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Bielack SS. Systemic treatment for primary malignant sarcomas arising in craniofacial bones. Front Oncol 2022; 12:966073. [PMID: 36158667 PMCID: PMC9492845 DOI: 10.3389/fonc.2022.966073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/22/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Craniofacial bones may be the site of origin of various sarcomas. We review the various malignancies affecting this region of the body and attempt to put systemic treatment approaches into perspective. Material and methods Non-systematic literature review Results Conventional types of osteosarcoma, Ewing sarcoma, and chondrosarcoma are the most frequent bone sarcomas occurring in craniofacial region, but variants may occur. The tumors’ biologies and the resulting treatment strategies vary distinctly. As a general rule, local control remains paramount regardless of histology. The efficacy of antineoplastic chemotherapy varies by type of malignancy. It is clearly indicated in Ewing sarcoma and related tumors, potentially of benefit in high-grade osteosarcoma, undifferentiated pleomorphic sarcoma, dedifferentiated and mesenchymal chondrosarcoma, and of no proven benefit in the others. Conclusions Various histologies demand various and distinct treatment approaches, with local control remaining paramount in all. The efficacy of systemic treatments varies by type of tumor. Prospective trials would help in all of these to better define systemic treatment strategies.
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Affiliation(s)
- Stefan S. Bielack
- Pediatrics 5 (Oncology, Hematology, Immunology), Center for Pediatric, Adolescent and Women’s Medicine, Stuttgart Cancer Center, Klinikum Stuttgart–Olgahospital, Stuttgart, Germany
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Muenster, Muenster, Germany
- *Correspondence: Stefan S. Bielack,
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2
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Wu K, Zhu X, Li Y, Wen D, Wu H, Lai Y, Li Y, Wu J, Liu Z. Primary Ewing’s sarcoma of sphenoid sinus: A case report and literature review. Front Oncol 2022; 12:894833. [PMID: 36046048 PMCID: PMC9422175 DOI: 10.3389/fonc.2022.894833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/06/2022] [Indexed: 01/25/2023] Open
Abstract
BackgroundPrimary Ewing’s sarcoma of sphenoid sinus, observed in children and adolescents, is an extremely rare malignancy. Such rarity makes the imaging features and treatment strategies for Ewing’s sarcoma of sphenoid sinus unclear. This study aimed to offer guidance for treating this very disease by describing a patient with a rare primary Ewing’s sarcoma of sphenoid sinus and reviewing the available data in the literature.Case descriptionA case of Ewing’s sarcoma in sphenoid sinus treated with multidisciplinary treatment approaches, including tumor resection, radiotherapy, chemotherapy, and antiangiogenic therapy, was presented in this study. Moreover, literature for Ewing’s sarcoma in the head was systematically searched, and two cases in the sphenoid sinus and five cases in the sphenoid bone were identified. Furthermore, the clinical features, imaging findings, pathological characteristics, treatment, and prognosis were summarized.ConclusionTumor resection combined with radiotherapy and chemotherapy may provide favorable results for patients with Ewing’s sarcoma of sphenoid sinus and bone. However, more reports are still necessary to further clarify optimal management.
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Affiliation(s)
- Kunpeng Wu
- Department of Oncology, Heyuan Hospital of Guangdong Provincial People’s Hospital, Heyuan People’s Hospital, Heyuan, China
- *Correspondence: Kunpeng Wu, ; Zhuoxing Liu,
| | - Xiaoyan Zhu
- Department of Otorhinolaryngology, Heyuan Hospital of Guangdong Provincial People’s Hospital, Heyuan People’s Hospital, Heyuan, China
| | - Yan Li
- Department of Radiology, Heyuan Hospital of Guangdong Provincial People’s Hospital, Heyuan People’s Hospital, Heyuan, China
| | - Daxiong Wen
- Department of Pathology, Heyuan Hospital of Guangdong Provincial People’s Hospital, Heyuan People’s Hospital, Heyuan, China
| | - Huiyu Wu
- Department of Pathology, Heyuan Hospital of Guangdong Provincial People’s Hospital, Heyuan People’s Hospital, Heyuan, China
| | - Yanzhen Lai
- Department of Oncology, Heyuan Hospital of Guangdong Provincial People’s Hospital, Heyuan People’s Hospital, Heyuan, China
| | - Yun Li
- Department of Oncology, Heyuan Hospital of Guangdong Provincial People’s Hospital, Heyuan People’s Hospital, Heyuan, China
| | - Jian Wu
- Department of Oncology, Heyuan Hospital of Guangdong Provincial People’s Hospital, Heyuan People’s Hospital, Heyuan, China
| | - Zhuoxing Liu
- Department of Oncology, Heyuan Hospital of Guangdong Provincial People’s Hospital, Heyuan People’s Hospital, Heyuan, China
- *Correspondence: Kunpeng Wu, ; Zhuoxing Liu,
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3
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Wei D, Jianguo Z, Xiao L, Pengpeng Q. Primary primitive neuroectodermal tumor of the cervix confirmed with molecular analysis in a pregnant woman: A case report and literature review. Front Genet 2022; 13:871531. [PMID: 36035131 PMCID: PMC9399424 DOI: 10.3389/fgene.2022.871531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
Primary primitive neuroectodermal tumor (PNET) in the female tract is rare. Recently, a case of cervical PNET was diagnosed in our hospital. A 29-year-old pregnant woman presented with a cystic-solid cervical mass at the 7th week of gestation. The mass grew rapidly during follow-up and ruptured at the 22nd week. A biopsy was performed on the mass. Pathological examination revealed a malignant neoplasm composed of small cells which exhibited positive immunohistochemical (IHC) staining for CD99, SYN, and FLI1. Fluorescence in situ hybridization (FISH) displayed the presence of EWS-FLI1 fusion gene resulting from the chromosomal translocation t (11;22, q24;q12), which confirmed the diagnosis of cervical PNET. The reverse transcription-polymerase chain reaction (RT-PCR) results showed type 2 EWS-FLI1 fusion occurred in this tumor, suggesting a poor prognosis. The patient underwent surgical resection and was given adjuvant chemotherapy followed by pelvic radiotherapy. PNET arising from the genital tract, especially in the uterine cervix, is very rare and presents a diagnostic challenge. FISH and RT-PCR analysis are helpful for the diagnosis of such a tumor at an unusual site, as in the present case.
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Affiliation(s)
- Ding Wei
- Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China
| | - Zhao Jianguo
- Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China
| | - Li Xiao
- Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China
| | - Qu Pengpeng
- Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, China
- Clinical School of Obstetrics and Gynecology Center, Tianjin Medical University, Tianjin, China
- *Correspondence: Qu Pengpeng,
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Stephen N, Srinivas BH, Ravi S, Ganesh RN, Badhe BA, Toi P, Jinkala S, Sekar R, Alexander A, Narendhar, Pandjatcharam J. Neuroectodermal tumours of the sino-nasal tract: a clinicopathological study of 18 cases with a newly proposed revised classification and a brief review of literature. Eur Arch Otorhinolaryngol 2021; 279:1181-1191. [PMID: 34568968 DOI: 10.1007/s00405-021-07051-6] [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: 06/09/2021] [Accepted: 08/17/2021] [Indexed: 11/29/2022]
Abstract
AIM Sino-nasal tract tumours constitute 3% of the head and neck malignancies. Among these tumours, neuroectodermal tumours are rare with histo-morphological and immunohistochemical overlap making them a challenge for the pathologist. We included Ewing's/PNET, olfactory neuroblastoma (OFN), mucosal malignant melanomas (MMM), Melanotic neuroectodermal tumour of infancy (MNTI), small-cell neuroendocrine carcinoma (SNEC), and the newest entity Adamantinoma like Ewing's sarcoma (ALES) as part of the neuroectodermally derived tumours of the sino-nasal tract. The last three entities were added to the existing ones, which also has been emphasized in this paper. METHODS AND RESULTS A comprehensive analysis was done on all neuroectodermally derived tumours from 2016 to 2020. A total of 18 cases were collected, which included OFN (10 cases), SNEC (2 cases), MMM (2 cases), Ewing's/PNET (2 cases), MNTI (1 case), and ALES (1 case). The most common presentation in NE tumours was nasal obstruction (80-100%). Except for OFN, all other tumours were confined to the nasal and paranasal sinuses. 4/10 cases of OFN showed orbital extension. Cervical lymph-node metastasis was seen in 50% of cases of SNEC and MMM groups. An array of relevant immune-histochemical markers were performed. The marker expression was very subtle among the groups. On follow-up, recurrence was seen in the OFN and MMM groups in 30 and 50%, respectively. Metastasis was seen in SNEC group (100%) and OFN group (10%). CONCLUSION As sino-nasal neuroectodermal tumours pose a diagnostic challenge and have different therapies and are prognostically different, the pathologist must be aware of the subtle morphological, immunohistochemical clues which have been dealt with in-depth in this study.
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Affiliation(s)
- Norton Stephen
- Pathology, Sri Venkateswara Medical College Hospital and Research Centre, Pondicherry, India
| | | | | | | | | | - Pampa Toi
- Pathology, JIPMER, Pondicherry, India
| | | | | | | | - Narendhar
- Radiotherapy, JIPMER, Pondicherry, India
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Balasubramanian D, Subramanian N, Marchi F, Camillo Carobbio A, Missale F, Thankappan K, Iyer S. Induction chemotherapy in sinonasal malignancies: A review of literature. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2019. [DOI: 10.4103/jhnps.jhnps_6_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Bouaoud J, Temam S, Cozic N, Galmiche-Rolland L, Belhous K, Kolb F, Bidault F, Bolle S, Dumont S, Laurence V, Plantaz D, Tabone MD, Marec-Berard P, Quassemyar Q, Couloigner V, Picard A, Gomez-Brouchet A, Le Deley MC, Mahier-Ait Oukhatar C, Kadlub N, Gaspar N. Ewing's Sarcoma of the Head and Neck: Margins are not just for surgeons. Cancer Med 2018; 7:5879-5888. [PMID: 30449071 PMCID: PMC6308064 DOI: 10.1002/cam4.1801] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/18/2022] Open
Abstract
Background, Methods To describe the characteristics, treatments (systemic/local), and outcome (oncological/functional) of French patients with head and neck Ewing's sarcomas (HNES) registered in the Euro‐Ewing 99 (EE99) database. Specific patient‐level data were reviewed retrospective. Results Forty‐seven HNES patients in the EE99 database had a median age of 11 years, 89% had bone tumors (skull 55%, mandible 21%, maxilla 11%), 89% had small tumors (<200 mL), and they were rarely metastatic (9%). Local treatment was surgery radiotherapy (55%), exclusively surgery (28%), or radiotherapy (17%). Metastatic relapses occurred in five patients with high relapse risk factors (metastasis at diagnosis, poor histological response, large tumors). Local progression/relapses (LR) after exclusive radiotherapy occurred in three patients with persistent extra‐osseous residue and in four patients considered R0 margins (postchemotherapy surgery, without postoperative radiotherapy [PORT]), reclassified by pathological review as R1a. Pathological review reclassified 72% of R0 margins: 11/18 to R1a and 2/18 to R2. Five patients had confirmed R0 margins after postchemotherapy surgery without PORT and had no LR Eight patients had R2 margins (initial surgery without previous chemotherapy, with PORT) and had no LR With a median follow‐up of 9.3 years, the 3‐year LR rate, EFS, and OS were 84.8%, 78.6%, and 89.3%, respectively. Among the 5‐year survivors, 88% had long‐term sequelae. Conclusion To optimize HNES management, patients should be treated from diagnosis in expert centers with multidisciplinary committees to discuss treatment strategy (type of surgery, need for PORT) and validate surgical margins.
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Affiliation(s)
- Jebrane Bouaoud
- Unit of maxillofacial and Plastic Surgery, Necker-Enfants Malades, Paris, France
| | - Stephane Temam
- Unit of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - Nathalie Cozic
- Department of Biostatistics, Gustave Roussy, Villejuif, France
| | - Louise Galmiche-Rolland
- Department of Pathology, Necker-Enfants Malades, Paris, France.,University Paris Descartes, Paris, France
| | - Kahina Belhous
- University Paris Descartes, Paris, France.,Department of Pediatric Radiology, Necker-Enfants Malades, Paris, France
| | - Frederic Kolb
- Plastic and Reconstructive Surgery Department, Gustave Roussy, Villejuif, France
| | | | - Stephanie Bolle
- Radiation Oncology Department, Gustave Roussy, Villejuif, France
| | - Sarah Dumont
- Department of medical oncology, Gustave Roussy, Villejuif, France
| | | | - Dominique Plantaz
- Department of Pediatric Hematology-Oncology, University Hospital Centre of Grenoble, Grenoble, France
| | | | - Perrine Marec-Berard
- Department of Pediatric Oncology, Léon Bérard Cancer Center, Institute for Paediatric Haematology and Oncology, Lyon, France
| | - Quentin Quassemyar
- Plastic and Reconstructive Surgery Department, Gustave Roussy, Villejuif, France
| | - Vincent Couloigner
- University Paris Descartes, Paris, France.,Unit of Otolaryngology and Head and Neck Surgery, Necker-Enfants Malades, Paris, France
| | - Arnaud Picard
- Unit of maxillofacial and Plastic Surgery, Necker-Enfants Malades, Paris, France.,University Paris Descartes, Paris, France
| | | | - Marie-Cécile Le Deley
- Centre Oscar Lambret, Lille, France.,CESP, INSERM, Fac. de médecine - Univ. Paris-Sud, Université Paris-Saclay, Villejuif, France
| | | | - Natacha Kadlub
- Unit of maxillofacial and Plastic Surgery, Necker-Enfants Malades, Paris, France.,University Paris Descartes, Paris, France
| | - Nathalie Gaspar
- Department of Oncology for Child and Adolescents, Gustave Roussy, Villejuif, France
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Gore MR. Treatment, outcomes, and demographics in sinonasal sarcoma: a systematic review of the literature. BMC EAR, NOSE, AND THROAT DISORDERS 2018; 18:4. [PMID: 29581706 PMCID: PMC5861608 DOI: 10.1186/s12901-018-0052-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 03/01/2018] [Indexed: 02/06/2023]
Abstract
Background Sarcomas comprise a diverse group of soft tissue mesenchymal malignancies. The sinuses and nasal region are a relatively rare site of sarcomas. Methods Retrospective review of the literature on sinonasal sarcomas from 1987-2017. Data were analyzed for demographics, treatment type, stage, and histopathologic type. Kaplan-Meier analysis was used to assess and compare survival. Results A total of 198 cases of sinonasal sarcoma were identified and analyzed. The median age at diagnosis was 39 years. Overall 5-, 10-, and 20-year survival was 61.3%, 58.9%, and 49.1%, respectively, and disease-free 5-, 10-, and 20-year survival was 53.2%, 49.1%, and 38.3%, respectively. Lymph node metastasis was present at diagnosis in 3.0% of cases, and distant metastasis was present in 3.5% of cases. On univariate analysis T stage, overall stage, treatment type, histopathologic subtype, and presence of distant metastasis significantly affected survival. On multivariate analysis overall stage alone significantly predicted overall survival. Open vs. endoscopic surgery, total radiation dose, and presence of neck metastasis did not significantly affect survival. Combined modality treatment was associated with higher survival rates than single modality therapy. Conclusions Sinonasal sarcoma is a relatively rare malignancy. Lower T and overall stage, lack of distant metastasis, and multimodality therapy were associated with improved survival. Certain histopathologic subtypes were associated with poorer survival. Electronic supplementary material The online version of this article (10.1186/s12901-018-0052-5) contains supplementary material, which is available to authorized users.
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Iatrou I, Theologie-Lygidakis N, Schoinohoriti O, Tzermpos F, Mylonas AI. Ewing's sarcoma of the maxillofacial region in Greek children: Report of 6 cases and literature review. J Craniomaxillofac Surg 2018; 46:213-221. [DOI: 10.1016/j.jcms.2017.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/02/2017] [Accepted: 12/08/2017] [Indexed: 11/28/2022] Open
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MiR-107 suppresses cell proliferation and tube formation of Ewing sarcoma cells partly by targeting HIF-1β. Hum Cell 2017; 31:42-49. [DOI: 10.1007/s13577-017-0183-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 08/29/2017] [Indexed: 12/12/2022]
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Singh GR, Choudhary V, Agrawal R. Primary Ewing Sarcoma of Sphenoid Bone with Intracranial Extension: A Common Tumour at an Uncommon Location. J Clin Diagn Res 2017; 11:ED15-ED16. [PMID: 28384876 DOI: 10.7860/jcdr/2017/23541.9275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 10/19/2016] [Indexed: 11/24/2022]
Abstract
Primary Ewing Sarcoma of the cranial bone is rare, contributing to only 1% of all Ewing Sarcomas. Primary cranial Ewing Sarcoma occurs most commonly in temporal bone followed by parietal and occipital bones. Sphenoid bone is less commonly involved. We report a case of Ewing Sarcoma of the sphenoid bone with intra-cranial extension in a 20-month-old boy. On CT scan a provisional diagnosis of rhabdomyosarcoma was made. Fine Needle Aspiration Cytology (FNAC) and histopathological examination of core needle biopsy showed small round cell tumour. On Immunohistochemistry (IHC), CD99 (MIC2) and FLI 1 were strongly positive and final diagnosis of Ewing Sarcoma was made. Considering the rarity of this unusual site, we report a case of primary Ewing Sarcoma arising in the sphenoid bone with erosion of adjacent bones and intra-cranial extension.
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Affiliation(s)
- Guddi Rani Singh
- Senior Resident, Department of Pathology, Indira Gandhi Institute of Medical Sciences , Patna, Bihar, India
| | - Vijayanand Choudhary
- Additional Professor, Department of Pathology, Indira Gandhi Institute of Medical Sciences , Patna, Bihar, India
| | - Rawi Agrawal
- Senior Resident, Department of Pathology, Indira Gandhi Institute of Medical Sciences , Patna, Bihar, India
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