences are readily manageable by re-excision. Angiosarcoma is characterized by extensive superficial growth, aggressive biological behavior, and predominantly hematogenous spread.
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Affiliation(s)
- Katharina Welsch
- Department of Dermatology, Eberhardt Karls University, Tübingen Germany
| | - Helmut Breuninger
- Department of Dermatology, Eberhardt Karls University, Tübingen Germany
| | - Gisela Metzler
- Department of Dermatology, Eberhardt Karls University, Tübingen Germany
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Welsch K, Breuninger H, Metzler G, Sickinger F, Eberle FC, Häfner HM, Schnabl SM. Infiltrationsmuster und Lokalrezidive von kutanen Sarkomen unterschiedlichen Typs nach 3D-Histologie. J Dtsch Dermatol Ges 2018; 16:1434-1442. [PMID: 30537307 DOI: 10.1111/ddg.13708_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/19/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Katharina Welsch
- Universitäts-Hautklinik Tübingen, Eberhard-Karls-Universität Tübingen
| | - Helmut Breuninger
- Universitäts-Hautklinik Tübingen, Eberhard-Karls-Universität Tübingen
| | - Gisela Metzler
- Universitäts-Hautklinik Tübingen, Eberhard-Karls-Universität Tübingen
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25
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Zacher M, Heppt MV, Brinker TJ, Hayani KM, Flaig MJ, Berking C. Primary leiomyosarcoma of the skin: a comprehensive review on diagnosis and treatment. Med Oncol 2018; 35:135. [PMID: 30140957 DOI: 10.1007/s12032-018-1196-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/15/2018] [Indexed: 12/19/2022]
Abstract
Sarcomas are a heterogeneous group of mesenchymal tumors which can affect bone and soft tissue. Leiomyosarcoma (LMS) is a rare subtype localized to the skin or subcutaneous tissue. Due to the heterogeneity of sarcomas, reviews and guidelines with an in-depth focus specifically on primary LMS of the skin are sparse. This article is intended to provide an up to date and systematic overview on diagnosis, treatment, and surveillance of this rare entity to provide a framework for decision making and management for dermato-oncologists. We discuss novel treatment options for advanced disease such as targeted therapy with kinase inhibitors and immune checkpoint blockade which may improve the prognosis even in advanced stages of LMS.
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Affiliation(s)
- Martina Zacher
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Markus V Heppt
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Titus J Brinker
- Department of Dermatology, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany.,Department of Translational Oncology, German Cancer Research Center, National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Kinan M Hayani
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Michael J Flaig
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Carola Berking
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany.
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Wollina U, Langner D, Schönlebe J, França K, Lotti T, Tchernev G. Dermatofibrosarcoma Protuberans: Retrospective Single Center Analysis Over 16 Years. Open Access Maced J Med Sci 2018; 6:35-37. [PMID: 29483976 PMCID: PMC5816309 DOI: 10.3889/oamjms.2018.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 09/22/2017] [Accepted: 09/24/2017] [Indexed: 11/23/2022] Open
Abstract
Dermatofibrosarcoma protuberans (DFSP) is rare mesenchymal neoplasia with a high risk of local recurrence but a low risk of metastatic spread. Tumor cells express CD34 and show a characteristic translocation t(17;22)(q22;q13). We analysed the documented cases at the Department of Dermatology and Allergology between 08/2001 and 08/2017. The diagnosis had been confirmed by histology and immunohistology in all cases. We identified four adults and a pediatric patient with DFSP. All patients were treated by wide surgical excision and controlled by three-dimensional histologic margin control. We observed no recurrence and no metastatic spread. We discuss prognostic factors and emerging treatments.
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Affiliation(s)
- Uwe Wollina
- Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen, Germany
| | - Dana Langner
- Städtisches Klinikum Dresden - Department Dermatology and Allergology, Dresden, Germany
| | - Jacqueline Schönlebe
- Städtisches Klinikum Dresden - Institute of Pathology "Georg Schmorl", Dresden, Germany
| | - Katlein França
- Department of Dermatology and Cutaneous Surgery, Department of Psychiatry & Behavioral Sciences; Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Torello Lotti
- University of Rome, Institute of Deramtology, Rome, Italy
| | - Georgi Tchernev
- Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, Sofia, Bulgaria.,Onkoderma Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
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27
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Jiang YY, Zeng YP, Jin HZ. Eosinophilic Pustular Folliculitis Associated with Cutaneous Angiosarcoma. Chin Med J (Engl) 2018; 131:115-116. [PMID: 29271395 PMCID: PMC5754951 DOI: 10.4103/0366-6999.221284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Yan-Yun Jiang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Yue-Ping Zeng
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Hong-Zhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
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