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Tomioka A, Asakuma M, Kawaguchi N, Komeda K, Shimizu T, Uchiyama K, Lee SW. Long-term disease-free survival of an undifferentiated pleomorphic sarcoma of the spleen: A case report and literature review. Medicine (Baltimore) 2022; 101:e31642. [PMID: 36451413 PMCID: PMC9704966 DOI: 10.1097/md.0000000000031642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Undifferentiated pleomorphic sarcoma (UPS) primarily occurs in the soft tissues of the extremities, trunk, and retroperitoneum. As the primary UPS of the spleen (splenic UPS) is extremely rare, to the best of our knowledge, only 19 cases have been reported in English literature. No cases of long-term survival without a local or distant recurrence have been reported. PATIENT CONCERNS We report the case of a 37-year-old man who was referred to our hospital for a splenic tumor. He had no past medical or relevant familial history. On abdominal computed tomography (CT), a low attenuation solid mass and cystic component with mural calcifications were present at the lower pole of his spleen. The fluorodeoxyglucose-positron emission tomography (CT) indicated it as malignant tumor of the spleen. DIAGNOSES The patient's provisional diagnosis was deduced to be angiosarcoma, which was the most common malignant tumor of the spleen. INTERVENTIONS An elective laparoscopic splenectomy was performed, and the histology of the tumor was consistent with UPS (pT1, pN0, cM0, and AJCC8th). No adjuvant therapy was administered. OUTCOMES Ten years have passed since the patient's splenectomy, and he continues to do well, without evidence of local or distant recurrence. LESSONS To the best of our knowledge, this is the first case of long-term recurrence-free survival after surgical management of a splenic UPS. It is probable that radical splenectomy during the disease played the most important role in the patient's long-term survival. Understanding the characteristic findings of a splenic UPS in an abdominal CT may help to diagnose properly.
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Affiliation(s)
- Atsushi Tomioka
- General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
- * Correspondence: Atsushi Tomioka, General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, 2-7, Daigaku-cho, Takatsuki City, Osaka 569-8686, Japan. (e-mail: )
| | - Mitsuhiro Asakuma
- General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Nao Kawaguchi
- General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Koji Komeda
- General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Tetsunosuke Shimizu
- General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Kazuhisa Uchiyama
- General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Sang-Woong Lee
- General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
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Ang X, Zhang J, Xu Z, Zhang Z, Ling Z, Zhou F, Chen W. Inflammatory undifferentiated pleomorphic sarcoma of the kidney with obstinate cough and fever as the first symptom: a case report and literature review. ALL LIFE 2021. [DOI: 10.1080/26895293.2021.1905079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Xiaojie Ang
- Department of Urology, The First Affiliated Hospital of Soochow University, Jiangsu, People’s Republic of China
| | - Junjun Zhang
- Department of Urology, Suzhou Wuzhong People’s Hospital, Jiangsu, People’s Republic of China
| | - Zekun Xu
- Department of Urology, The First Affiliated Hospital of Soochow University, Jiangsu, People’s Republic of China
| | - Zhiyu Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Jiangsu, People’s Republic of China
| | - Zhixin Ling
- Department of Urology, The First Affiliated Hospital of Soochow University, Jiangsu, People’s Republic of China
| | - Feng Zhou
- Department of Urology, The First Affiliated Hospital of Soochow University, Jiangsu, People’s Republic of China
| | - Weiguo Chen
- Department of Urology, The First Affiliated Hospital of Soochow University, Jiangsu, People’s Republic of China
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Abstract
Soft tissue sarcomas (STSs) account for less than 1% of adult solid tumors and about 7% of pediatric malignancies, causing 2% of cancer-related deaths. With the advent of PET-computed tomography (CT), the value of (18) fluorine-2-fluoro-2-deoxy-d-glucose (FDG) PET imaging to improve the management of STSs has been explored. FDG PET imaging has been found useful in restaging and treatment response assessment. This article reviews current knowledge and application of FDG PET-CT in initial diagnosis, staging, restaging, treatment response monitoring, and prognosis, with a brief overview of the most common histologic subtypes of STS.
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Makis W, Samji K, Hung RW, Deschenes J. Pleomorphic spindle cell sarcoma (PSCS) (formerly known as malignant fibrous histiocytoma, MFH) of the spleen, mimics an atypical haemangioma on 99mTc-RBC, CT and Ultrasound: staging with 18F-FDG PET/CT. BJR Case Rep 2017; 3:20150519. [PMID: 30363227 PMCID: PMC6159194 DOI: 10.1259/bjrcr.20150519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 01/12/2017] [Accepted: 02/01/2017] [Indexed: 01/03/2023] Open
Abstract
A 63-year-old male was found to have a 7.5-cm splenic mass that had imaging appearances of an atypical haemangioma on CT, ultrasound and a 99mTc-RBC scan, and he was followed conservatively with serial ultrasounds. Sixteen months later, however, the splenic lesion grew and he developed numerous new liver masses which were biopsy confirmed to be a pleomorphic spindle cell sarcoma (PSCS), formerly known as malignant fibrous histiocytoma (MFH). A staging 18F-FDG PET/CT was performed and showed innumerable, mostly necrotic hepatic and splenic masses. The patient passed away a few days after the PET/CT, before a treatment program could be implemented. The use of 18F-FDG PET/CT in the staging of splenic PSCS has not been previously described. We present the 99mTc-RBC and 18F-FDG PET/CT image characteristics of a patient with splenic PSCS.
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Affiliation(s)
- William Makis
- Department of Diagnostic Imaging, Cross Cancer Institute, Edmonton, AB, Canada
| | - Karim Samji
- Department of Diagnostic Imaging, Cross Cancer Institute, Edmonton, AB, Canada
| | - Ryan W Hung
- Department of Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, Canada
| | - Jean Deschenes
- Department of Pathology, Cross Cancer Institute, Edmonton, AB, Canada
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Abstract
Metastatic malignant fibrous histiocytoma (MFH) in the stomach is extremely rare. We report a 73-year-old man with MFH in the left popliteal fossa that metastasized to the stomach. Whole-body F-FDG PET/CT showed abnormal tracer uptakes in the stomach, which was subsequently confirmed as metastatic MFH.
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Sheikhbahaei S, Marcus C, Hafezi-Nejad N, Taghipour M, Subramaniam RM. Value of FDG PET/CT in Patient Management and Outcome of Skeletal and Soft Tissue Sarcomas. PET Clin 2015; 10:375-93. [PMID: 26099673 DOI: 10.1016/j.cpet.2015.03.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Fluorodeoxyglucose (FDG)-PET/computed tomography (CT) has been increasingly used in bone and soft tissue sarcomas and provides advantages in the initial tumor staging, tumor grading, therapy assessment, and recurrence detection. FDG-PET/CT metabolic parameters are reliable predictors of survival in sarcomas and could be implemented in risk stratification models along with other prognostic factors in these patients.
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Affiliation(s)
- Sara Sheikhbahaei
- Russell H Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, JHOC 3230, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Charles Marcus
- Russell H Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, JHOC 3230, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Nima Hafezi-Nejad
- Russell H Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, JHOC 3230, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Mehdi Taghipour
- Russell H Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, JHOC 3230, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Rathan M Subramaniam
- Russell H Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, JHOC 3230, 601 North Caroline Street, Baltimore, MD 21287, USA; Department of Oncology, Johns Hopkins School of Medicine, 401 North Broadway, Baltimore, MD 21231, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore, MD 21205, USA.
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Abstract
There is an expanding and exciting repertoire of PET imaging radiotracers for urogenital diseases, particularly in prostate cancer, renal cell cancer, and renal function. Prostate cancer is the most commonly diagnosed cancer in men. With growing therapeutic options for the treatment of metastatic and advanced prostate cancer, improved functional imaging of prostate cancer beyond the limitations of conventional CT and bone scan is becoming increasingly important for both clinical management and drug development. PET radiotracers, apart from ¹⁸F-FDG, for prostate cancer are ¹⁸F-sodium fluoride, ¹¹C-choline, and ¹⁸F-fluorocholine, and (¹¹C-acetate. Other emerging and promising PET radiotracers include a synthetic l-leucine amino acid analogue (anti-¹⁸F-fluorocyclobutane-1-carboxylic acid), dihydrotestosterone analogue (¹⁸F-fluoro-5α-dihydrotestosterone), and prostate-specific membrane antigen-based PET radiotracers (eg, N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-¹⁸F-fluorobenzyl-l-cysteine, ⁸⁹Zr-DFO-J591, and ⁶⁸Ga [HBED-CC]). Larger prospective and comparison trials of these PET radiotracers are needed to establish the role of PET/CT in prostate cancer. Although renal cell cancer imaging with FDG-PET/CT is available, it can be limited, especially for detection of the primary tumor. Improved renal cell cancer detection with carbonic anhydrase IX (CAIX)-based antibody (¹²⁴I-girentuximab) and radioimmunotherapy targeting with ¹⁷⁷Lu-cG250 appear promising. Evaluation of renal injury by imaging renal perfusion and function with novel PET radiotracers include p-¹⁸F-fluorohippurate, hippurate m-cyano-p-¹⁸F-fluorohippurate, and rubidium-82 chloride (typically used for myocardial perfusion imaging). Renal receptor imaging of the renal renin-angiotensin system with a variety of selective PET radioligands is also becoming available for clinical translation.
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Affiliation(s)
- Steve Y Cho
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, MD
| | - Zsolt Szabo
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, MD.
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A therapeutic strategy for metastatic malignant fibrous histiocytoma through mesenchymal stromal cell-mediated TRAIL production. Ann Surg 2013; 257:952-60. [PMID: 23108118 DOI: 10.1097/sla.0b013e3182710401] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To overcome the therapeutic limitations of malignant fibrous histiocytoma (MFH), we evaluated human adipose tissue-derived mesenchymal stromal cells (MSCs) that secrete tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) on metastatic MFH. BACKGROUND MFH is a highly malignant and metastatic type of sarcoma but surgical removal is the only effective method for treating MFH. MSCs are easily transduced to express a high level of transgene and can migrate toward cancer. For this reason, MSCs are a promising candidate for metastatic MFH therapies. METHODS In vitro sustainability of MSC-TRAIL against MFH-ino was analyzed by apoptosis assay. For preclinical study, anti-MFH effects of MSC-TRAILs were validated in murine models for local tumorigenesis and metastasis. Furthermore, a time-interval metastasis model of MFH was applied to confirm antimetastatic ability of MSC-TRAIL for preestablished metastatic MFH. RESULTS We found that MFH-ino is highly susceptible to recombinant TRAIL and MSC-TRAIL, which selectively induce apoptosis via caspase-8 activation in vitro. Moreover, not only MFH-ino but xenograft explants were also significantly inhibited by MSC-TRAIL in local tumorigenesis. In particular, the metastatic ability of MFH-ino was considerably reduced by MSC-TRAIL in metastasis murine model, particularly for preestablished metastatic MFH. CONCLUSIONS These results suggest that MSC-TRAIL is sufficiently effective in inhibiting MFH-ino metastasis and the application using MSC-TRAIL could be extended to other sarcomas and recurrent metastatic cancers for cell-mediated cancer therapy.
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¹⁸F-FDG-PET/CT findings of retroperitoneal tumors: a pictorial essay. Jpn J Radiol 2013; 31:301-9. [PMID: 23456547 DOI: 10.1007/s11604-013-0192-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 02/05/2013] [Indexed: 10/27/2022]
Abstract
A variety of different tumors can arise from any of the tissues present in the retroperitoneum, and they exhibit a wide range of pathologic types. Although computed tomography (CT) and magnetic resonance imaging (MRI) can demonstrate important characteristics of these tumors, diagnosis is often challenging for radiologists. The purpose of this pictorial essay is to review (18)F-fluorodeoxyglucose positron emission tomography/CT (FDG-PET/CT) features of different kinds of benign and malignant retroperitoneal tumors in comparison with CT or MRI findings alone and to become familiar with the wide variety of imaging characteristics.
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12
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Choi BH, Yoon SH, Lee S, Jo KS, Song HS, An YS, Yoon JK, Lee SJ. Primary Malignant Fibrous Histiocytoma in Mediastinum: Imaging with (18)F-FDG PET/CT. Nucl Med Mol Imaging 2012; 46:304-7. [PMID: 24900079 DOI: 10.1007/s13139-012-0157-5] [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: 05/10/2012] [Revised: 07/02/2012] [Accepted: 07/05/2012] [Indexed: 11/29/2022] Open
Abstract
Malignant fibrous histiocytoma (MFH) is the most common soft tissue tumor which often occurs in the extremities and the retroperitoneum. Primary mediastinal MFH is rare; thus, findings on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) of mediastinal MFH have not been reported yet. We report herein the case of a 64-year-old man who was presented with a superior mediastinal mass. The mass showed intense (18)F-FDG uptake with central metabolic defect on PET/CT. The maximum standardized uptake value was 17.4. After tumor removal via median sternotomy, an MFH of the storiform-pleomorphic type was diagnosed on histopathologic examination. We present the first report of (18)F-FDG PET/CT imaging of MFH in the superior mediastinum.
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Affiliation(s)
- Bong-Hoi Choi
- Clinical Research Institute, Gyeongsang National University Hospital, Chiram-dong, Jinju, Gyeongsangnam-do South Korea
| | - Seok-Ho Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Sungsoo Lee
- Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Kyung Sook Jo
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Hee-Sung Song
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
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Gil-Julio H, Vázquez-Alonso F, Puche-Sanz I, Fernández-Sánchez AJ, Cózar-Olmo JM. Conservative treatment of malignant fibrous histiocytoma of the kidney: a case report. Curr Urol 2012; 6:46-9. [PMID: 24917710 DOI: 10.1159/000338870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 02/13/2012] [Indexed: 11/19/2022] Open
Abstract
Primary renal malignant fibrous histiocytoma is an extremely rare disease. There are neither clinical nor radiological signs to distinguish it from the most common renal cell carcinoma. Its prognosis is poor because of its tendency to locally recur and metastasize. Therefore, early diagnosis and proper treatment are very important. We present the case of a 66-year-old woman diagnosed with primary renal malignant fibrous histiocytoma who underwent partial nephrectomy. After 41 months' follow-up, there was no evidence of any recurrence. To our knowledge, this is the first reported case of conservative surgery for this kind of tumor.
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Affiliation(s)
- Hernani Gil-Julio
- Department of Urology, Virgen de las Nieves Universitary Hospital, Granada, Spain
| | | | - Ignacio Puche-Sanz
- Department of Urology, Virgen de las Nieves Universitary Hospital, Granada, Spain
| | | | - José M Cózar-Olmo
- Department of Urology, Virgen de las Nieves Universitary Hospital, Granada, Spain
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