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Mannelli G, Bassani S, Cosi G, Fermi M, Gazzini L, Liberale C, Mazzetti L, Parrinello G, Saibene AM, Molteni G, Comini LV. Global frequency and distribution of head and neck sarcomas in adulthood: a systematic review. Eur Arch Otorhinolaryngol 2024; 281:2553-2567. [PMID: 38381151 DOI: 10.1007/s00405-024-08477-4] [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: 09/26/2023] [Accepted: 01/12/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE Head and neck sarcomas (HNS) constitute a rare and heterogeneous cancer entity. Management remains a challenge due their rarity and different biological behaviour among tens of subtypes. This systematic review aimed to describe HNS global frequency and distribution in adulthood. METHODS A systematic review was performed using PICOTS search strategies for qualitative question and it was written in accordance with PRISMA 2020 Statement. 70,653 publications were identified, and 15 variables were evaluated for a total of 2428 patients. RESULTS We identified 47 studies from 21 different countries from 5 different continents. Most of studies (83.3%) were performed in single institutions and America and Asia overruled for number of papers included (21 and 10, respectivelly). Osteosarcoma was more frequent, followed by chondrosarcoma, angiosarcoma and malignant fibrous histiocytoma. Early stage accounted for almost 80% of cases; advanced stage prevailed in developing countries. 1783 patients (90.1%) underwent surgery and 780 (39.4%) had adjuvant therapy. 50.8% of patients experienced tumour recurrence and the lowest mortality rate was reported in Europe (29.9%). CONCLUSIONS HNS holds a relative poor prognosis possibly explained by the heterogeneity of the disease. Treatment of HNS has shown to be highly diverse among different countries, underlining the importance of uniformed treatment guidelines to achieve better patient management and to improve survival outcomes.
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Affiliation(s)
- Giuditta Mannelli
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Sara Bassani
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Unit of Otorhinolaryngology, Head and Neck Department, University of Verona, Verona, Italy
| | - Ginevra Cosi
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Matteo Fermi
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Luca Gazzini
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Otolaryngology-Head and Neck Surgery, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medical Private University (PMU), Bolzano, Italy
| | - Carlotta Liberale
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Unit of Otorhinolaryngology, Head and Neck Department, University of Verona, Verona, Italy
| | - Luca Mazzetti
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giampiero Parrinello
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Department of Otolaryngology-Head and Neck Surgery, IRCCS San Martino Polyclinc Hospital, Genoa, Italy
| | - Alberto Maria Saibene
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otolaryngology Department, Department of Health Sciences, Santi Paolo e Carlo Hospital, Università Degli Studi di Milano, Milan, Italy
| | - Gabriele Molteni
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Lara Valentina Comini
- Young Confederation of European ORL-HNS, Y-CEORL-HNS, Vienna, Austria.
- Head and Neck Oncology, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale, 142-KM 3.95, 10060, Candiolo, TO, Italy.
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2
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Warren D, Koch C, Parsons MS, Pérez-Carrillo GJG, Eldaya RW. Head and Neck Sarcoma Tumor Board Survival Guide for Neuroradiologists: Imaging Findings, History, and Pathology. Curr Probl Diagn Radiol 2023; 52:275-288. [PMID: 36792427 DOI: 10.1067/j.cpradiol.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/12/2023] [Accepted: 01/18/2023] [Indexed: 01/28/2023]
Abstract
Sarcomas of the head and neck carry a poor prognosis as diagnosis is often delayed until a late stage of the disease. Accordingly, it is essential to be familiar with the clinical and imaging features of sarcomas to suggest an appropriate differential diagnosis for collaborating surgeons and pathologists. However, as there are only 1000-1500 cases in the United States annually, many radiologists lack experience with pertinent imaging findings of sarcoma and lack knowledge of both treatment and necessary follow-up. In this review, a brief discussion of WHO definitions and histopathology is included to decode information provided by pathologists. Finally, staging and treatments are illuminated to aid the radiologist with initial imaging staging and follow-up care. This review aims to increase the comprehensive knowledge of a neuroradiologist and further their value to the multidisciplinary tumor board.
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Affiliation(s)
- Daniel Warren
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO.
| | - Cameron Koch
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO
| | - Matthew S Parsons
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO
| | | | - Rami W Eldaya
- Neuroradiology Section, Mallinckrodt Institute of Radiology, St. Louis, MO
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3
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Desai S, Choudhury J, Varghese K, Kapoor T. Primary Osseous Low-grade Myxofibrosarcoma of Metatarsal Masquerading as Enchondroma: A Case Report. J Orthop Case Rep 2022; 12:35-39. [PMID: 36660161 PMCID: PMC9826560 DOI: 10.13107/jocr.2022.v12.i05.2806] [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: 10/09/2021] [Revised: 12/13/2021] [Indexed: 01/22/2023] Open
Abstract
Introduction Low-grade myxofibrosarcoma (LGMFS) is a neoplasm of soft tissues. According to the World Health Organization, LGMFS is a malignant myofibroblastic tumor arising from deep soft tissues with potential for recurrence and late metastatic spread. The incidence estimates are 0.18/million, accounting for 0.6% of all soft-tissue sarcomas. It can directly invade the bone and metastasize to bone; however, primary osseous low-grade myxofibrosarcoma is a rare entity. Thus, recognizing atypical presentations of uncommon neoplasms are a pertinent skill for the radiologist due to significant implications for management. Case Report A 40-year-old male with complaints of midfoot pain was referred to radiology department for imaging. Radiographs of the foot showed a lytic mildly expansile lesion in the first metacarpal with wide zone of transition and no sclerotic margin or matrix calcification. Magnetic resource imaging (MRI) and computed tomography (CT) examination demonstrated well defined lobulated lesion which appeared heterogeneously hyperintense on T2W images with cortical breach, extraosseous soft-tissue component, and early rapid progressive enhancement. The radiological diagnosis of enchondroma with pathological fracture was considered. Atypical findings of early progressive enhancement and extraosseous soft-tissue component were, however, incongruous with enchondroma and possibility of an aggressive/malignant etiology was also considered. Hence, the lesion was biopsied and diagnosis of LGMFS was made and subsequently confirmed on excised specimen. Follow-up CT scan post 6 months of surgical resection demonstrated no recurrence. Conclusion Primary osseous LGMFS is a rare entity and radiologically mimics enchondromas. Both LGMFS and enchondromas show T2W hyperintensity. MRI features that distinguish LGMFS from enchondroma include low apparent diffusion coefficient values and slow progressive enhancement in dynamic contrast-enhanced MRI.
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Affiliation(s)
- Sanjay Desai
- Department of Radiodiagnosis, Deenanath Mangeshkar Hospital, Eradhwane, Pune, Maharashtra, India,Address of Correspondence: Dr. Sanjay Desai, Consultant Musculoskeletal Radiologist, Deenanath Mangeshkar Hospital, Eradhwane, Pune - 411 004, Maharashtra, India. E-mail:
| | - Jayeta Choudhury
- Department of Radiodiagnosis, Deenanath Mangeshkar Hospital, Eradhwane, Pune, Maharashtra, India
| | - Kevin Varghese
- Department of Radiodiagnosis, Deenanath Mangeshkar Hospital, Eradhwane, Pune, Maharashtra, India
| | - Tushar Kapoor
- Department of Radiodiagnosis, Deenanath Mangeshkar Hospital, Eradhwane, Pune, Maharashtra, India
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4
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Rodriguez JD, Selleck AM, Abdel Razek AAK, Huang BY. Update on MR Imaging of Soft Tissue Tumors of Head and Neck. Magn Reson Imaging Clin N Am 2021; 30:151-198. [PMID: 34802577 DOI: 10.1016/j.mric.2021.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article reviews soft tissue tumors of the head and neck following the 2020 revision of WHO Classification of Soft Tissue and Bone Tumours. Common soft tissue tumors in the head and neck and tumors are discussed, along with newly added entities to the classification system. Salient clinical and imaging features that may allow for improved diagnostic accuracy or to narrow the imaging differential diagnosis are covered. Advanced imaging techniques are discussed, with a focus on diffusion-weighted and dynamic contrast imaging and their potential to help characterize soft tissue tumors and aid in distinguishing malignant from benign tumors.
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Affiliation(s)
- Justin D Rodriguez
- Department of Radiology, Duke University, 2301 Erwin Rd, Durham, NC 27705, USA
| | - A Morgan Selleck
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, 170 Manning Drive, CB 7070, Physicians Office Building, Rm G190A, Chapel Hill, NC 27599, USA
| | | | - Benjamin Y Huang
- Department of Radiology, UNC School of Medicine, 101 Manning Drive, CB#7510, Chapel Hill, NC 27599, USA.
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5
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Kaur S, Lalam R, Cassar-Pullicino V, Tyrrell P, Singh J. Neoplastic Elbow Diseases and Mimickers. Semin Musculoskelet Radiol 2021; 25:600-616. [PMID: 34706390 DOI: 10.1055/s-0041-1735608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Tumors around the elbow are infrequent, and delayed diagnosis is a common theme because of the low incidence and lack of familiarity. However, just like any other site, the radiologic work-up of musculoskeletal tumors around the elbow remains the same, with plain films the first investigation in a patient with a suspected bone tumor and ultrasound the first modality to evaluate a soft tissue lump. The management of both bone and soft tissue tumors around the elbow is unique because of a large number of important structures in an anatomically confined space and little normal tissue to spare without severely compromising the joint's function. Many benign nonneoplastic entities can mimic bone and soft tissue tumors on imaging. It is important to keep the characteristic imaging appearance in mind while formulating a differential diagnosis to avoid an unnecessary additional work-up. This article reviews the most common benign and malignant bone and soft tissue tumors around the elbow, mimickers, imaging features, and current therapeutic concepts.
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Affiliation(s)
- Simranjeet Kaur
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, United Kingdom
| | - Radhesh Lalam
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, United Kingdom
| | - Victor Cassar-Pullicino
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, United Kingdom
| | - Prudencia Tyrrell
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, United Kingdom
| | - Jaspreet Singh
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, United Kingdom
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6
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Goel K, Slipak A, Ercolano L, Silverman JF, Tang BT. Primary Osseous Low-Grade Myxofibrosarcoma of Clavicle Presenting With Multiple Skeletal Metastases. Cureus 2020; 12:e10170. [PMID: 33029450 PMCID: PMC7529489 DOI: 10.7759/cureus.10170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Myxofibrosarcoma is a soft tissue neoplasm that usually affects the extremities of the elderly. It usually presents as a slow-growing painless mass that can metastasize to the lung and bone. However, the reported incidence of primary osseous myxofibrosarcoma is very low. Moreover, the metastatic pattern of these bone tumors is largely unknown. We describe a unique case of a young Caucasian male with symptomatic low-grade myxofibrosarcoma arising in the left clavicle, who presented with multiple bone metastases.
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Affiliation(s)
- Kanika Goel
- Department of Pathology, Allegheny Health Network, Pittsburgh, USA
| | - Alan Slipak
- Department of Orthopedics, Allegheny Health Network, Pittsburgh, USA
| | - Lisa Ercolano
- Department of Orthopedics, Allegheny Health Network, Pittsburgh, USA
| | - Jan F Silverman
- Department of Pathology, University of North Carolina, Chapel Hill, USA
| | - Bang T Tang
- Department of Pathology, Allegheny Health Network, Pittsburgh, USA
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7
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Benites BM, Miranda-Silva W, Fonseca FP, Oliveira CRGCMD, Fregnani ER. Undifferentiated pleomorphic sarcoma of the mandible. J Korean Assoc Oral Maxillofac Surg 2020; 46:282-287. [PMID: 32855376 PMCID: PMC7469968 DOI: 10.5125/jkaoms.2020.46.4.282] [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: 07/28/2018] [Revised: 12/01/2018] [Accepted: 12/05/2018] [Indexed: 11/07/2022] Open
Abstract
Undifferentiated pleomorphic sarcoma (UPS) is a high-grade neoplasm that is usually located in the extremities and retroperitoneum. In the past, UPS was considered the most common soft tissue sarcoma in adults; due to improvements in diagnostic techniques, most cases have been reclassified as other lineage-specific tumors. Gnathic bones are rarely affected, and the clinicopathological characteristics of this neoplasm when diagnosed in the jaw remain to be better described. In this report, we present a rare case of mandibular UPS affecting an 88-year-old female who demonstrated a painful swelling on the right side of the mandible that was accompanied by a pathological fracture. Microscopic examination revealed a pleomorphic spindle-cell neoplasm with mitotic figures and necrosis. The patient underwent surgery and adjuvant radiotherapy but experienced metastasis after 12 months of follow-up and died. Diagnosis of UPS is challenging, and oral pathologists must be aware of this entity when dealing with aggressive undifferentiated neoplasms.
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Affiliation(s)
| | | | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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8
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Zhurakivska K, Troiano G, Montella M, Lo Muzio L, Fiorillo L, Cervino G, Cicciù M, D’Amico C, Rullo R, Laino G, Di Stasio D, Laino L. Oral Health and Molecular Aspects of Malignant Fibrous Histiocytoma Patients: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1426. [PMID: 32102165 PMCID: PMC7068479 DOI: 10.3390/ijerph17041426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/16/2022]
Abstract
Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in adults. It occurs only occasionally in oral soft tissues, and knowledge about its characteristics is based on a limited number of cases reported in the literature. Malignant fibrous histiocytoma belongs to the group of soft tissue sarcomas and makes up less than 10% of soft tissue sarcomas. For therapeutic purposes, complete exeresis of the lesion (macroscopic and microscopic) is performed because they have frequent recurrences. As for complementary therapy in addition to surgery, neither radiotherapy nor chemotherapy have been shown to reduce the risk of death related to the disease. Often patients complain of a swelling that grows in a short period of time. It is quite common for patients to report trauma in the area, which is not the cause, but rather the event that allows diagnosis. The mass usually does not cause pain unless it compresses an adjacent nerve structure. The aim of this study is to systematically review the scientific literature in order to identify the most recent studies concerning malignant fibrous histiocytomas localized in oral soft tissues and report their main data. The main outcomes of this study concern the immunohistochemical, molecular, and clinical aspects of this pathology. A systematic review of articles in the electronic databases pubmed, Scopus, and Web of Science was performed. After the selection process, 11 studies met the inclusion criteria and were included in the review. The mean age of the patients was 50.8 years old. The lesions affected various parts of the oral cavity, showing predominantly storiform-pleomorphic patterns. All cases except one were treated with surgical resection and radiation therapy. Although some data emerged from this review, they remain limited to a few case reports. Further studies are necessary in order to standardize the approach to patients affected by oral malignant fibrous histiocytoma (MFH).
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Affiliation(s)
- Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (K.Z.); (G.T.); (L.L.M.)
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (K.Z.); (G.T.); (L.L.M.)
| | - Marco Montella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, 80100 Naples, Italy; (M.M.); (R.R.); (G.L.); (D.D.S.); (L.L.)
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (K.Z.); (G.T.); (L.L.M.)
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Policlinico G. Martino, Via Consolare Valeria, 98100 Messina ME, Italy; (G.C.); (M.C.); (C.D.)
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Policlinico G. Martino, Via Consolare Valeria, 98100 Messina ME, Italy; (G.C.); (M.C.); (C.D.)
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Policlinico G. Martino, Via Consolare Valeria, 98100 Messina ME, Italy; (G.C.); (M.C.); (C.D.)
| | - Cesare D’Amico
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Policlinico G. Martino, Via Consolare Valeria, 98100 Messina ME, Italy; (G.C.); (M.C.); (C.D.)
| | - Rosario Rullo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, 80100 Naples, Italy; (M.M.); (R.R.); (G.L.); (D.D.S.); (L.L.)
| | - Gregorio Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, 80100 Naples, Italy; (M.M.); (R.R.); (G.L.); (D.D.S.); (L.L.)
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, 80100 Naples, Italy; (M.M.); (R.R.); (G.L.); (D.D.S.); (L.L.)
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, 80100 Naples, Italy; (M.M.); (R.R.); (G.L.); (D.D.S.); (L.L.)
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9
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Sessa M, Tonni D, Zangrandi A, Oscar Redaelli de Zinis L, Cuda D. Management of undifferentiated high-grade pleomorphic sarcoma of parotid region in elderly women. Clin Case Rep 2019; 7:537-541. [PMID: 30899489 PMCID: PMC6406222 DOI: 10.1002/ccr3.1951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 11/11/2018] [Accepted: 11/12/2018] [Indexed: 11/21/2022] Open
Abstract
Undifferentiated high-grade pleomorphic sarcoma is a slow-growing tumor rarely localized in the head and neck region. The treatment of UHPS should be based on large surgical resections in free margins associated with neck dissection. Postoperative radiotherapy improves local control of the disease and the prognosis quod vitam.
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Affiliation(s)
- Michele Sessa
- Department of OtorhinolaryngologyG. da Saliceto HospitalPiacenzaItaly
| | - Daniela Tonni
- Department of Pediatric Otolaryngology Head Neck SurgeryChildren Hospital “ASST Spedali Civili”BresciaItaly
| | - Adriano Zangrandi
- Department of Oncology and HematologyG. da Saliceto HospitalPiacenzaItaly
| | | | - Domenico Cuda
- Department of OtorhinolaryngologyG. da Saliceto HospitalPiacenzaItaly
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Head and Neck Sarcomas: A Review of Clinical and Imaging Findings Based on the 2013 World Health Organization Classification. AJR Am J Roentgenol 2018; 212:644-654. [PMID: 30589383 DOI: 10.2214/ajr.18.19894] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Head and neck sarcomas are a complex, heterogeneous group of tumors that present a diagnostic challenge to radiologists because they have many overlapping imaging features. The purpose of this article is to review the imaging and clinical features and highlight distinguishing features of head and neck sarcomas. CONCLUSION An understanding of characteristic imaging and clinical features of head and neck sarcomas is important for the radiologist to narrow the differential diagnosis and help guide management.
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11
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Sarode SC, Sarode GS, Ingale Y, Ingale M, Raj AT, Patil S. Malignant fibrous histiocytoma of the mandible - A case report and review of published case reports. J Oral Biol Craniofac Res 2018; 9:221-225. [PMID: 31211040 DOI: 10.1016/j.jobcr.2018.04.004] [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: 03/07/2018] [Accepted: 04/12/2018] [Indexed: 10/17/2022] Open
Abstract
The natural history of malignant fibrous histiocytoma (MFH) is still heavily debated. It's anonymous natural history is precisely denoted by its new adapted terminology 'undifferentiated pleomorphic sarcoma (UPS)'. Thus to diagnose a lesion as UPS, it is vital to correlate its histopathological features along with its immunohistochemical (IHC) expressions to confirm the tumor cell lineage. MFH is extremely rare in mandible with the literature search in PubMed database revealing only 13 case reports of MFH involving the mandible. Among these, only 7 case reports provide IHC details of the case. Without IHC data it is not possible to determine the accuracy of the diagnosis in the remaining 6 cases. Here we report an additional 8th case of MFH involving the ramus and angle of the mandible. Histopathology revealed proliferating malignant spindle cells interspersed with histiocyte-like cells. The tumor cells were strongly positive for vimentin and CD68 and were negative for S-100, epithelial membrane antigen (EMA) and cytokeratin (CK). The diagnosis was made by correlating the histopathological findings with the IHC profile. The report also provides the data (clinical, radiographic, histopathological, immunohistochemical features and treatment details) extracted from the 7 confirmed MFH case reports involving the mandible.
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Affiliation(s)
- Sachin C Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune - 18, Maharashtra, India
| | - Gargi S Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune - 18, Maharashtra, India
| | - Yashwant Ingale
- Department of Dentistry, Yashwantrao Chavan Memorial Hospital, Sant-Tukaram Nagar, Pimpri, Pune 411018, MH, India
| | - Manjusha Ingale
- Department of Oral Medicine and Radiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune - 18, Maharashtra, India
| | - A Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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12
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Zhu Y, Hao D, Tang X, Sun L. Undifferentiated high-grade pleomorphic sarcoma of ethmoid sinus: a case report and literature review. Braz J Otorhinolaryngol 2017. [PMID: 28629789 PMCID: PMC9449229 DOI: 10.1016/j.bjorl.2017.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Yupeng Zhu
- Affiliated Hospital of Qingdao University, Department of Radiology, Qingdao, China
| | - Dapeng Hao
- Affiliated Hospital of Qingdao University, Department of Radiology, Qingdao, China.
| | - Xiaoyan Tang
- Affiliated Hospital of Qingdao University, Department of Radiology, Qingdao, China
| | - Lei Sun
- Affiliated Hospital of Qingdao University, Department of Radiology, Qingdao, China
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13
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Skeletal muscle metastases on magnetic resonance imaging: analysis of 31 cases. Contemp Oncol (Pozn) 2016; 20:242-50. [PMID: 27647989 PMCID: PMC5013688 DOI: 10.5114/wo.2016.61568] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 11/19/2014] [Indexed: 12/21/2022] Open
Abstract
Aim of the study To investigate the magnetic resonance imaging (MRI) features of skeletal muscle metastases (SMM). Material and methods The records of 31 patients with proven SMM were retrospectively reviewed. Clinical history, type of primary malignancy, location of metastases, and MRI features of SMM were evaluated. Based on MRI findings, SMM were divided into three MRI types. The correlation between MRI types with ages and pathology category, between MRI types of SMM and ages, as well as MRI types of SMM and pathology category were analysed with Spearman's rho. Results The most common primary tumour was genital tumour (25.8%) and bronchial carcinoma (19.4%), and the most common cell type was adenocarcinoma (58.1%). SMM were located in the iliopsoas muscle (26.3%), paravertebral muscles (21.1%), and upper extremity muscles (18.4%). MRI features: (1) Type-I localised lesions (12.90%), round-like mass limited to local regions with heterogeneous iso-signal intensity in T1WI and heterogeneous hyper-intensity in T2WI; (2) Type-II diffuse lesions without bone destruction (35.48%), abnormal diffuse swelling of the muscle with irregular boundaries and slightly hypo- to iso-intensity in T1WI and hyper-intensity in T2WI; and (3) Type-III diffuse lesions with bone destruction (51.61%), distinct irregular lump with iso-intensity in T1WI and heterogeneous hyper-intensity in T2WI with adjacent bone invasion. There was positive correlation between MRI types and ages (r = 0.431, p < 0.05). There were no significant differences of MRI types with pathology category (p > 0.05). Conclusions SMM features on MRI can be broadly used to classify lesions, which is beneficial for SMM diagnosis.
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Rai DV, Guttal KS, Patil PB, Burde KN, Joshi S. Undifferentiated pleomorphic sarcoma of the left parotid gland: a case report. Oral Radiol 2016. [DOI: 10.1007/s11282-016-0246-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Soft-Tissue Sarcomas: An Update for Radiologists Based on the Revised 2013 World Health Organization Classification. AJR Am J Roentgenol 2016; 206:924-32. [PMID: 26998884 DOI: 10.2214/ajr.15.15498] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Soft-tissue sarcomas are a diverse group of malignancies, and our rapidly improving understanding of their molecular pathogenesis and treatment is leading to better clinical outcomes. The revised 2013 World Health Organization (WHO) classification of soft-tissue sarcomas introduced several important changes. We provide a comprehensive overview of the relevant changes for radiologists. CONCLUSION Rapid advances in the understanding of the pathogenesis and molecular biology of soft-tissue sarcomas led to major revisions in the 2013 WHO classification. To provide optimal multidisciplinary patient care, radiologists must remain up-to-date with the latest developments in the field of soft-tissue sarcomas to best correlate the histologic and imaging features of the various types of tumors and understand the unique patterns of treatment response and disease recurrence.
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16
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Li J, Geng ZJ, Lv XF, Zhang XK, Xie CM. Computed tomography and magnetic resonance imaging findings of malignant fibrous histiocytoma of the head and neck. Mol Clin Oncol 2016; 4:888-892. [PMID: 27123302 DOI: 10.3892/mco.2016.811] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 02/25/2016] [Indexed: 01/30/2023] Open
Abstract
The aim of this study was to analyze the imaging findings of 15 cases of malignant fibrous histiocytoma (MFH) of the head and neck, in order to better understand the tumor characteristics based on computed tomography (CT) and magnetic resonance imaging (MRI). CT (n=11) and MRI (n=4) images from 15 patients with histologically diagnosed MFH of the head and neck were retrospectively analyzed. The imaging characteristics were analyzed and compared among different histological subtypes. The lesions were primarily located in the maxillary sinus in 5 patients, the ethmoid sinus in 1 patient, the infratemporal fossa in 2 patients, the neck in 4 patients, the left mandible in 1 patient, the gingiva in 1 patient and the epiglottis in 1 patient. A total of 4 cases were associated with radiotherapy. All the lesions were ill-defined, ranging in size from 2.1 to 5.1 cm in the largest diameter. Bone fractures were evident in 9 cases. The attenuation, signal and enhancement patterns varied, although inflammatory MFH exhibited prolonged enhancement in dual-phase enhanced CT scans. MFH of the head and neck is rare but may be associated with radiotherapy. Although the imaging manifestations of MFH are various and non-specific, inflammatory MFH exhibits prolonged enhancement on dual-phase enhanced CT scans.
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Affiliation(s)
- Jing Li
- Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong 510060, P.R. China; Department of Medical Imaging, Cancer Center, Sun Yat-Sen University, Guangzhou, Guangdong 510060, P.R. China
| | - Zhi-Jun Geng
- Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong 510060, P.R. China; Department of Medical Imaging, Cancer Center, Sun Yat-Sen University, Guangzhou, Guangdong 510060, P.R. China
| | - Xiao-Fei Lv
- Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong 510060, P.R. China; Department of Medical Imaging, Cancer Center, Sun Yat-Sen University, Guangzhou, Guangdong 510060, P.R. China
| | - Xin-Ke Zhang
- Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong 510060, P.R. China; Department of Pathology, Cancer Center, Sun Yat-Sen University, Guangzhou, Guangdong 510060, P.R. China
| | - Chuan-Miao Xie
- Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-Sen University, Guangzhou, Guangdong 510060, P.R. China; Department of Medical Imaging, Cancer Center, Sun Yat-Sen University, Guangzhou, Guangdong 510060, P.R. China
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Kim SH, Kim MJ, Lee BJ, Kim JH. Sinonasal Undifferentiated Pleomorphic Sarcoma in Five Patient Cases. JOURNAL OF RHINOLOGY 2016. [DOI: 10.18787/jr.2016.23.2.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Sung-Hee Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Joo Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bong-Jae Lee
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Heui Kim
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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18
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Malignant fibrous histiocytoma of maxillary sinus- a diagnostic challenge. Indian J Surg Oncol 2015; 6:259-62. [PMID: 27217674 DOI: 10.1007/s13193-015-0384-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 02/06/2015] [Indexed: 10/24/2022] Open
Abstract
Malignant fibrous histiocytoma (MFH) is a malignant mesenchymal tumor uncommonly seen in head and neck region and even rarer in maxillary sinus with less than thirty cases reported in literature. Microscopic diagnosis at this rare site may be challenging because of the spectrum of features, which frequently overlap with other benign and malignant tumors. We herein report a case of malignant fibrous histiocytoma of the maxillary sinus in a 40-year-old man who presented with epistaxis. The initial biopsy appeared benign whereas histopathology of wide surgical excision was consistent with MFH. In view of the deep location, the diagnosis may be missed on a small biopsy, which can appear deceptive leading to diagnostic errors. This case report highlights the histopathological difficulties and pitfalls of this tumor at this rare site.
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Shamim T. The Spindle Cell Neoplasms of the Oral Cavity. IRANIAN JOURNAL OF PATHOLOGY 2015; 10:175-184. [PMID: 26351482 PMCID: PMC4539774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 06/27/2014] [Indexed: 06/05/2023]
Abstract
Spindle cell neoplasms are defined as neoplasms that consist of spindle-shaped cells in the histopathology. Spindle cell neoplasms can affect the oral cavity. In the oral cavity, the origin of the spindle cell neoplasms may be traced to epithelial, mesenchymal and odontogenic components. This article aims to review the spindle cell neoplasms of the oral cavity with emphasis on histopathology.
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Affiliation(s)
- Thorakkal Shamim
- Dept. of Dentistry, Oral Pathology and Microbiology, Government Taluk Head Quarters Hospital, Malappuram, India
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20
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De Amorim Bernstein K, Delaney TF. Role of radiation therapy for non-extremity soft tissue sarcomas. J Surg Oncol 2014; 111:604-14. [PMID: 25556548 DOI: 10.1002/jso.23863] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 11/15/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND Negative surgical margins are uncommon for non-extremity soft tissue sarcomas. Radiation therapy is usually recommended to improve local control; however, appropriate RT dosing is challenging due to nearby dose-limiting normal structures. MATERIAL AND METHODS Comprehensive literature search using PubMed (March 2014). RESULTS Data suggest radiation therapy is an important modality in maximizing local tumor control in non-extremity sarcomas. CONCLUSION The literature supports the use of RT to improve local control for non-extremity soft tissue sarcomas.
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21
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Kim CH, Jang JW, Kim MY, Kim YH, Kim HG, Kim JH. Undifferentiated Pleomorphic Sarcoma in Mandible. Maxillofac Plast Reconstr Surg 2014; 36:303-7. [PMID: 27489851 PMCID: PMC4283541 DOI: 10.14402/jkamprs.2014.36.6.303] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 10/01/2014] [Accepted: 11/04/2014] [Indexed: 11/28/2022] Open
Abstract
Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma, occurs commonly in the soft tissues in adult, but is rare in the maxillofacial region. It consists of undifferentiated mesenchymal tumor cells resembling histiocytes and fibroblasts. The purpose of this article is to report a case of UPS in the mandible. A 44-year-old patient presented with a painful growing mass in the mandible of two months’ duration. Computed tomography and positron emission tomography-computed tomography revealed an ill-defined heterogenous, hypermetabolic mass about 4 cm in size in the left mandible invading adjacent soft tissues. A left mandiblulectomy and reconstruction with a fibular free flap were performed. Immunohistochemical study gave a diagnosis of UPS. The patient was referred for adjuvant chemotherapy after surgical removal of the tumor.
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Affiliation(s)
- Chul-Hwan Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University
| | - Jong-Won Jang
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University
| | - Moon-Young Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University
| | - Yong-Hwan Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University
| | - Hang-Gul Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University
| | - Joo-Hwan Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University
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22
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Li W, Li D, Zhu X, Lu S, He C, Yang Q. Low-grade myxofibrosarcoma following a metal implantation in femur: a case report. Diagn Pathol 2014; 9:6. [PMID: 24444015 PMCID: PMC3926977 DOI: 10.1186/1746-1596-9-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 12/27/2013] [Indexed: 12/15/2022] Open
Abstract
UNLABELLED Myxofibrosarcoma is a myxoid variant of malignant fibrous histiocytoma that most commonly involves the extremities of elderly people. However, a primary myxofibrosarcoma with bone invasion in young adults is extremely rare. Herein, we report the case of a 31-year-old male with a gradually enlarging left thigh mass, who had a history of left femur fracture and received an open reduction and internal fixation with titanium alloy plates and screws 33 months previously. Imaging investigations revealed an irregularly shaped soft tissue mass around the left femur shaft and a partial bone defect in the middle one-third of the left femur. Pathological examination of the resected specimen showed a multi-nodular appearance, abundant myxoid matrix and elongated curvilinear capillaries. Immunohistochemical studies revealed that the tumor cells was positive for VIM and MDM2, and was negative for CK, MSA, SMA, DES, S-100 and CD34. Labeling index of Ki-67 was 25%. Based on the morphological finding and immunostaining, it was diagnosed as a low-grade myxofibrosarcoma. The clinical and imaging examinations did not reveal the evidence of a primary cancer elsewhere, and the patient had no personal or family history of malignancy. To our knowledge, this is the first case of a primary myxofibrosarcoma developed following a fracture and metal implantation in young adults. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1745984882113605.
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Affiliation(s)
| | - Dan Li
- Department of Pathology, Gannan Medical University, No, 1, Yixueyuan Road, Ganzhou, Jiangxi 341000, China.
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23
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Vuity D, Bogdan S, Csurgay K, Sapi Z, Nemeth Z. Malignant fibrous histiocytoma/undifferentiated high-grade pleomorphic sarcoma of the maxillary sinus: report of a case and review of the literature. Pathol Oncol Res 2013; 19:605-9. [PMID: 23812657 DOI: 10.1007/s12253-013-9640-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 04/11/2013] [Indexed: 11/24/2022]
Abstract
Malignant fibrous histiocytoma (MFH) also known as undifferentiated high-grade pleomorphic sarcoma (UHPS) is a soft tissue sarcoma, composed of undifferentiated mesenchymal tumors possessed fibrohistiocytic morphology without definite true histiocytic differentiation. Head and neck localization is very rare, showing an incidence ranging from 4 % to 10 % in different series of investigations. The most frequent involved sites in UHPS are the neck and parotid, followed by the scalp, face, anterior skull base and orbit. Upper aerodigestive tract, lateral skull base and ear are rare locations. The incidence of the lymphatic metastases is also rare. The aim of this article is to report a case of UHPS in the maxillary sinus with palatal, orbital and ethmoidal involvement, with lymphatic metastasis and its surgical treatment. In addition, we review the literature of similar cases of the past 12 years.
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Affiliation(s)
- Drazsen Vuity
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Budapest, Hungary,
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24
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Kurywchak P, Kiefer J, Lenkiewicz E, Evers L, Holley T, Barrett M, Weiss GJ. Elucidating potentially significant genomic regions involved in the initiation and progression of undifferentiated pleomorphic sarcoma. Rare Tumors 2013; 5:e14. [PMID: 23772300 PMCID: PMC3682453 DOI: 10.4081/rt.2013.e14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 11/30/2012] [Indexed: 11/23/2022] Open
Abstract
Sarcomas are cancers that arise in soft tissues or bone and make up a small percentage of malignancies. In an effort to identify potential genetic targets for therapy, this study explores the genomic landscape of a metastatic undifferentiated pleomorphic sarcoma (UPS) with spindle cell morphology. Thick sections (50 µm) of formalin-fixed, paraffin-embedded tissue from a primary, recurrent, and metastatic tumor were collected and processed from a single patient for DNA content-based flow-sorting and analyses. Nuclei of diploid and aneuploid populations were sorted from the malignant tissues and their genomes interrogated with array comparative genomic hybridization. The third sample was highly degraded and did not contain any intact ploidy peaks in our flow assays. A 2.5N aneuploid population was identified in the primary and recurrent sample. We detected a series of shared and unique genomic aberrations in the sorted aneuploid populations. The patterns of aberrations suggest that two similar but independent clonal populations arose during the clinical history of this rare tumor. None of these aberrations were detected in the matching sorted diploid samples. The targeted regions of interest might play a role in UPS and may lead to clinical significance with further investigation.
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Affiliation(s)
- Paul Kurywchak
- Cancer and Cell Biology Division, Translational Genomics Research Institute, Phoenix, AZ
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25
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Abstract
Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare and recently recognized mesenchymal tumor with intermediate malignant potential, most of which arises in the soft tissue of the extremities with obvious specificity on histopathology. Here, we report a case of CT findings of PHAT arising from the posterior neck as a 3.4 × 4 × 5-cm mass in a 35-year-old woman. Precontrast CT showed an ill-defined, inhomogenous and oval-shaped mass. On contrast-enhanced CT, the mass appeared well defined except for a very small part, most of which showed marked and heterogenous enhancement, with a maximum CT value of 161 HU, which was almost identical to that of the vessels.
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26
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Qiubei Z, Cheng L, Yaping X, Shunzhang L, Jingping F. Myxofibrosarcoma of the sinus piriformis: case report and literature review. World J Surg Oncol 2012; 10:245. [PMID: 23152982 PMCID: PMC3534627 DOI: 10.1186/1477-7819-10-245] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 09/21/2012] [Indexed: 01/07/2023] Open
Abstract
Myxofibrosarcoma is a common sarcoma in the extremities of older people, but is rare in the head and neck region. Here, we report the case of a 42-year-old male patient in whom myxofibrosarcoma generated from the sinus piriformis. Histopathologically, the tumor was characterized by spindle cellular proliferation with moderate cellular density in fibromyxoid stroma. Immunohistochemically, the tumor cells showed positive reactivity for vimentin, Ki-67, smooth muscle actin, and CD34, but negative staining for S-100. Based on these results, the tumor was diagnosed as a low-grade myxofibrosarcoma. Resection of the tumor was performed via a transcervical approach. The patient’s postoperative clinical course was uneventful and no local recurrence or distant metastasis has been found so far. The pathology, clinical characteristics, and treatment of myxofibrosarcoma are also reviewed.
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Affiliation(s)
- Zhu Qiubei
- Department of ear, nose and throat, Changzheng Hospital, No 415, Fengyang Road, Shanghai, Huangpu District, 200003, China
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27
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Xu LW, Yu YL, Li GH. Malignant fibrous histiocytoma of the spermatic cord: case report and literature review. J Int Med Res 2012; 40:816-23. [PMID: 22613448 DOI: 10.1177/147323001204000249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This case study reports on a rare case of malignant fibrous histiocytoma arising in the right spermatic cord. An 80-year old male presented with a 2-week history of a right inguinal mass, with mild pain in the same region. Ultrasonography and computed tomography showed a mass arising from the right spermatic cord. A right radical orchiectomy was performed with wide dissection of the mass; the right testicle and epididymis were found not to be grossly involved. The patient had an uneventful postoperative course and recovered well. The patient and his family refused further adjuvant radiotherapy. There was no evidence of recurrence or metastasis during 20 months of regular follow-up. The diagnosis, histological classification, treatment and prognosis of this case are presented, together with a review of the literature.
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Affiliation(s)
- L W Xu
- Department of Urology, Affiliated Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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28
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Mankin HJ, Hornicek FJ, DeLaney TF, Harmon DC, Schiller AL. Pleomorphic spindle cell sarcoma (PSCS) formerly known as malignant fibrous histiocytoma (MFH): a complex malignant soft-tissue tumor. Musculoskelet Surg 2012; 96:171-7. [PMID: 23129168 DOI: 10.1007/s12306-012-0225-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 06/21/2012] [Indexed: 10/27/2022]
Abstract
A presentation defining the nature, characteristics, causation, treatment and outcome of patients with lesions formerly known as malignant fibrous histiocytoma and now as pleomorphic spindle cell sarcoma is clearly a very difficult subject. Many authors do not believe that the tumor exists and instead describe them as forms of fibrosarcomas, fibromyxoid lesions, dedifferentiated chondrosarcomas or even leiomyosarcomas. The reasons for this confusion are presumably related to the fact that the malignant pleomorphic spindle cell sarcoma does not seem to be a distinct type of lesion with specific histologic and genetic characteristics. Instead, the tumor has at least four separate histologic variations and no specific gene signature and in fact does not seem to be either familial or ethnic in presentation. In view of the fact that the tumor was traditionally the most frequently encountered malignant soft-tissue neoplasm, the world of orthopedic oncology is clearly distressed by the problems that these patients have and is joined by the radiation oncologists and chemotherapists in seeking new solutions.
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Affiliation(s)
- H J Mankin
- Department of Orthopaedic Oncology, Massachusetts General Hospital, Boston, MA, USA.
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29
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Clinical Usefulness of Orbital and Facial Time-Resolved Imaging of Contrast KineticS (TRICKS) Magnetic Resonance Angiography. Ophthalmic Plast Reconstr Surg 2012; 28:361-8. [DOI: 10.1097/iop.0b013e318261161e] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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30
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Kim KH, Lee SH, Cha SH, Kim YS, Sung DJ. Malignant fibrous histiocytoma arising from a hydronephrotic kidney: a case report and review of the literature. Clin Imaging 2012; 36:239-42. [PMID: 22542387 DOI: 10.1016/j.clinimag.2011.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 09/14/2011] [Indexed: 10/28/2022]
Abstract
Primary malignant fibrous histiocytoma (MFH) is extremely rare, and MFH arising from a hydronephrotic kidney has not been reported. When MFH originates from a long-standing hydronephrotic kidney, the imaging findings can include nearly invisible renal parenchyma and atrophy of the ureter and renal artery, in addition to the findings attributable to the MFH, and the MFH with hydronephrosis may be confused with a cystic renal cell carcinoma.
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Affiliation(s)
- Ki Hwan Kim
- Department of Radiology, Ansan Hospital, Korea University, College of Medicine, Korea University, Danwon-Gu, Ansan-City, Gyeonggi-Do, Korea
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31
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Razek AA, Huang BY. Soft tissue tumors of the head and neck: imaging-based review of the WHO classification. Radiographics 2012; 31:1923-54. [PMID: 22084180 DOI: 10.1148/rg.317115095] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The World Health Organization (WHO) system for defining and classifying soft tissue tumors is usually applied to lesions that occur in the trunk and extremities, but it also provides an excellent framework for characterizing nonepithelial extraskeletal tumors of the head and neck. Although nonepithelial extraskeletal tumors are in the minority among head and neck lesions, they are by no means rare. The WHO classification system recognizes nine major types based on histologic differentiation: adipocytic, fibroblastic or myofibroblastic, fibrohistiocytic, smooth muscle, skeletal muscle, vascular, pericytic, and chondro-osseous tumors, as well as soft tissue tumors of uncertain differentiation. Tumors of each histologic type may be further subclassified on the basis of their biologic behavior as benign, intermediate (ie, having malignant potential), or malignant. Imaging plays an important role in the noninvasive diagnosis and characterization of nonepithelial soft tissue tumors of the head and neck, providing clues about tumor grade, composition, extent, and involvement of adjacent structures. Although the imaging characteristics of many such tumors are nonspecific, consideration of the clinical history in concert with the imaging findings may help limit the differential diagnosis or even allow reliable diagnosis of some of these tumors.
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Affiliation(s)
- Ahmed Abdel Razek
- Diagnostic Radiology Department, Mansoura Faculty of Medicine, Elgomheryia St, Mansoura, Egypt 35512
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32
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Debnam JM, Guha-Thakurta N, Mahfouz YMM, Garden AS, Benjamin RS, Sturgis EM, Ginsberg LE. Radiation-associated head and neck sarcomas: spectrum of imaging findings. Oral Oncol 2012; 48:155-61. [PMID: 21937260 DOI: 10.1016/j.oraloncology.2011.08.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Accepted: 08/23/2011] [Indexed: 02/03/2023]
Abstract
Sarcomas developing after radiation treatment for primary malignancies of the head and neck are often detected clinically when they are very aggressive. We reviewed the patient demographics and imaging findings in 21 patients with radiation-associated sarcomas (RAS) of the head and neck treated at our institution. Twenty-one RAS of the head and neck were retrospectively reviewed. The lesions were assessed for presence of a soft tissue mass, enhancement pattern, bone destruction, characteristics of tumor matrix, and FDG avidity. The RAS developed 4.5-25 years (mean 12.7 years) after irradiation. On both CT and MRI, all 21 lesions presented with a soft tissue mass. A variable imaging appearance was noted on CT, MR, and PET/CT, most, but not all, demonstrated aggressive features. At a median follow-up time of 19.1 months, 11 of the 21 patients had died from the sarcoma. RAS have variable imaging appearances. While most demonstrate aggressive features, some appear benign, which can lead to misdiagnosis. Head and neck radiologists, surgeons and oncologists who manage patients after radiation treatment should be aware of the wide range of clinical presentations and imaging features of RAS, because failure to diagnose can delay appropriate treatment.
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Affiliation(s)
- J Matthew Debnam
- Department of Diagnostic Radiology, Section of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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Malignant fibrous histiocytoma of the mandible and the infratemporal fossa-A case report. Int J Surg Case Rep 2011; 2:134-7. [PMID: 22096706 DOI: 10.1016/j.ijscr.2011.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Revised: 03/25/2011] [Accepted: 03/27/2011] [Indexed: 11/22/2022] Open
Abstract
Malignant fibrous histiocytoma is a sarcoma which commonly occurs in the soft tissues, joints and tendons of the extremities of adults but its occurrence in the oral and maxillofacial region is very rare. We present a rare case of malignant fibrous histiocytoma of the mandible with recurrence in the infratemporal fossa after surgery and radiotherapy. Patient underwent second surgery and complete tumor excision with minimal loss of function was achieved. Patient survived 8 years after surgery and died of natural cause.
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Norval EJG, Raubenheimer EJ. Myxofibrosarcoma arising in the maxillary sinus: a case report with a review of the ultrastructural findings and differential diagnoses. J Maxillofac Oral Surg 2011. [PMID: 23204750 DOI: 10.1007/s12663-011-0259-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
This is a case report of a patient presenting with a destructive lesion with histologic features of a low grade malignancy in a predominantly myxoid matrix. Various low grade myxoid malignancies were considered in the differential diagnosis of which an overview is presented. A literature review of the ultrastructural findings and possible histogenesis is discussed along with the diagnostic criteria and recent change in the terminology regarding the malignancies previously diagnosed as myxoid malignant fibrous histiocytomas. A final diagnosis of a myxofibrosarcoma was only possible after assessing the immuno-histochemical profile, results of histochemical stains and ultrastructural features of this lesion.
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Affiliation(s)
- Ernst J G Norval
- Department of Diagnostics, Oral and Dental Teaching Hospital, University of the Western Cape, Private Bag X1, Tygerberg, 7505 South Africa
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Sertznig P, Megahed M. [Malignant fibrous histiocytoma]. Hautarzt 2011; 62:327-9. [PMID: 21431446 DOI: 10.1007/s00105-011-2167-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A 62-year-old patient presented with slow-growing blue-red tumor on his left forearm for around two years. A biopsy revealed the tumor was a rare malignant fibrous histiocytoma (MFH). The finger-like extensions of MFH in the fatty tissue are responsible not only for the high local recurrence rate, but also increase the metastatic potential and affect the prognosis. For this reason radical surgery with surgical margins of 2-3 cm is absolutely required. After wide excision, the patient has been alive for years without evidence of local recurrence or distant metastasis.
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Affiliation(s)
- P Sertznig
- Klinik für Dermatologie und Allergologie, RWTH Aachen University, Pauwelsstrasse 30, Aachen, Germany.
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Liu F, Li W, Yao Y, Li G, Yang Y, Dou W, Zhong D, Wang L, Zhu X, Hu H, Zhang J, Wang R, Chen G. A case of McCune-Albright syndrome associated with pituitary GH adenoma: therapeutic process and autopsy. J Pediatr Endocrinol Metab 2011; 24:283-7. [PMID: 21823524 DOI: 10.1515/jpem.2011.178] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND McCune-Albright syndrome (MAS) is a clinical syndrome with low incidence, and its concurrence with pituitary GH adenoma is rare. Little of the history, treatment and outcome has been studied. METHOD Follow-up of a 37-year-old male patient of MAS associated with pituitary GH adenoma was performed continuously recording the disease development and the treatment process until death, after which an autopsy was performed. RESULTS Radiation therapy (RT) efficaciously controlled GH hypersecretion, however, it may have been the cause of the malignant transformation of the dysplastic bone tissue, which eventually caused brain hernia and death; autopsy demonstrated that the cranium had significant thickening (as much as 10 cm), the pathological diagnosis was fibrous dysplasia of bone associated with chondrosarcoma; and undifferentiated chondrosarcoma with malignant fibrous histocytoma subtype in the sellar region; nodular goiter with the thyroid gland, one nodus was pathologically demonstrated as papillary carcinoma. CONCLUSION GH adenoma, present in a patient with MAS, might be cured by RT; but the risk of malignant transformation of the dysplastic bone tissue in the field of irradiation make it controversial. Lessons from the case reported here told us that we should take great caution when recommending RT for patients like this.
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Affiliation(s)
- Fuyi Liu
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hang Zhou 310009, China
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de Bree R, van der Waal I, de Bree E, Leemans CR. Management of adult soft tissue sarcomas of the head and neck. Oral Oncol 2010; 46:786-90. [PMID: 20947413 DOI: 10.1016/j.oraloncology.2010.09.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 09/02/2010] [Accepted: 09/03/2010] [Indexed: 12/25/2022]
Abstract
Adult soft tissue sarcoma of the head and neck are rare and represent a heterogeneous group of tumours of different histological variants. Management of these neoplasms presents a great challenge. Malignant fibrous histiocytoma, fibrosarcoma, angiosarcoma and malignant peripheral nerve sheath tumour are the most frequently found sarcoma types in the head and neck. Although traditional morphological assessment is the foundation of clinical decision making, the role of immunohistochemistry and molecular biology are useful for diagnosis, prognosis and identification of possible targets for molecular therapy. The most frequently involved tumour sites are scalp/face, sinonasal tract/anterior skull base and parotid/neck. The management of soft tissue sarcomas in the head and neck is primarily surgical. Since it is difficult to obtain wide margins during surgical treatment in head and neck sarcomas, because of anatomic constraints, most patients undergo post-operative irradiation. Survival varies from 50 to 80%. Prognostic factors are tumour grade, margin status and tumour size. With further insight into the biology of soft tissue sarcoma, modern imaging techniques and new treatment options, we will most certainly be able to improve clinical outcome in patients with soft tissue sarcoma in the upcoming years.
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Affiliation(s)
- Remco de Bree
- Department of Otolaryngology, Head and Neck Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
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Yanagi Y, Murakami J, Hisatomi M, Katase N, Nagatsuka H, Asaumi JI. A case of malignant fibrous histiocytoma of the maxillary sinus. ACTA ACUST UNITED AC 2010; 109:e99-e104. [DOI: 10.1016/j.tripleo.2009.11.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Accepted: 11/17/2009] [Indexed: 11/28/2022]
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