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Montatore M, Masino F, Muscatella G, Gifuni R, Fascia G, Sciacqua A, Guglielmi G. An aggressive soft-tissue sarcoma of the extremity: A myxofibrosarcoma, grade 3 (FNCLCC system). Radiol Case Rep 2024; 19:2911-2917. [PMID: 38737183 PMCID: PMC11087895 DOI: 10.1016/j.radcr.2024.03.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/28/2024] [Accepted: 03/31/2024] [Indexed: 05/14/2024] Open
Abstract
We report a case of myxofibrosarcoma of the posterior region of the femur, part of the group of soft-tissue sarcomas: a set of rare and heterogeneous tumors with various subtypes and different prognostic. It is characterized by local infiltrative activity and an extremely high rate of local recurrence. A 58-year-old man came to the Radiology Department to examine a voluminous round and expansive formation of the posterior thigh region. The patient stated that the mass had grown suddenly for about 3 months, maybe after a trauma, increasing in volume exponentially and causing him discomfort, embarrassment, and pain. The result of the first diagnostic approach, with the US, was unexpected and suspicious, and the radiologist wanted to do first a CT, and then maybe plan an MRI. The CT revealed an inhomogeneous density formation and in MRI the mass resulted to be compatible, with the radiologic pattern, with the diagnosis of a sarcoma of the soft tissue. The physicians had already alerted the pathological anatomy, as they suspected something malignant. So, some days after the MRI examination, the patient underwent histological sampling, confirming the suspicion: a myxofibrosarcoma (stage III) of the posterior region of the femoral region. The patient started on radio and chemotherapy, which increases survival and in the hope of reducing the size of the mass, and a strict follow-up was posed before doing the surgery.
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Affiliation(s)
- Manuela Montatore
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Federica Masino
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Gianmichele Muscatella
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Rossella Gifuni
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Giacomo Fascia
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Alessio Sciacqua
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
| | - Giuseppe Guglielmi
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, (FG) Italy
- Radiology Unit, “Dimiccoli” Hospital, Viale Ippocrate 15, 70051, Barletta (BT), Italy
- Radiology Unit, “IRCCS Casa Sollievo della Sofferenza” Hospital, Viale Cappuccini 1,71013 San Giovanni Rotondo, (FG) Italy
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Van Tine BA, Ingham MA, Attia S, Meyer CF, Baird JD, Brooks-Asplund E, D'Silva D, Kong R, Mwatha A, O'Keefe K, Weetall M, Spiegel R, Schwartz GK. Phase Ib Study of Unesbulin (PTC596) Plus Dacarbazine for the Treatment of Locally Recurrent, Unresectable or Metastatic, Relapsed or Refractory Leiomyosarcoma. J Clin Oncol 2024; 42:2404-2414. [PMID: 38684039 DOI: 10.1200/jco.23.01684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 12/13/2023] [Accepted: 02/28/2024] [Indexed: 05/02/2024] Open
Abstract
PURPOSE This multicenter, single-arm, open-label, phase Ib study was designed to determine the recommended phase II dose (RP2D) and to evaluate the safety and preliminary efficacy of unesbulin plus dacarbazine (DTIC) in patients with advanced leiomyosarcoma (LMS). PATIENTS AND METHODS Adult subjects with locally advanced, unresectable or metastatic, relapsed or refractory LMS were treated with escalating doses of unesbulin orally twice per week in combination with DTIC 1,000 mg/m2 intravenously (IV) once every 21 days. The time-to-event continual reassessment method was used to determine the RP2D on the basis of dose-limiting toxicities (DLTs) assessed during the first two 21-day treatment cycles. All explored doses of unesbulin (200 mg up to 400 mg) were in combination with DTIC. An expansion cohort was enrolled to evaluate the safety and efficacy of unesbulin at the RP2D. RESULTS Unesbulin 300 mg administered orally twice per week in combination with DTIC 1,000 mg/m2 IV once every 21 days was identified as the RP2D. On the basis of data from 27 subjects who were deemed DLT-evaluable, toxicity was higher in the unesbulin 400 mg group, with three of four subjects (75%) experiencing DLTs versus one of four subjects (25%) in the 200 mg group and three of 19 subjects (15.8%) in the 300 mg group. The most commonly reported DLTs and treatment-related grade 3 and 4 adverse events were thrombocytopenia and neutropenia. At the RP2D, seven subjects who were efficacy evaluable achieved partial response for an objective response rate of 24.1%. CONCLUSION Unesbulin 300 mg twice per week plus DTIC 1,000 mg/m2 once every 21 days was identified as the RP2D, demonstrating a favorable benefit-risk profile in a heavily pretreated population of adults with advanced LMS.
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Affiliation(s)
| | | | | | - Christian F Meyer
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
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Viswanath A, Dales J, Shah V, Levy M. Management of a giant adrenal schwannoma. BMJ Case Rep 2024; 17:e260183. [PMID: 38969390 DOI: 10.1136/bcr-2024-260183] [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] [Indexed: 07/07/2024] Open
Abstract
In this case report, we present a man in his 60s who presented with an incidentally discovered right adrenal mass, which turned out to be an adrenal schwannoma. This is a very rare tumour that originates from Schwann cells and involves the peripheral nerves. The tumour was removed by open adrenalectomy, and this 15-cm adrenal schwannoma is one of the largest reported in the literature, with none >16 cm having ever been reported. This case highlights the importance of keeping an open mind about the cause of an incidentally discovered adrenal mass, which is an increasingly common way for adrenal tumours to present given the increased access to cross-sectional imaging. As well as presenting the case and the pathological basis behind adrenal schwannomas, we include a review of the literature and a general discussion about incidentally discovered adrenal masses.
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Affiliation(s)
- Aditya Viswanath
- Department of Medicine, University of Leicester Medical School, Leicester, UK
| | - Jolyon Dales
- Department of Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Vikas Shah
- Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Miles Levy
- Department of Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, UK
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Özdenoğlu FY, Ödemiş DA, Erciyas SK, Tunçer ŞB, Gültaşlar BK, Salduz A, Büyükkapu S, Olgaç NV, Kebudi R, Yazıcı H. High Expression of miR-218-5p in the Peripheral Blood Stream and Tumor Tissues of Pediatric Patients with Sarcomas. Biochem Genet 2024:10.1007/s10528-024-10873-8. [PMID: 38954213 DOI: 10.1007/s10528-024-10873-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024]
Abstract
Sarcomas are malignant tumors that may metastasize and the course of the disease is highly aggressive in children and young adults. Because of the rare incidence of sarcomas and the heterogeneity of tumors, there is a need for non-invasive diagnostic and prognostic biomarkers in sarcomas. The aim of the study was to investigate the level of miR-218-5p in peripheral blood and tumor tissue samples of Ewing's sarcoma, osteosarcoma, spindle cell sarcoma patients, and healthy controls, and assessed whether the corresponding molecule was a diagnostic and prognostic biomarker. The study was performed patients (n = 22) diagnosed and treated with Ewing's sarcoma and osteosarcoma and in a control group of 22 healthy children who were matched for age, gender, and ethnicity with the patient group. The expression level of miR-218-5p in RNA samples from peripheral blood and tissue samples were analyzed using the RT-PCR and the expression level of miR-218-5p was evaluated by comparison with the levels in patients and healthy controls. The expression level of miR-218-5p was found to be statistically higher (3.33-fold, p = 0.006) in pediatric patients with sarcomas and when the target genes of miR-218-5p were investigated using the bioinformatics tools, the miR-218-5p was found as an important miRNA in cancer. In this study, the miR-218-5p was shown for the first time to have been highly expressed in the peripheral blood and tumor tissue of sarcoma patients. The results suggest that miR-218-5p can be used as a diagnostic and prognostic biomarker in sarcomas and will be evaluated as an important therapeutic target.
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Affiliation(s)
- Fazilet Yıldız Özdenoğlu
- Division of Cancer Genetics, Department of Basic Oncology, Oncology Institute, Istanbul University, 34093, Fatih, Istanbul, Türkiye
- Division of Cancer Genetics, Department of Basic Oncology, Health Sciences Institute, Istanbul University, 34093, Fatih, Istanbul, Türkiye
- Vocational School of Health Service, Medical LaboratortyTechniquies, İstanbul Okan University, Tuzla, Istanbul, Türkiye
| | - Demet Akdeniz Ödemiş
- Division of Cancer Genetics, Department of Basic Oncology, Oncology Institute, Istanbul University, 34093, Fatih, Istanbul, Türkiye
- Turkey Cancer Institute, Health Institutes of Turkey, 34734, Kadıköy, Istanbul, Türkiye
| | - Seda Kılıç Erciyas
- Division of Cancer Genetics, Department of Basic Oncology, Oncology Institute, Istanbul University, 34093, Fatih, Istanbul, Türkiye
| | - Şeref Buğra Tunçer
- Division of Cancer Genetics, Department of Basic Oncology, Oncology Institute, Istanbul University, 34093, Fatih, Istanbul, Türkiye
| | - Büşra Kurt Gültaşlar
- Division of Cancer Genetics, Department of Basic Oncology, Oncology Institute, Istanbul University, 34093, Fatih, Istanbul, Türkiye
| | - Ahmet Salduz
- Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul University, Istanbul, Türkiye
| | - Sema Büyükkapu
- Division of Pediatric Hematology and Oncology, Department of Clinical Oncology, Oncology Institute, Istanbul University, 34093, Fatih, Istanbul, Türkiye
| | - Necat Vakur Olgaç
- Faculty of Dentistry, Department of Oral Pathology, Istanbul University, 34093, Fatih, Istanbul, Türkiye
| | - Rejin Kebudi
- Division of Pediatric Hematology and Oncology, Department of Clinical Oncology, Oncology Institute, Istanbul University, 34093, Fatih, Istanbul, Türkiye
| | - Hülya Yazıcı
- Division of Cancer Genetics, Department of Basic Oncology, Oncology Institute, Istanbul University, 34093, Fatih, Istanbul, Türkiye.
- Istanbul Arel Medical Faculty, Department of Medical Biology and Genetics, Istanbul Arel University, 34010, Zeytinburnu, Istanbul, Türkiye.
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Mohan SL, Dhamija E, Bakhshi S, Malik PS, Rastogi S, Sheragaru Hanumanthappa C, Jain D, Pandey R. Identification of CT Features to Differentiate Pulmonary Sarcoma from Carcinoma. Indian J Radiol Imaging 2024; 34:390-404. [PMID: 38912250 PMCID: PMC11188704 DOI: 10.1055/s-0043-1777834] [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: 06/25/2024] Open
Abstract
Background Primary lung sarcoma (PLS) differs in management protocols and prognosis from the more common primary lung carcinoma (PLC). It becomes imperative to raise a high index of suspicion on radiological and pathological features. Purpose The aim of this study is to highlight the variable imaging appearances of PLS compared with PLC, which impacts radiologic - pathologic correlation. Materials and Methods A retrospective observational study of 68 patients with biopsy-proven lung tumors who underwent baseline imaging at our tertiary care cancer hospital was conducted between January 2018 and March 2022. The patient details and imaging parameters of the mass on contrast-enhanced computed tomography (CECT) were recorded and analyzed for patients with PLS and compared with PLC. Follow-up imaging was available in 9/12 PLS and 52/56 PLC patients. Results Among 12 patients with PLS, 5 patients had synovial sarcoma on histopathology. PLS was seen in patients with a mean age of 40.8 years; the mass showed a mean size of 13.2 cm, lower lobe (75%), parahilar (75%), hilar involvement (41.7%), oval shape (41.7%), circumscribed (25%) or lobulated (75%) margins, lower mean postcontrast attenuation of 57.3 HU, fissural extension (50%), calcification (50%), and no organ metastasis other than to the lung. PLC (56 patients) was seen in the elderly with a mean age of 54.8 years; the mass showed a mean size of 5.7 cm, irregular shape (83.9%), spiculated margins (73.2%), higher mean postcontrast attenuation (77.3 HU), chest wall infiltration (30.4%), and distant metastasis (58.9%) at baseline imaging. A statistically significant difference ( p < 0.05) was seen between sarcoma and carcinoma in the mean age, size, site, shape, margins, postcontrast attenuation, presence of calcifications, fissural extension, and distant metastasis. Conclusion The distinct imaging features of sarcoma help in differentiating it from carcinoma. This can also be used to corroborate with histopathology to achieve concordance and guide clinicians on further approach.
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Affiliation(s)
| | - Ekta Dhamija
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhat Singh Malik
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Rastogi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Deepali Jain
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Rambha Pandey
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
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Merino-Rueda LR, Casas-Ramos P, Honrado-Franco E, Izquierdo-García FM, Ramos-Pascua LR. [Translated article] Comparative study of deep lipomas and atypical lipomatous tumours: Malignancy risk factors. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:T383-T389. [PMID: 38508379 DOI: 10.1016/j.recot.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/17/2023] [Accepted: 01/02/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The diagnostic suspicion of an atypical lipomatous tumour (ALT) is difficult. The aim of this study is to delve into the most controversial diagnostic aspects of the subject. MATERIAL AND METHOD Observational, longitudinal and retrospective study of a series of 96 deep adipose tumours (75 lipomas and 21 TLA) from 2006 to 2016: demographic, clinical, imaging and pathological variables were analysed and compared, as well as other variables related to treatment and oncological outcomes of the patients. A descriptive analysis of the collected variables was performed for the statistical study. To evaluate the potential predictor variables of malignancy, a multivariate logistic regression analysis was performed, including those that were statistically significant in the univariate analysis. RESULTS Older age at diagnosis, lower limb location and larger size were significantly more frequent in ALTs. MRI findings showed no statistically significant differences between the two groups. In multivariate analysis, the same clinical variables were confirmed as predictors of malignancy. In the ROC curve, an optimal cut-off point of 134.0mm was used as a predictor of malignancy. CONCLUSIONS Advanced age, location in the lower limbs and larger size are risk factors for malignancy in the differential diagnosis of deep lipomas and atypical lipomatous tumours. No radiological variable on MRI reached significance as a predictor of malignancy in our series.
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Affiliation(s)
- L R Merino-Rueda
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, Spain; Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario La Paz, Madrid, Spain.
| | - P Casas-Ramos
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de León, León, Spain
| | - E Honrado-Franco
- Servicio de Anatomía Patológica, Hospital Universitario de León, León, Spain
| | | | - L R Ramos-Pascua
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, Spain
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7
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Franza A, Fabbroni C, Pasquali S, Casali PG, Sanfilippo R. New targeted therapies in liposarcoma: state of art and future perspectives. Curr Opin Oncol 2024; 36:291-296. [PMID: 38726840 DOI: 10.1097/cco.0000000000001055] [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: 06/07/2024]
Abstract
PURPOSE OF REVIEW Liposarcomas (LPSs) represent the most common soft tissue sarcoma (STS) subtype, and exhibit distinct clinical molecular features according to histological subgroup. Chemotherapy (ChT), and in particular anthracycline-based schedules, still remains the standard of treatment for all LPS forms. However, given the increasing knowledge gained throughout last years about LPS molecular biology and their genomic profiling, new therapeutic alternatives with targeted drugs are now to be considered. In this review, we will highlight most promising ongoing and published clinical trials regarding targeted therapies in LPSs and provide some insights about future approaches and possible new treatment options for this rare disease. RECENT FINDINGS Among all the explored targets, mouse double minute 2 homolog amplification and CKD4-Rb axis inhibition seem to be the most promising target in well differentiated/dedifferentiated LPS subtype. On the other hand, myxoid LPS is known to have a particular sensitivity for trabectedin, which acts like a targeted drug due to its specific action on cellular DNA. In addition to these, multiple other strategies are now being evaluated in LPSs, including the administration of immune-checkpoint inhibitors (ICIs) and 'new-old' cytotoxic agents, such as cabazitaxel, in a continuously growing scenario. SUMMARY Although preliminary, results of recently published and ongoing examined clinical trials will hopefully be translated in clinical practice in the next future, leading the way to future research in this rare disease.
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Affiliation(s)
- Andrea Franza
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori
| | - Chiara Fabbroni
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori
| | - Sandro Pasquali
- Molecular Pharmacology, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori
| | - Paolo Giovanni Casali
- Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori
- Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy
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Merino-Rueda LR, Casas-Ramos P, Honrado-Franco E, Izquierdo-García FM, Ramos-Pascua LR. Comparative study of deep lipomas and atypical lipomatous tumours: Malignancy risk factors. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:383-389. [PMID: 38199434 DOI: 10.1016/j.recot.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/17/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The diagnostic suspicion of an atypical lipomatous tumour (ALT) is difficult. The aim of this study is to delve into the most controversial diagnostic aspects of the subject. MATERIAL AND METHOD Observational, longitudinal, and retrospective study of a series of 96 deep adipose tumours (75 lipomas and 21 TLA) from 2006 to 2016: demographic, clinical, imaging and pathological variables were analysed and compared, as well as other variables related to treatment and oncological outcomes of the patients. A descriptive analysis of the collected variables was performed for the statistical study. To evaluate the potential predictor variables of malignancy, a multivariate logistic regression analysis was performed, including those that were statistically significant in the univariate analysis. RESULTS Older age at diagnosis, lower limb location and larger size were significantly more frequent in ALTs. MRI findings showed no statistically significant differences between the two groups. In multivariate analysis, the same clinical variables were confirmed as predictors of malignancy. In the ROC curve, an optimal cut-off point of 134.0 mm was used as a predictor of malignancy. CONCLUSIONS Advanced age, location in the lower limbs and larger size are risk factors for malignancy in the differential diagnosis of deep lipomas and atypical lipomatous tumours. No radiological variable on MRI reached significance as a predictor of malignancy in our series.
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Affiliation(s)
- L R Merino-Rueda
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España; Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario La Paz, León, Madrid, España.
| | - P Casas-Ramos
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de León, León, España
| | - E Honrado-Franco
- Servicio de Anatomía Patológica, Hospital Universitario de León, León, España
| | | | - L R Ramos-Pascua
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España
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Mick P, Rohner M, Renkawitz T, Lehner B, Geisbüsch A, Tsitlakidis S, Hariri M, Deisenhofer J, Müller M, Doll J. From Benign Lipoma to G3 Liposarcoma: Contrast-Enhanced Ultrasound Reveals Tumor Microperfusion and Indicates Malignancy. ULTRASOUND IN MEDICINE & BIOLOGY 2024:S0301-5629(24)00234-5. [PMID: 38955624 DOI: 10.1016/j.ultrasmedbio.2024.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/27/2024] [Accepted: 05/31/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE Lipomatous soft tissue tumors (STT), ranging from benign lipomas to malignant liposarcomas, require accurate differentiation for timely treatment. Complementary to MRI, Contrast-enhanced ultrasound (CEUS) is emerging as a promising tool, providing insight into tumor microperfusion in real-time. This study aims to explore the potential of preoperative CEUS in differentiating benign lipomatous tumors from malignant liposarcoma subtypes. METHODS Eighty-seven patients with lipomatous STT scheduled for surgery were enrolled. Clinical and MRI assessments were conducted to obtain general tumor characteristics. CEUS was used for a standardized tumor perfusion evaluation. Perfusion analysis included peak enhancement, rise time, wash-in perfusion index, and wash-out rate, reflecting the perfusion kinetics. Histopathological results were obtained for every STT and compared to perfusion characteristics. RESULTS In total, 48 lipoma, 23 ALT and 11 liposarcoma were identified. Significant differences in tumor microperfusion were demonstrated, with higher perfusion levels indicating higher malignancy (Peak enhancement [a.u.] of Lipoma: 145 ± 238; ALT: 268 ± 368; Liposarcoma: 3256 ± 4333; p (ALT vs. Liposarcoma) < 0.001). A perfusion-based identification of a benign lipoma or ALT versus sarcoma resulted in a positive predictive value of 93%. Patient-related factors (age, gender, BMI, ASA score, smoking status) had no significant impact on the CEUS-based perfusion parameters. CONCLUSION Our study suggests CEUS as a capable non-invasive tool for improving preoperative assessment of lipomatous STT. It can assist in the distinction between benign and malignant STT, accelerating treatment decisions and enhancing patient outcomes. Significant correlations between CEUS-derived parameters and malignancy highlight its risk assessment potential.
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Affiliation(s)
- Paul Mick
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany.
| | - Marie Rohner
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Tobias Renkawitz
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Burkhard Lehner
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas Geisbüsch
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefanos Tsitlakidis
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Mustafa Hariri
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Julian Deisenhofer
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Michelle Müller
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
| | - Julian Doll
- Department for Orthopaedics, Heidelberg University Hospital, Heidelberg, Germany
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Zhou C, Qian G, Wang Y, Li H, Shen Z, Zheng S. Safety and efficacy of fruquintinib-based therapy in patients with advanced or metastatic sarcoma. Cancer Med 2024; 13:e7438. [PMID: 38967496 PMCID: PMC11225144 DOI: 10.1002/cam4.7438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 06/02/2024] [Accepted: 06/18/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the efficacy and safety of fruquintinib-based therapy as a salvage therapy for patients with advanced or metastatic sarcoma, including soft tissue sarcoma (STS) and bone sarcoma. METHODS Patients with advanced or metastatic sarcoma were divided into two groups. One group received fruquintinib monotherapy, while the other received fruquintinib combined therapy. Safety and efficacy of fruquintinib-based therapy were recorded and reviewed retrospectively, including progression-free survival (PFS), overall response rate (ORR), and adverse events (AEs). RESULTS Between August 2021 and December 2022, 38 sarcoma patients were retrospectively included. A total of 14 patients received fruquintinib alone (including 6 STS and 8 bone sarcoma), while 24 were treated with fruquintinib combined therapy (including 2 STS and 22 bone sarcoma). The median follow-up was 10.2 months (95% CI, 6.4-11.5). For the entire population, the median PFS was 8.0 months (95% CI, 5.5-13.0). The ORR was 13.1%, while the disease control rate (DCR) was 86.8%. The univariate analysis showed that radiotherapy history (HR, 4.56; 95% CI, 1.70-12.24; p = 0.003), bone sarcoma (HR, 0.34; 95% CI, 0.14-0.87; p = 0.024), and treatment method of fruquintinib (HR, 0.36; 95% CI, 0.15-0.85; p = 0.021) were significantly associated with PFS. The multivariate analysis showed that patients without radiotherapy history were associated with a better PFS (HR, 3.71; 95% CI: 1.31-10.55; p = 0.014) than patients with radiotherapy history. Patients in combination group reported pneumothorax (8.3%), leukopenia (33.3%), thrombocytopenia (12.5%), diarrhea (4.2%), and anemia (4.2%) as the most frequent grade 3 or higher treatment-emergent AEs (TEAEs), while there was no severe TEAEs occurred in the monotherapy group. CONCLUSIONS Fruquintinib-based therapy displayed an optimal tumor control and an acceptable safety profile in patients with advanced or metastatic sarcoma.
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Affiliation(s)
- Chenliang Zhou
- Department of OncologyShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Guowei Qian
- Department of OncologyShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yonggang Wang
- Department of OncologyShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Hongtao Li
- Department of OncologyShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zan Shen
- Department of OncologyShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Shuier Zheng
- Department of OncologyShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
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Tlemsani C, Heske CM, Elloumi F, Pongor L, Khandagale P, Varma S, Luna A, Meltzer PS, Khan J, Reinhold WC, Pommier Y. Sarcoma_CellminerCDB: A tool to interrogate the genomic and functional characteristics of a comprehensive collection of sarcoma cell lines. iScience 2024; 27:109781. [PMID: 38868205 PMCID: PMC11167437 DOI: 10.1016/j.isci.2024.109781] [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: 10/26/2023] [Revised: 12/28/2023] [Accepted: 04/15/2024] [Indexed: 06/14/2024] Open
Abstract
Sarcomas are a diverse group of rare malignancies composed of multiple different clinical and molecular subtypes. Due to their rarity and heterogeneity, basic, translational, and clinical research in sarcoma has trailed behind that of other cancers. Outcomes for patients remain generally poor due to an incomplete understanding of disease biology and a lack of novel therapies. To address some of the limitations impeding preclinical sarcoma research, we have developed Sarcoma_CellMinerCDB, a publicly available interactive tool that merges publicly available sarcoma cell line data and newly generated omics data to create a comprehensive database of genomic, transcriptomic, methylomic, proteomic, metabolic, and pharmacologic data on 133 annotated sarcoma cell lines. The reproducibility, functionality, biological relevance, and therapeutic applications of Sarcoma_CellMinerCDB described herein are powerful tools to address and generate biological questions and test hypotheses for translational research. Sarcoma_CellMinerCDB (https://discover.nci.nih.gov/SarcomaCellMinerCDB) aims to contribute to advancing the preclinical study of sarcoma.
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Affiliation(s)
- Camille Tlemsani
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
- Department of Medical Oncology, Cochin Hospital, Paris Cancer Institute CARPEM, Université Paris Cité, APHP. Centre, Paris, France
- Institut Cochin, INSERM U1016, CNRS UMR8104, Paris Cancer Institute CARPEM, Université Paris Cité, Paris, France
| | - Christine M. Heske
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Fathi Elloumi
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Lorinc Pongor
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
- Hungarian Centre of Excellence for Molecular Medicine, Cancer Genomics and Epigenetics Core Group, Szeged, Hungary
| | - Prashant Khandagale
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Sudhir Varma
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Augustin Luna
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
- Computational Biology Branch, National Library of Medicine, NIH, Bethesda, Maryland 20892, USA
| | - Paul S. Meltzer
- Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Javed Khan
- Genetics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - William C. Reinhold
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
| | - Yves Pommier
- Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD 20892, USA
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Behrendt P, Grunow T, K-H F, Krause M, Fahlbusch H, Priemel M. Not every knee tumour is a ganglion - retrospective analysis of benign and malign tumour entities around the knee. Arch Orthop Trauma Surg 2024:10.1007/s00402-024-05401-7. [PMID: 38904683 DOI: 10.1007/s00402-024-05401-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 06/13/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Due to a lack of routine, there is often uncertainty regarding diagnostics of tumours around the knee joint. This study aimed to provide knowledge about the frequency, distribution and diagnostic algorithm of different bone and soft tissue tumour entities of the knee at a large referral university hospital in Germany. METHODS Retrospective, longitudinal, single-centre study that reviewed adult patients from 2010 until 2020 with a suspected tumours diagnosis around the knee at a university cancer centre. Inclusion criteria were adults with true bone or soft-tissue tumours in the knee joint and in its adjacent compartments. Suspected diagnosis, histological tumour entity, localization and its surgical treatment by biopsy, resection, osteosynthesis or tumour endoprosthesis were investigated. RESULTS A total number of 310 adult patients were included with a mean age of 54.2 ± 18.8 years. In total 160 (51.6%) soft-tissue tumours (69/43.1% benign; 74/46.2% malignant; 17/10.6% intermediate), 92 (29.6%) primary bone tumours (46/50% benign; 39/42.3% malignant; 7/7.6% intermediate), 36 (11.6%) metastases and 22 (7.1%) lymphomas were detected. 171 (55.1%) tumours were classified as malignant. Suspected diagnosis was matched with histology in 74.5% (231/310) of all cases. In 6 cases a primarily suspected benign diagnosis turned out to be malignant. The majority of primary bone tumours was cartilage derived (63.1%;58/92) and located in the distal 2/3 of the femur, whereas intracapsular tumours of the knee joint were rare (13.0%). Soft-tissue tumours were located primarily in the middle third of the thigh (36.8%). The MRI was the diagnostic tool of choice in 98.1% of soft tissue tumours and 82.6% bone tumours. CONCLUSION Awareness is crucial for detecting rare and malignant tumours around the knee, with adipocytic tumours being the most common soft tissue tumour and chondrogenic tumours as the most prevalent malignant bone tumour. Accurate diagnosis of bone tumours necessitates radiographs and frequently an additional MRI scan, while soft tissue tumours require mandatory MRI scans. Incorrectly diagnosing a tumour can have severe consequences, emphasizing the need for histological confirmation in all cases. Additionally, malignant tumours within joint capsules in adults are infrequent.
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Affiliation(s)
- Peter Behrendt
- Department of Orthopedic and Trauma Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
- Department of Anatomy, Christian-Albrechts- University, Kiel, Germany.
| | - T Grunow
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frosch K-H
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany
| | - M Krause
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Fahlbusch
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Priemel
- Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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CHMIEL PAULINA, SłOWIKOWSKA ALEKSANDRA, BANASZEK ŁUKASZ, SZUMERA-CIEćKIEWICZ ANNA, SZOSTAKOWSKI BART, SPAłEK MATEUSZJ, ŚWITAJ TOMASZ, RUTKOWSKI PIOTR, CZARNECKA ANNAM. Inflammatory myofibroblastic tumor from molecular diagnostics to current treatment. Oncol Res 2024; 32:1141-1162. [PMID: 38948020 PMCID: PMC11209743 DOI: 10.32604/or.2024.050350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 04/09/2024] [Indexed: 07/02/2024] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm with intermediate malignancy characterized by a propensity for recurrence but a low metastatic rate. Diagnostic challenges arise from the diverse pathological presentation, variable symptomatology, and lack of different imaging features. However, IMT is identified by the fusion of the anaplastic lymphoma kinase (ALK) gene, which is present in approximately 70% of cases, with various fusion partners, including ran-binding protein 2 (RANBP2), which allows confirmation of the diagnosis. While surgery is the preferred approach for localized tumors, the optimal long-term treatment for advanced or metastatic disease is difficult to define. Targeted therapies are crucial for achieving sustained response to treatment within the context of genetic alteration in IMT. Crizotinib, an ALK tyrosine kinase inhibitor (TKI), was officially approved by the US Food and Drug Administration (FDA) in 2020 to treat IMT with ALK rearrangement. However, most patients face resistance and disease progression, requiring consideration of sequential treatments. Combining radiotherapy with targeted therapy appears to be beneficial in this indication. Early promising results have also been achieved with immunotherapy, indicating potential for combined therapy approaches. However, defined recommendations are still lacking. This review analyzes the available research on IMT, including genetic disorders and their impact on the course of the disease, data on the latest targeted therapy regimens and the possibility of developing immunotherapy in this indication, as well as summarizing general knowledge about prognostic and predictive factors, also in terms of resistance to systemic therapy.
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Affiliation(s)
- PAULINA CHMIEL
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
- Faculty of Medicine, Medical University of Warsaw, Warsaw, 02-091, Poland
| | - ALEKSANDRA SłOWIKOWSKA
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
- Faculty of Medicine, Medical University of Warsaw, Warsaw, 02-091, Poland
| | - ŁUKASZ BANASZEK
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
- Faculty of Medicine, Medical University of Warsaw, Warsaw, 02-091, Poland
| | - ANNA SZUMERA-CIEćKIEWICZ
- Department of Pathology, Maria Sklodowska Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
| | - BARTłOMIEJ SZOSTAKOWSKI
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
| | - MATEUSZ J. SPAłEK
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
- Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
| | - TOMASZ ŚWITAJ
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
| | - PIOTR RUTKOWSKI
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
| | - ANNA M. CZARNECKA
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 02-781, Poland
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14
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An W, Xue Z, Zhuo H, Wang N, Meng L, Jia W. Cheek alveolar soft part sarcoma recurrence at the primary site during follow-up: a case report and review of the literature. BMC Oral Health 2024; 24:689. [PMID: 38872175 DOI: 10.1186/s12903-024-04431-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Alveolar soft part sarcoma (ASPS) occurs most often in the deep muscles or fascia of the extremities in adults, with only 3.4% of these tumours originating from the head, face and neck. To date, only 17 cases of buccal ASPS have been reported, including the case presented here. Only one case of ASPS recurrence at the primary site, similar to our case, has been reported thus far. Immune checkpoint inhibitors (ICPis)-associated diabetes, with an estimated incidence of 0.43%, is usually seen in older cancer patients and has not been reported in younger people or in patients with ASPS. CASE PRESENTATION A 24-year-old male patient presented with a slowly progressing right cheek mass with a clinical history of approximately 28 months. Sonographic imaging revealed a hypoechoic mass, which was considered a benign tumour. However, a pathological diagnosis of ASPS was made after excision of the mass. Five days later, functional right cervical lymph node dissection was performed. No other adjuvant therapy was administered after surgery. In a periodic follow-up of the patient six months later, blood-rich tumour growth was noted at the primary site, and Positron emission tomography-computedtomography (PET-CT) ruled out distant metastasis in other areas. The patient was referred to the Ninth People's Hospital of Shanghai Jiaotong University. Due to the large extent of the mass, the patient received a combination of a Programmed Cell Death Ligand 1(PD-L1) inhibitor and a targeted drug. Unfortunately, the patient developed three episodes of severe diabetic ketoacidosis after the administration of the drugs. A confirmed diagnosis of ICPis-associated diabetes was confirmed. After the second operation, the postoperative pathological diagnosis was ASPS, and the margins were all negative. Therefore, we made a final clinical diagnosis of ASPS recurrence at the primary site. Currently in the follow-up, the patient is alive, has no distant metastases, and undergoes multiple imaging examinations every 3 months for the monitoring of their condition. CONCLUSIONS In analysing the characteristics of all previously reported cases of buccal ASPS, it was found that the clinical history ranged from 1 to 24 months, with a mean of approximately 3 to 9 months. Tumour recurrence at the primary site has been reported in only one patient with buccal ASPS, and the short-term recurrence in our patient may be related to the extraordinarily long 28-month history. ICPis-associated diabetes may be noted in young patients with rare tumours, and regular insulin level monitoring after use is necessary.
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Affiliation(s)
- Wenyu An
- Department of Pathology and Key Laboratory for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine/The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Zhongxu Xue
- Department of Pathology and Key Laboratory for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine/The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Huifang Zhuo
- Department of Pathology and Key Laboratory for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine/The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Ning Wang
- Department of Pathology and Key Laboratory for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine/The First Affiliated Hospital, Shihezi University, Shihezi, China
| | - Lian Meng
- Department of Pathology and Key Laboratory for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine/The First Affiliated Hospital, Shihezi University, Shihezi, China.
| | - Wei Jia
- Department of Pathology and Key Laboratory for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine/The First Affiliated Hospital, Shihezi University, Shihezi, China.
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Yuan J, Xie D, Fang S, Meng F, Wu Y, Shan D, Shao N, Wang B, Tian Z, Wang Y, Xu C, Chen X. Qualitative and quantitative MRI analysis of alveolar soft part sarcoma: correlation with histological grade and Ki-67 expression. Insights Imaging 2024; 15:142. [PMID: 38866951 PMCID: PMC11169322 DOI: 10.1186/s13244-024-01687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/02/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVE To investigate the correlation between MRI findings and histological features for preoperative prediction of histological grading and Ki-67 expression level in alveolar soft part sarcoma (ASPS). METHODS A retrospective analysis was conducted on 63 ASPS patients (Jan 2017-May 2023). All patients underwent 3.0-T MRI examinations, including conventional sequences, dynamic contrast-enhanced scans with time-intensity curve analysis, and diffusion-weighted imaging with apparent diffusion coefficient (ADC) measurements. Patients were divided into low-grade (histological Grade I) and high-grade (histological Grade II/III) groups based on pathology. Immunohistochemistry was used to assess Ki-67 expression levels in ASPS. Statistical analysis included chi-square tests, Wilcoxon rank-sum test, binary logistic regression analysis, Spearman correlation analysis, and receiver operating characteristic curve analysis of various observational data. RESULTS There were 29 low-grade and 34 high-grade patients (26 males and 37 females) and a wide age range (5-68 years). Distant metastasis, tumor enhancement characteristics, and ADC values were independent predictors of high-grade ASPS. High-grade ASPS had lower ADC values (p = 0.002), with an area under the curve (AUC), sensitivity, and specificity of 0.723, 79.4%, and 58.6%, respectively, for high-grade prediction. There was a negative correlation between ADC values and Ki-67 expression (r = -0.526; p < 0.001). When the cut-off value of ADC was 0.997 × 10-3 mm²/s, the AUC, sensitivity, and specificity for predicting high Ki-67 expression were 0.805, 65.6%, and 83.9%, respectively. CONCLUSION Qualitative and quantitative MRI parameters are valuable for predicting histological grading and Ki-67 expression levels in ASPS. CRITICAL RELEVANCE STATEMENT This study will help provide a more nuanced understanding of ASPS and guide personalized treatment strategies. KEY POINTS There is limited research on assessing ASPS prognosis through MRI. Metastasis, enhancement, and ADC correlated with histological grade; ADC related to Ki-67 expression. MRI provides clinicians with valuable information on ASPS grading and proliferation activity.
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Affiliation(s)
- Junhui Yuan
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Deshun Xie
- Department of Radiology, Heze Municipal Hospital, Heze, Shandong, China
| | - Shaobo Fang
- Department of Medical Imaging, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China
| | - Fan Meng
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Yue Wu
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Dongqiu Shan
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Nannan Shao
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Bangmin Wang
- Department of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Zhichao Tian
- Department of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Yuanyuan Wang
- Department of Pathology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Chunmiao Xu
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China.
| | - Xuejun Chen
- Department of Medical Imaging, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China.
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16
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Li Y, Mondaza-Hernandez JL, Moura DS, Revenko AS, Tolentino A, Nguyen JT, Tran N, Meyer CA, Merino-Garcia J, Ramos R, Di Lernia D, Martin-Broto J, Hayenga HN, Bleris L. STAT6-targeting antisense oligonucleotides against solitary fibrous tumor. MOLECULAR THERAPY. NUCLEIC ACIDS 2024; 35:102154. [PMID: 38511173 PMCID: PMC10950871 DOI: 10.1016/j.omtn.2024.102154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/13/2024] [Indexed: 03/22/2024]
Abstract
Solitary fibrous tumor (SFT) is a rare, non-hereditary soft tissue sarcoma thought to originate from fibroblastic mesenchymal stem cells. The etiology of SFT is thought to be due to an environmental intrachromosomal gene fusion between NGFI-A-binding protein 2 (NAB2) and signal transducer and activator protein 6 (STAT6) genes on chromosome 12, wherein the activation domain of STAT6 is fused with the DNA-binding domain of NAB2 resulting in the oncogenesis of SFT. All NAB2-STAT6 fusion variations discovered in SFTs contain the C-terminal of STAT6 transcript, and thus can serve as target site for antisense oligonucleotides (ASOs)-based therapies. Indeed, our in vitro studies show the STAT6 3' untranslated region (UTR)-targeting ASO (ASO 993523) was able to reduce expression of NAB2-STAT6 fusion transcripts in multiple SFT cell models with high efficiency (half-maximal inhibitory concentration: 116-300 nM). Encouragingly, in vivo treatment of SFT patient-derived xenograft mouse models with ASO 993523 resulted in acceptable tolerability profiles, reduced expression of NAB2-STAT6 fusion transcripts in xenograft tissues (21.9%), and, importantly, reduced tumor growth (32.4% decrease in tumor volume compared with the untreated control). Taken together, our study established ASO 993523 as a potential agent for the treatment of SFTs.
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Affiliation(s)
- Yi Li
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA
- Center for Systems Biology, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Jose L. Mondaza-Hernandez
- Health Research Institute Fundacion Jimenez Diaz, Universidad Autonoma de Madrid (IIS/FJD-UAM), 28049 Madrid, Spain
- University Hospital General de Villalba, 28400 Madrid, Spain
| | - David S. Moura
- Health Research Institute Fundacion Jimenez Diaz, Universidad Autonoma de Madrid (IIS/FJD-UAM), 28049 Madrid, Spain
| | - Alexey S. Revenko
- Department of Antisense Drug Discovery, Ionis Pharmaceuticals, Inc, Carlsbad, CA 92010, USA
| | - Angelica Tolentino
- Department of Antisense Drug Discovery, Ionis Pharmaceuticals, Inc, Carlsbad, CA 92010, USA
| | - John T. Nguyen
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA
- Center for Systems Biology, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Nam Tran
- Neurosurgical Oncology, Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Clark A. Meyer
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Jose Merino-Garcia
- Pathology Department, University Hospital Fundacion Jimenez Diaz, Universidad Autonoma, Av. Reyes Catolicos 2, 28040 Madrid, Spain
| | - Rafael Ramos
- Pathology Department, University Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Davide Di Lernia
- Health Research Institute Fundacion Jimenez Diaz, Universidad Autonoma de Madrid (IIS/FJD-UAM), 28049 Madrid, Spain
| | - Javier Martin-Broto
- Health Research Institute Fundacion Jimenez Diaz, Universidad Autonoma de Madrid (IIS/FJD-UAM), 28049 Madrid, Spain
- University Hospital General de Villalba, 28400 Madrid, Spain
- Medical Oncology Department, University Hospital Fundacion Jimenez Diaz, 28040 Madrid, Spain
| | - Heather N. Hayenga
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA
| | - Leonidas Bleris
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX 75080, USA
- Center for Systems Biology, University of Texas at Dallas, Richardson, TX 75080, USA
- Department of Biological Sciences, University of Texas at Dallas, Richardson, TX 75080, USA
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17
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Zang Y, Zhao R, Ma C, Gao D. Primary glomus tumor of the thymus in a 66-year-old patient. J Cardiothorac Surg 2024; 19:328. [PMID: 38858712 PMCID: PMC11163759 DOI: 10.1186/s13019-024-02806-8] [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: 03/17/2024] [Accepted: 05/25/2024] [Indexed: 06/12/2024] Open
Abstract
We report a unique case of a 66-year-old man who was incidentally identified to have a mass in the thymus region by computerized tomography scan. CT revealed a well-defined 1.6 × 1 × 0.9 cm thymus mass with moderate uniform enhancement. Thoracoscopic thymectomy was performed, and the pathological diagnosis was primary glomus tumor of the thymus. There were no atypia or malignant histological features, and no primary tumors in other sites. To our knowledge, this is the first case of primary thymic glomus tumor reported in the literature.
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Affiliation(s)
- Yibing Zang
- Department of Thoracic Surgery, the Second People's Hospital of Liaocheng, 306 Health Street, Linqing City, Shan Dong, 252600, China
| | - Ruixing Zhao
- Department of Thoracic Surgery, the Second People's Hospital of Liaocheng, 306 Health Street, Linqing City, Shan Dong, 252600, China
| | - Chengquan Ma
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Dejun Gao
- Department of Thoracic Surgery, the Second People's Hospital of Liaocheng, 306 Health Street, Linqing City, Shan Dong, 252600, China.
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18
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Shibui Y, Kohashi K, Hino Y, Tamaki A, Kinoshita I, Yamamoto H, Nakashima Y, Tajiri T, Oda Y. Expression of Forkhead Box M1 and Anticancer Effects of FOXM1 Inhibition in Epithelioid Sarcoma. J Transl Med 2024; 104:102093. [PMID: 38857782 DOI: 10.1016/j.labinv.2024.102093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/09/2024] [Accepted: 05/29/2024] [Indexed: 06/12/2024] Open
Abstract
Epithelioid sarcoma (ES) is a rare aggressive sarcoma that, unlike most soft-tissue sarcomas, shows a tendency toward local recurrence and lymph node metastasis. Novel antitumor agents are needed for ES patients. Forkhead box transcription factor 1 (FOXM1) is a member of the Forkhead transcription factor family and is associated with multiple oncogenic functions; FOXM1 is known to be overexpressed and correlated with pathogenesis in various malignancies. In this study, we immunohistochemically analyzed FOXM1 expression levels and their clinical, clinicopathologic, and prognostic significance in 38 ES specimens. In addition, to investigate potential correlations between FOXM1 downregulation and oncologic characteristics, we treated ES cell lines with thiostrepton, a naturally occurring antibiotic that inhibits both small interfering RNA (siRNA) and FOXM1. In the analyses using ES samples, all 38 specimens were diagnosed as positive for FOXM1 by immunohistochemistry. We separated specimens into high (n = 19) and low (n = 19) FOXM1-protein expression groups by staining index score, and into large (n = 12), small (n = 25), and unknown (n = 1) tumor-size groups using a cutoff of 5 cm maximum diameter. Although there were significantly more samples with high FOXM1 expression in the large tumor group (P = .013), there were no significant differences with respect to age (P = 1.00), gender (P = .51), primary site of origin (P = .74), histologic subtypes (P = 1.00), depth (P = .74), or survival rate (P = .288) between the high and low FOXM1-protein expression groups. In the in vitro experiments using ES cell lines, FOXM1 siRNA and thiostrepton successfully downregulated FOXM1 mRNA and protein expression. Furthermore, downregulation of FOXM1 inhibited cell proliferation, drug resistance against chemotherapeutic agents, migration, and invasion and caused cell cycle arrest in the ES cell lines. Finally, cDNA microarray analysis data showed that FOXM1 regulated cIAP2, which is one of the apoptosis inhibitors activated by the TNFα-mediated NF-κB pathway. In conclusion, the FOXM1 gene may be a promising therapeutic target for ES.
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Affiliation(s)
- Yuichi Shibui
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Pathology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yuko Hino
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akihiko Tamaki
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Izumi Kinoshita
- Department of Pathology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tatsuro Tajiri
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Kasper B, Gounder M, Hernandez L, Baumgarten C, Ratan R. Capturing Patient Voice to Improve Outcomes That Matter to Patients with Desmoid Tumor. Cancer Manag Res 2024; 16:617-628. [PMID: 38863992 PMCID: PMC11166168 DOI: 10.2147/cmar.s362694] [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: 04/10/2024] [Accepted: 05/27/2024] [Indexed: 06/13/2024] Open
Abstract
Desmoid tumors (DT) are rare, intermediate-grade sarcomas characterized by locally aggressive growths that commonly occur intra-abdominally, in the abdominal wall, or in the extremities. Desmoid tumors are 2-3-fold more common in females than males, with most patients aged <40 years at diagnosis. Clinical course of DT is highly variable but rarely fatal, with median overall survival >80% at 20 years. However, patient morbidity and DT symptom burden can be high. DT significantly reduce patient quality of life, imposing substantial physical, emotional, and social burdens. Pain, fatigue, and insomnia are common symptoms; disfigurement, mobility restrictions, and, rarely, the need for amputation may also result. Despite its limited impact on survival, patients with DT may have anxiety and depression levels commensurate with those associated with malignant sarcomas. Thus, DT impose an array of significant, long-term morbidities on a young patient population. In order to evaluate the impact of these morbidities, patient-reported outcome (PRO) tools are used, which assess outcomes of importance to patients that extend beyond traditional oncology endpoints. General or oncology-related PROs can be used; although currently, the only DT-specific, validated PRO measure is the GOunder/Desmoid Tumor Research Foundation DEsmoid Symptom/Impact Scale (GODDESS©), consisting of an 11-item DT Symptom Scale (DTSS) and a 17-item DT Impact Scale (DTIS). DTSS and DTIS were secondary endpoints in DeFi, a randomized phase 3 trial of nirogacestat; blinded, pooled data from DeFi were used to validate GODDESS reliability and responsiveness as a PRO measure in DT. Another DT-specific PRO measure, the Desmoid-Type Fibromatosis Quality of Life (DTF-QoL) questionnaire, has been developed but not validated. As novel DT therapies continue to be developed, incorporating DT-specific PRO measures into clinical trials will be key to capturing patient voice, improving outcomes of importance to this unique patient population, and assisting patients and providers in selecting optimal treatment.
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Affiliation(s)
- Bernd Kasper
- Sarcoma Unit, Mannheim Cancer Center (MCC), Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
| | - Mrinal Gounder
- Sarcoma Medical Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Lynne Hernandez
- The Desmoid Tumor Research Foundation, Woodcliff Lake, NJ, USA
| | - Christina Baumgarten
- sos-desmoid e.V. Mannheim; SPAGN Sarcoma Patients Advocacy Global Network e.V, Wölferscheim, Germany
| | - Ravin Ratan
- Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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20
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M S A, K C, Bhargavan RV, Somanathan T, Subhadradevi L. An overview on liposarcoma subtypes: Genetic alterations and recent advances in therapeutic strategies. J Mol Histol 2024; 55:227-240. [PMID: 38696048 DOI: 10.1007/s10735-024-10195-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 04/18/2024] [Indexed: 05/21/2024]
Abstract
Liposarcoma (LPS) is a rare malignancy of adipocytic differentiation. According to World Health Organization classification, LPS comprises of four principle subtypes Atypical lipomatous tumor/Well-differentiated liposarcoma (ATL/WDLPS), Dedifferentiated liposarcoma (WDLPS), Myxoid liposarcoma (MLPS), and Pleomorphic liposarcoma (PLPS). Each subtype can develop at any location and shows distinct clinical behavior and treatment sensitivity. ATL/ WDLPS subtype has a higher incidence rate, low recurrence, and is insensitive to radiation and chemotherapy. DDLPS is the focal progression of WDLPS, which is aggressive and highly metastasizing. MLPS is sensitive to radiation and chemotherapy, with a higher recurrence rate and metastasis. PLPS subtype is highly metastasizing, has a poor prognosis, and exhibiting higher recurrence rate. Initial histological analysis provides information for the characterization of LPS subtypes', further molecular and genetic analysis provides certain subtype specifications, such as gene amplifications and gene fusions. Such molecular genetic alterations will be useful as therapeutic targets in various cancers, including the LPS subtypes. A wide range of novel therapeutic agents based on genetic alterations that aim to target LPS subtypes specifically are under investigation. This review summarizes the LPS subtype classification, their molecular genetic characteristics, and the implications of genetic alterations in therapeutics.
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Affiliation(s)
- Anju M S
- Division of Cancer Research, Regional Cancer Centre (Research Centre, University of Kerala), Thiruvananthapuram, Kerala, 695011, India
| | - Chandramohan K
- Division of Surgical Oncology, Regional Cancer Centre (Research Centre, University of Kerala), Thiruvananthapuram, Kerala, 695011, India
| | - Rexeena V Bhargavan
- Division of Surgical Oncology, Regional Cancer Centre (Research Centre, University of Kerala), Thiruvananthapuram, Kerala, 695011, India
| | - Thara Somanathan
- Division of Pathology, Regional Cancer Centre (Research Centre, University of Kerala), Thiruvananthapuram, Kerala, 695011, India
| | - Lakshmi Subhadradevi
- Division of Cancer Research, Regional Cancer Centre (Research Centre, University of Kerala), Thiruvananthapuram, Kerala, 695011, India.
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21
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Evans D, Rothschild S, Tordella C, Chacón M. Leveraging Patient Engagement Through Collaboration for Improved Global Health Outcomes in Sarcoma. Am Soc Clin Oncol Educ Book 2024; 44:e438934. [PMID: 38862132 DOI: 10.1200/edbk_438934] [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: 06/13/2024]
Abstract
In the dynamic landscape of oncology, collaborative efforts between the medical community and patient advocacy groups are pivotal in shaping standards of care and advancing research. Nowhere is this collaboration more evident than in sarcoma, a group of rare cancers posing unique challenges to diagnosis, management, and treatment, which profoundly affect patient outcomes. Here, we explore the vital role of patient-centric collaboration in improving global health outcomes in sarcoma, emphasizing the transformative power of collective action and shared expertise. Challenges in sarcoma care, including diagnostic complexities, disparities in access to care, and genomic tumor heterogeneity, underscore the urgent need for collaborative solutions. Initiatives like the Sarcoma European and Latin American Network (SELNET) and The Life Raft Group (LRG) exemplify successful models of collaborative research and patient advocacy, driving advancements in diagnosis, treatment, and disease understanding. Stakeholders across disciplines are uniting to improve sarcoma care and outcomes through the development of clinical practice guidelines, continuous medical education, patient registries, virtual tumor boards, and consortium-driven research endeavors, all of which foster the growth of global collaborative groups. The success of these collaborative efforts serves as a model for other rare diseases, highlighting the potential of collective action to drive progress and innovation in health care.
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Affiliation(s)
| | | | | | - Matías Chacón
- Instituto Alexander Fleming, Buenos Aires, Argentina
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22
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Chmiel P, Rutkowski P, Spałek M, Szumera-Ciećkiewicz A, Czarnecka AM. What is the Optimal Treatment Strategy after Sarcoma R2 Surgery? Curr Treat Options Oncol 2024; 25:798-812. [PMID: 38809411 PMCID: PMC11222198 DOI: 10.1007/s11864-024-01218-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 05/30/2024]
Abstract
OPINION STATEMENT Soft tissue sarcomas (STS) are rare tumours of mesenchymal origin, most commonly occurring in the extremity but also in the retroperitoneum. The curative treatment for STS is radical surgery with wide margins, in some cases in combination with perioperative radiotherapy and chemotherapy. Nonradical resection (R2) of STS has been an emerging issue in recent decades, as optimal subsequent management remains debatable. Similarly, there is still no consensus on optimal surgical margins. Combining multiple treatment modalities in adjuvant therapy can achieve local and distant control in patients following surgery with positive margins. Patients who have undergone nonradical resection therefore require additional surgical interventions, and adjuvant radiotherapy resulting in a better prognosis but a higher number of complications. Following non-radical treatment, patients with limb and trunk wall sarcomas and retroperitoneal sarcomas should also undergo increased oncological surveillance. Given the potential issues that may emerge in such clinical situations, it is crucial to up-date the current guidelines to enhance the long-term prognosis of these patients.
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Affiliation(s)
- Paulina Chmiel
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781, Warsaw, Poland
- Faculty of Medicine, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781, Warsaw, Poland
| | - Mateusz Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781, Warsaw, Poland
- Department of Radiotherapy I, Maria Sklodowska-Curie National Research Institute of Oncology, 02-718, Warsaw, Poland
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781, Warsaw, Poland
- Biobank Maria Sklodowska-Curie National Research Institute of Oncology, 02-781, Warsaw, Poland
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781, Warsaw, Poland.
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute Polish Academy of Sciences, 02-106, Warsaw, Poland.
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23
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Wu W, Kang X, Fang W, Li Y, Ma R, Ma M, Hei Y, Wang Q, Wang X, Mu X, Zhao S, Yang X. Clinical, Diagnostic, and Treatment Characteristics of Orbital Liposarcoma. Am J Ophthalmol 2024; 262:134-140. [PMID: 38237748 DOI: 10.1016/j.ajo.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/31/2023] [Accepted: 01/12/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE To clarify the clinical, diagnostic, and treatment characteristics of orbital liposarcoma. DESIGN Retrospective observational case series. METHODS A review was performed of electronic medical records, histopathology, radiological images, and follow-up information for 21 patients with orbital liposarcoma. RESULTS The predominant clinical manifestation of this disease was painless exophthalmos. The most frequently encountered pathological types were well-differentiated and myxoid liposarcoma. Preoperative radiological images from 15 patients showed that orbital liposarcoma initially developed in extraocular muscle in 9 patients. Furthermore, all well-differentiated liposarcomas exhibited the radiographic characteristics of irregular and ill-defined adipose tissue, whereas only 12.5% of myxoid liposarcomas had the imaging characteristics. For the patients who exclusively underwent surgery, all of those with subtotal excisions experienced recurrence, 63.6% of marginal excisions recurred, and 50% of wide excisions resulted in recurrence. However, none of the patients who underwent marginal excisions or wide excisions combined with adjuvant radiotherapy exhibited recurrence. The analysis of magnetic resonance imaging findings in 3 patients who underwent neoadjuvant radiotherapy revealed that the tumor size remained stable in a patient with well-differentiated liposarcoma, whereas another patient with the same type of tumor exhibited a gradual increase in size. Conversely, a patient with myxoid liposarcoma experienced a significant reduction in tumor size following neoadjuvant radiotherapy. CONCLUSION Orbital liposarcoma demonstrated a propensity for developing in the extraocular muscle. The radiological images of orbital well-differentiated liposarcomas were characterized by irregular and ill-defined adipose tissue. Surgery combined with radiotherapy demonstrated potential in reducing recurrence rates. Notably, orbital myxoid liposarcoma exhibited greater sensitivity to radiotherapy compared to well-differentiated liposarcoma.
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Affiliation(s)
- Wei Wu
- From the Senior Department of Ophthalmology (W.W., X.K., Y.L., R.M., Y H., Q.W., X.W., X.Y.), 3rd Medical Center of Chinese PLA General Hospital, Beijing, China.
| | - Xin Kang
- From the Senior Department of Ophthalmology (W.W., X.K., Y.L., R.M., Y H., Q.W., X.W., X.Y.), 3rd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wei Fang
- National Clinical Research Center for Ocular Diseases (W.F.), Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yueyue Li
- From the Senior Department of Ophthalmology (W.W., X.K., Y.L., R.M., Y H., Q.W., X.W., X.Y.), 3rd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Rui Ma
- From the Senior Department of Ophthalmology (W.W., X.K., Y.L., R.M., Y H., Q.W., X.W., X.Y.), 3rd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Mingshen Ma
- Department of Ophthalmology (M.M.), Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Yan Hei
- From the Senior Department of Ophthalmology (W.W., X.K., Y.L., R.M., Y H., Q.W., X.W., X.Y.), 3rd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qi Wang
- From the Senior Department of Ophthalmology (W.W., X.K., Y.L., R.M., Y H., Q.W., X.W., X.Y.), 3rd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiaoyi Wang
- From the Senior Department of Ophthalmology (W.W., X.K., Y.L., R.M., Y H., Q.W., X.W., X.Y.), 3rd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xuetao Mu
- Department of Radiology (X.M.), 3rd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shuixi Zhao
- Department of Radiation Oncology (S.Z.), 3rd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xinji Yang
- From the Senior Department of Ophthalmology (W.W., X.K., Y.L., R.M., Y H., Q.W., X.W., X.Y.), 3rd Medical Center of Chinese PLA General Hospital, Beijing, China.
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24
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Mittal M, Pillai S, Monappa V, Devaraja K, Majumdar KS. Desmoid fibromatosis-a diagnostic dilemma. Eur Arch Otorhinolaryngol 2024; 281:3269-3278. [PMID: 38530459 DOI: 10.1007/s00405-024-08558-4] [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: 12/03/2023] [Accepted: 02/12/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Desmoid fibromatosis in head and neck is infrequent and poses a significant challenge to the clinicians due to its non-specific characteristics. METHODS This case report focuses on a 69-year-old male who presented to a tertiary healthcare center in Karnataka, India with a swelling in the oral cavity. RESULTS Despite initial suspicions of malignancy based on clinical examination and findings on computed tomography imaging, subsequent histopathology and immunohistochemistry revealed an unexpected finding. CONCLUSION The case highlights the importance of clinical suspicion and histopathological evaluation as well as the need for greater awareness to facilitate early diagnosis and appropriate management of desmoid fibromatosis. We also present a literature review of varied presentations of desmoid tumors afflicting various subsites of the head and neck.
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Affiliation(s)
- Manaswini Mittal
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.
| | - Suresh Pillai
- Division of Head and Neck Surgery, Department of Otorhinolaryngology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Vidya Monappa
- Department of Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - K Devaraja
- Division of Head and Neck Surgery, Department of Otorhinolaryngology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Kinjal Shankar Majumdar
- Division of Head and Neck Surgery, Department of Otorhinolaryngology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
- Department of Surgical Oncology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
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25
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Czarnecka AM, Chmiel P, Błoński P, Rutkowski P. Establishing biomarkers for soft tissue sarcomas. Expert Rev Anticancer Ther 2024; 24:407-421. [PMID: 38682679 DOI: 10.1080/14737140.2024.2346187] [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: 11/18/2023] [Accepted: 04/18/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Soft tissue sarcomas (STS) are a rare and diverse group of tumors. Curative options are limited to localized disease, with surgery being the mainstay. Advanced stages are associated with a poor prognosis. Currently, the prognosis of the patient is based on histological classification and clinical characteristics, with only a few biomarkers having entered clinical practice. AREAS COVERED This article covers extensive recent research that has established novel potential biomarkers based on genomics, proteomics, and clinical characteristics. Validating and incorporating these biomarkers into clinical practice can improve prognosis, prediction of recurrence, and treatment response. Relevant literature was collected from PubMed, Scopus, and clinicaltrials.gov databases (November 2023). EXPERT OPINION Currently, defining prognostic markers in soft tissue sarcomas remains challenging. More studies are required, especially to personalize treatment through advanced genetic profiling and analysis using individual tumor and patient characteristics.
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Affiliation(s)
- Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Paulina Chmiel
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Medical Faculty, Warsaw Medical University, Warsaw, Poland
| | - Piotr Błoński
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Medical Faculty, Warsaw Medical University, Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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26
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Le MCN, Smith KA, Dopico PJ, Greer B, Alipanah M, Zhang Y, Siemann DW, Lagmay JP, Fan ZH. Investigating surface proteins and antibody combinations for detecting circulating tumor cells of various sarcomas. Sci Rep 2024; 14:12374. [PMID: 38811642 PMCID: PMC11137101 DOI: 10.1038/s41598-024-61651-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 05/08/2024] [Indexed: 05/31/2024] Open
Abstract
Circulating tumor cells (CTCs) have gathered attention as a biomarker for carcinomas. However, CTCs in sarcomas have received little attention. In this work, we investigated cell surface proteins and antibody combinations for immunofluorescence detection of sarcoma CTCs. A microfluidic device that combines filtration and immunoaffinity using gangliosides 2 and cell surface vimentin (CSV) antibodies was employed to capture CTCs. For CTC detection, antibodies against cytokeratins 7 and 8 (CK), pan-cytokeratin (panCK), or a combination of panCK and CSV were used. Thirty-nine blood samples were collected from 21 patients of various sarcoma subtypes. In the independent samples study, samples were subjected to one of three antibody combination choices. Significant difference in CTC enumeration was found between CK and panCK + CSV, and between panCK and panCK + CSV. Upon stratification of CK+ samples, those of metastatic disease had a higher CTC number than those of localized disease. In the paired samples study involving cytokeratin-positive sarcoma subtypes, using panCK antibody detected more CTCs than CK. Similarly, for osteosarcoma, using panCK + CSV combination resulted in a higher CTC count than panCK. This study emphasized deliberate selection of cell surface proteins for sarcoma CTC detection and subtype stratification for studying cancers as heterogeneous as sarcomas.
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Affiliation(s)
- Minh-Chau N Le
- Interdisciplinary Microsystems Group, Department of Mechanical and Aerospace Engineering, University of Florida, PO Box 116250, Gainesville, FL, 32611, USA
| | - Kierstin A Smith
- Interdisciplinary Microsystems Group, Department of Mechanical and Aerospace Engineering, University of Florida, PO Box 116250, Gainesville, FL, 32611, USA
| | - Pablo J Dopico
- Interdisciplinary Microsystems Group, Department of Mechanical and Aerospace Engineering, University of Florida, PO Box 116250, Gainesville, FL, 32611, USA
| | - Beate Greer
- Department of Pediatrics, Division of Hematology-Oncology, University of Florida, Gainesville, FL, 32610, USA
| | - Morteza Alipanah
- Interdisciplinary Microsystems Group, Department of Mechanical and Aerospace Engineering, University of Florida, PO Box 116250, Gainesville, FL, 32611, USA
| | - Yang Zhang
- Interdisciplinary Microsystems Group, Department of Mechanical and Aerospace Engineering, University of Florida, PO Box 116250, Gainesville, FL, 32611, USA
| | - Dietmar W Siemann
- Department of Radiation Oncology, University of Florida, Gainesville, FL, 32610, USA
| | - Joanne P Lagmay
- Department of Pediatrics, Division of Hematology-Oncology, University of Florida, Gainesville, FL, 32610, USA.
| | - Z Hugh Fan
- Interdisciplinary Microsystems Group, Department of Mechanical and Aerospace Engineering, University of Florida, PO Box 116250, Gainesville, FL, 32611, USA.
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA.
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27
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Broggi G, Attanasio G, Bonanno A, La Mantia I, Barresi S, Alaggio R, Magro G. NTRK3-EML4-rearranged spindle cell tumor with co-expression of S100 and CD34: an unusual mesenchymal tumor in the spectrum of the bland-looking spindle cell lesions of the oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00314-6. [PMID: 38926044 DOI: 10.1016/j.oooo.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/11/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024]
Abstract
A novel category of spindle cell tumors characterized by Neurotrophic Tyrosine Receptor Kinase (NTRK) rearrangements with a dual immunoreactivity for S-100 and CD34 has emerged in the last years as a distinct entity among soft tissue neoplasms. These genetic alterations lead to the continuous activation of NTRK genes, driving tumorigenesis and offering a unique prospect for targeted therapy. We herein present a rare case of NTRK3-rearranged spindle cell tumor with a hitherto unreported gene fusion involving the exon 14 of NTRK3 with the exon 2 of Echinoderm Microtubule-Associated Protein-Like 4, arising in the head and neck region. Tumor occurred in a 45-year-old patient who presented with a painful nodule in the oral mucosa. Due to the possibility of personalizing the treatment strategy for such tumors, pathologists should be aware of this emerging group of spindle cell tumors to promptly recognize them even when they occur in uncommon locations, including the oral cavity.
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Affiliation(s)
- Giuseppe Broggi
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, Catania, Italy.
| | - Giulio Attanasio
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, Catania, Italy
| | - Antonio Bonanno
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia" ENT Section, University of Catania, Catania, Italy
| | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia" ENT Section, University of Catania, Catania, Italy
| | - Sabina Barresi
- Pathology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Rita Alaggio
- Pathology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Rome, Italy
| | - Gaetano Magro
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Anatomic Pathology, University of Catania, Catania, Italy
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28
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Todo MC, Gonçalves de Carvalho JA, Ferreira da Silveira E Freitas JB, Grecca LS, Chahud F, Velasco E Cruz AA. Orbital invasion of a conjunctival atypical fibroxanthoma in a patient with systemic diffuse large B-cell lymphoma. Orbit 2024:1-4. [PMID: 38796753 DOI: 10.1080/01676830.2024.2350041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/25/2024] [Indexed: 05/28/2024]
Abstract
An 88-year-old male patient presented with a large mass on the left lateral bulbar conjunctiva. The tumor appeared two months after the resection of a conjunctival atypical fibroxanthoma (AFX) performed by a cornea specialist. Magnetic resonance imaging of the orbits showed deep orbital invasion along the lateral rectus muscle. The mass and the entire conjunctival sac were totally excised with lid-sparing orbital exenteration. Histopathological analysis confirmed that the mass was an extension of the AFX. Two weeks after surgery, large B-cell lymphoma was diagnosed in the oropharynx. Chemotherapy was initiated, and after seven months of follow-up, there was no recurrence of the AFX. The authors believe that this is the first report of orbital invasion by AFX.
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Affiliation(s)
- Márcia Cristina Todo
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Julie Anne Gonçalves de Carvalho
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Luís Sérgio Grecca
- Department of Ophthalmology, Hospital D'olhos, São José do Rio Preto, Brazil
| | - Fernando Chahud
- Department of Pathology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Antônio Augusto Velasco E Cruz
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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29
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Devaraja K, Aggarwal S, Pillai S, Singh BMK. Large atypical lipomatous tumour of the neck with mediastinal extension managed by transcervical excision. BMJ Case Rep 2024; 17:e258292. [PMID: 38789269 DOI: 10.1136/bcr-2023-258292] [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] [Indexed: 05/26/2024] Open
Abstract
Tumours of adipose tissue origin are relatively rare in the head and neck. Here, we report a case of an unfamiliar lipomatous lesion that involved the neck and mediastinum. A nil-comorbid man in his 40s presented with a slowly progressive anterior neck swelling of 3 years, which was diagnosed as lipoma by histopathological sampling. Computed tomography demonstrated the lesion to be involving parapharyngeal and retropharyngeal spaces with mediastinal extension. The lesion was removed by the transcervical approach. The final histology of the excised specimen, with immunohistochemistry for mouse double minute 2 (MDM2) and p16, suggested an atypical lipomatous tumour (ALT). This report accentuates the occurrence of this rare neoplasm in the neck, which often mimics lipoma clinically. Although radiology can demonstrate suggestive features, histology with MDM2 and/or p16 positivity can confirm the diagnosis of ALT as against the lipoma. A successful transcervical excision, despite the deeper extension of the lesion between the critical structures of the neck and mediastinum, demonstrates the non-infiltrating nature of the tumour.
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Affiliation(s)
- K Devaraja
- Division of Head and Neck Surgery, Department of Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka-576104, India
| | - Shruti Aggarwal
- Division of Head and Neck Surgery, Department of Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka-576104, India
| | - Suresh Pillai
- Division of Head and Neck Surgery, Department of Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka-576104, India
| | - Brij Mohan Kumar Singh
- Department of Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka-576104, India
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Fiore M, Bortoli M, Sambri A, Lotrecchiano L, Lovato L, Mirelli M, Neri I, De Paolis M, Piraccini BM, Gargiulo M. Soft Tissue Vascular Anomalies of the Extremities: A Proposed Diagnostic Approach. Life (Basel) 2024; 14:670. [PMID: 38929654 PMCID: PMC11204615 DOI: 10.3390/life14060670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/19/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
This narrative review aims to summarise the classification of vascular anomalies, their clinical presentation, and their radiological features to propose a diagnostic algorithm to approach patients with suspected soft tissue vascular anomalies of the extremities. The management of vascular anomalies necessitates a multidisciplinary approach. Clinical presentation and physical examination are sufficient in most cases to achieve a correct diagnosis. This is especially true for small congenital lesions of the skin and subcutaneous tissue. Imaging is used for accurate characterization of these lesions, especially in cases of atypical or vague clinical presentation, and to assess extension in cases of lesions that are larger and localized in deeper tissues.
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Affiliation(s)
- Michele Fiore
- Orthopedic and Traumatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.F.); (M.B.); (M.D.P.)
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy; (B.M.P.); (M.G.)
| | - Marta Bortoli
- Orthopedic and Traumatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.F.); (M.B.); (M.D.P.)
| | - Andrea Sambri
- Orthopedic and Traumatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.F.); (M.B.); (M.D.P.)
| | - Ludovica Lotrecchiano
- Oncoematologic and Emergencies Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.L.); (L.L.)
| | - Luigi Lovato
- Oncoematologic and Emergencies Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.L.); (L.L.)
| | - Michele Mirelli
- IRCCS, Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Iria Neri
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Massimiliano De Paolis
- Orthopedic and Traumatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.F.); (M.B.); (M.D.P.)
| | - Bianca Maria Piraccini
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy; (B.M.P.); (M.G.)
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Mauro Gargiulo
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy; (B.M.P.); (M.G.)
- IRCCS, Vascular Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
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Xu B, Tan H, Bian P. Endoscopic Management of Recurrent Epistaxis Caused by Retiform Hemangioendothelioma in a Child: A Case Report. EAR, NOSE & THROAT JOURNAL 2024:1455613241253372. [PMID: 38757668 DOI: 10.1177/01455613241253372] [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: 05/18/2024] Open
Abstract
Retiform hemangioendothelioma (RH) is a rare intermediate (locally aggressive) vascular tumor that mostly affects the dermis of the trunk and limbs, but has never been reported in the inferior turbinate. A 10-year-old Chinese boy presented with recurrent epistaxis in his left nasal cavity and anemia for more than 2 years. Radiographic and electronic video laryngoscopic images showed an expansile mass in the left inferior turbinate. Endoscopic surgery and electrocautery were performed to resect the tumor beyond the macroscopic border. Histopathologically, the tissues were infiltrated by hyperplastic blood vessels arranged in a retiform pattern, and endothelial cells proliferate significantly in some areas. Immunohistochemistry showed a positive result for CD31, CD34, Fli-1, and ERG. No epistaxis, tumor recurrence, or metastasis was found on reexamination over 18 months after surgery.
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Affiliation(s)
- Baicheng Xu
- Department of Otolaryngology-Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Huan Tan
- Department of Otolaryngology-Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Panpan Bian
- Department of Otolaryngology-Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China
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32
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Li G, Zhou H, Jin W, Bai Y. Undifferentiated pleomorphic sarcoma of pancreas: A case report. Asian J Surg 2024:S1015-9584(24)00918-7. [PMID: 38760223 DOI: 10.1016/j.asjsur.2024.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024] Open
Affiliation(s)
- Gen Li
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650106, China
| | - Hong Zhou
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
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Gersing AS, Kimm MA, Bollwein C, Ilg P, Mogler C, Gassert FG, Feuerriegel GC, Knebel C, Woertler K, Pfeiffer D, Busse M, Pfeiffer F. Chondrosarcoma evaluation using hematein-based x-ray staining and high-resolution 3D micro-CT: a feasibility study. Eur Radiol Exp 2024; 8:58. [PMID: 38735899 PMCID: PMC11089022 DOI: 10.1186/s41747-024-00454-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/04/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Chondrosarcomas are rare malignant bone tumors diagnosed by analyzing radiological images and histology of tissue biopsies and evaluating features such as matrix calcification, cortical destruction, trabecular penetration, and tumor cell entrapment. METHODS We retrospectively analyzed 16 cartilaginous tumor tissue samples from three patients (51-, 54-, and 70-year-old) diagnosed with a dedifferentiated chondrosarcoma at the femur, a moderately differentiated chondrosarcoma in the pelvis, and a predominantly moderately differentiated chondrosarcoma at the scapula, respectively. We combined a hematein-based x-ray staining with high-resolution three-dimensional (3D) microscopic x-ray computed tomography (micro-CT) for nondestructive 3D tumor assessment and tumor margin evaluation. RESULTS We detected trabecular entrapment on 3D micro-CT images and followed bone destruction throughout the volume. In addition to staining cell nuclei, hematein-based staining also improved the visualization of the tumor matrix, allowing for the distinction between the tumor and the bone marrow cavity. The hematein-based staining did not interfere with further conventional histology. There was a 5.97 ± 7.17% difference between the relative tumor area measured using micro-CT and histopathology (p = 0.806) (Pearson correlation coefficient r = 0.92, p = 0.009). Signal intensity in the tumor matrix (4.85 ± 2.94) was significantly higher in the stained samples compared to the unstained counterparts (1.92 ± 0.11, p = 0.002). CONCLUSIONS Using nondestructive 3D micro-CT, the simultaneous visualization of radiological and histopathological features is feasible. RELEVANCE STATEMENT 3D micro-CT data supports modern radiological and histopathological investigations of human bone tumor specimens. It has the potential for being an integrative part of clinical preoperative diagnostics. KEY POINTS • Matrix calcifications are a relevant diagnostic feature of bone tumors. • Micro-CT detects all clinically diagnostic relevant features of x-ray-stained chondrosarcoma. • Micro-CT has the potential to be an integrative part of clinical diagnostics.
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Affiliation(s)
- Alexandra S Gersing
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany.
- Department of Neuroradiology, LMU University Hospital, LMU Munich, Munich, Germany.
| | - Melanie A Kimm
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany.
- Department of Radiology, LMU University Hospital, LMU Munich, Marchioninistr. 15, Munich, 81377, Germany.
| | - Christine Bollwein
- Institute of Pathology, School of Medicine, Technical University of Munich, Trogerstrasse 18, Munich, 81675, Germany
| | - Patrick Ilg
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, 85748, Germany
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, 85748, Germany
| | - Carolin Mogler
- Institute of Pathology, School of Medicine, Technical University of Munich, Trogerstrasse 18, Munich, 81675, Germany
| | - Felix G Gassert
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany
| | - Georg C Feuerriegel
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany
| | - Carolin Knebel
- Department of Orthopedics and Sports Orthopedics, Technical University of Munich, Ismaninger Str. 22, Munich, 81675, Germany
| | - Klaus Woertler
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany
- Musculoskeletal Radiology Section, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, 81675, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, 85748, Germany
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, 85748, Germany
- Munich Institute for Advanced Study, Technical University of Munich, Garching, 85748, Germany
| | - Madleen Busse
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, 85748, Germany
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, 85748, Germany
| | - Franz Pfeiffer
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstr. 22, Munich, 81675, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, 85748, Germany
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, Garching, 85748, Germany
- Munich Institute for Advanced Study, Technical University of Munich, Garching, 85748, Germany
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Li CY, Gao YP, Jia MH, Zhou Y, Xu JY. Case report: Rapidly progressive desmoid tumor after surgery for esophagogastric junction cancer and slowly progressive primary desmoid tumor: a report of two cases and literature review. Front Oncol 2024; 14:1401839. [PMID: 38800396 PMCID: PMC11116560 DOI: 10.3389/fonc.2024.1401839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
Background Desmoid tumor (DT) is a rare locally aggressive but non-metastatic mesenchymal soft tissue neoplasm that predominantly occurs in the abdominal wall, abdominal cavity, and extremities. Its occurrence in the mesentery is relatively uncommon. Case reports This article reports two cases of desmoid tumor treated at the Department of Gastrointestinal Surgery, Weifang People's Hospital. The first case was a 59-year-old male patient who had previously undergone surgery for esophagogastric junction cancer. Postoperatively, he developed an intra-abdominal mass that rapidly increased in size within three months. The second case was a 60-year-old male patient who incidentally discovered a mass in the left lower abdomen. Both patients underwent surgical treatment, and the postoperative pathological diagnosis was mesenteric desmoid tumor. Conclusion The treatment of desmoid tumor remains challenging. Simple surgical resection often yields unsatisfactory outcomes, and the efficacy of adjuvant radiotherapy and chemotherapy is also limited. Further research and clinical practice are necessary to improve diagnostic and therapeutic strategies, aiming to enhance patient survival and quality of life.
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Affiliation(s)
- Chuan-Ying Li
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
- Department of Gastrointestinal Surgery, Weifang People’s Hospital, Weifang, Shandong, China
| | - Yan-Peng Gao
- Department of Gastrointestinal Surgery, Weifang People’s Hospital, Weifang, Shandong, China
| | - Ming-Hao Jia
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
- Department of Gastrointestinal Surgery, Weifang People’s Hospital, Weifang, Shandong, China
| | - Yuan Zhou
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Jia-You Xu
- Department of Gastrointestinal Surgery, Weifang People’s Hospital, Weifang, Shandong, China
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35
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Cullen MM, Floyd W, Dow B, Schleupner B, Brigman BE, Visgauss JD, Cardona DM, Somarelli JA, Eward WC. ATRX and Its Prognostic Significance in Soft Tissue Sarcoma. Sarcoma 2024; 2024:4001796. [PMID: 38741704 PMCID: PMC11090676 DOI: 10.1155/2024/4001796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/05/2023] [Accepted: 04/18/2024] [Indexed: 05/16/2024] Open
Abstract
Purpose Recently, the association between ATRX and a more aggressive sarcoma phenotype has been shown. We performed a retrospective study of sarcomas from an individual institution to evaluate ATRX as a prognosticator in soft tissue sarcoma. Experimental Design. 128 sarcomas were collected from a single institution and stained for ATRX. The prognostic significance of these markers was evaluated in a smaller cohort of primary soft tissue sarcomas (n = 68). Kaplan-Meier curves were created for univariate analysis, and Cox regression was utilized for multivariate analysis. Results High expression of ATRX was found to be a positive prognostic indicator for overall survival and metastasis-free survival in our group of soft tissue sarcomas both in univariate analysis and multivariate analysis (HR: 0.38 (0.17-0.85), P=0.02 and HR: 0.49 (0.24-0.99), P=0.05, respectively). Conclusions High expression of ATRX is a positive prognostic indicator of overall survival and metastasis-free survival in patients with STS. This is consistent with studies in osteosarcoma, which indicate possible mechanisms through which loss of ATRX leads to more aggressive phenotypes. Future prospective clinical studies are required to validate the prognostic significance of these findings.
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Affiliation(s)
- Mark M. Cullen
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
| | - Warren Floyd
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bobby Dow
- Texas A&M University Health Center College of Medicine, Bryan, TX, USA
| | | | - Brian E. Brigman
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Julia D. Visgauss
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Diana M. Cardona
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
- Department of Pathology, Duke University Health System, Durham, NC, USA
| | - Jason A. Somarelli
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - William C. Eward
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
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Samargandi R. Etiology, pathogenesis, and management of angiosarcoma associated with implants and foreign body: Clinical cases and research updates. Medicine (Baltimore) 2024; 103:e37932. [PMID: 38701315 PMCID: PMC11062743 DOI: 10.1097/md.0000000000037932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/28/2024] [Indexed: 05/05/2024] Open
Abstract
Angiosarcomas are rare and highly malignant soft tissue sarcomas originating from endothelial cells lining the lymphatic or vascular system. While they predominantly emerge from (sub)cutaneous regions, occurrences have been reported throughout the body. The etiology of angiosarcoma remains elusive in most clinical cases. Nevertheless, several prognosis risk factors play a pivotal role, including chronic lymphedema, therapeutic irradiation, environmental carcinogens, familial syndromes, and the presence of foreign materials like metallic objects and biomedical implants. Despite evidence implicating retained foreign material in angiosarcoma development, understanding its prognosis and pathogenesis remains limited. The pathogenesis of angiosarcoma appears to involve a complex interplay of chronic inflammation, tissue remodeling, and genetic factors that create a conducive microenvironment for malignant transformation. Management of these sarcomas remains challenging due to their infiltrative nature owing to the high chance of metastasis and local recurrence. The primary treatment modalities currently include surgery, radiotherapy, and chemotherapy, but recent advances in targeted immunotherapy and gene therapy hold promise for more effective approaches. This comprehensive review delves into the potential etiological and pathogenic roles of foreign materials, such as metallic objects, biomedical implants, and biomaterials, in the development of angiosarcoma. Further research into the underlying molecular mechanisms could provide valuable insights for tailored management and developing novel targeted therapeutic strategies.
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Affiliation(s)
- Ramy Samargandi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
- Service de Chirurgie Orthopédique et Traumatologique, CHRU Trousseau, Faculté de Médecine de Tours, Université de Tours, Chambray-les-Tours, France
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37
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Zago Baltazar R, Claerhout S, Vander Borght S, Spans L, Sciot R, Schöffski P, Hompes D, Sinnaeve F, Wafa H, Renard M, van den Hout MFCM, Vernemmen A, Libbrecht L, De Roo A, Mazzeo F, van Marcke C, Deraedt K, Bourgain C, Vanden Bempt I. Recurrent and novel fusions detected by targeted RNA sequencing as part of the diagnostic workflow of soft tissue and bone tumours. J Pathol Clin Res 2024; 10:e12376. [PMID: 38738521 PMCID: PMC11089496 DOI: 10.1002/2056-4538.12376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/16/2024] [Accepted: 04/15/2024] [Indexed: 05/14/2024]
Abstract
The identification of gene fusions has become an integral part of soft tissue and bone tumour diagnosis. We investigated the added value of targeted RNA-based sequencing (targeted RNA-seq, Archer FusionPlex) to our current molecular diagnostic workflow of these tumours, which is based on fluorescence in situ hybridisation (FISH) for the detection of gene fusions using 25 probes. In a series of 131 diagnostic samples targeted RNA-seq identified a gene fusion, BCOR internal tandem duplication or ALK deletion in 47 cases (35.9%). For 74 cases, encompassing 137 FISH analyses, concordance between FISH and targeted RNA-seq was evaluated. A positive or negative FISH result was confirmed by targeted RNA-seq in 27 out of 49 (55.1%) and 81 out of 88 (92.0%) analyses, respectively. While negative concordance was high, targeted RNA-seq identified a canonical gene fusion in seven cases despite a negative FISH result. The 22 discordant FISH-positive analyses showed a lower percentage of rearrangement-positive nuclei (range 15-41%) compared to the concordant FISH-positive analyses (>41% of nuclei in 88.9% of cases). Six FISH analyses (in four cases) were finally considered false positive based on histological and targeted RNA-seq findings. For the EWSR1 FISH probe, we observed a gene-dependent disparity (p = 0.0020), with 8 out of 35 cases showing a discordance between FISH and targeted RNA-seq (22.9%). This study demonstrates an added value of targeted RNA-seq to our current diagnostic workflow of soft tissue and bone tumours in 19 out of 131 cases (14.5%), which we categorised as altered diagnosis (3 cases), added precision (6 cases), or augmented spectrum (10 cases). In the latter subgroup, four novel fusion transcripts were found for which the clinical relevance remains unclear: NAB2::NCOA2, YAP1::NUTM2B, HSPA8::BRAF, and PDE2A::PLAG1. Overall, targeted RNA-seq has proven extremely valuable in the diagnostic workflow of soft tissue and bone tumours.
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Affiliation(s)
| | - Sofie Claerhout
- Department of Human GeneticsUniversity Hospitals KU LeuvenLeuvenBelgium
| | - Sara Vander Borght
- Department of Human GeneticsUniversity Hospitals KU LeuvenLeuvenBelgium
- Department of PathologyUniversity Hospitals KU LeuvenLeuvenBelgium
| | - Lien Spans
- Department of Human GeneticsUniversity Hospitals KU LeuvenLeuvenBelgium
| | - Raphael Sciot
- Department of PathologyUniversity Hospitals KU LeuvenLeuvenBelgium
| | - Patrick Schöffski
- Department of General Medical OncologyUniversity Hospitals KU LeuvenLeuvenBelgium
| | - Daphne Hompes
- Department of Surgical OncologyUniversity Hospitals KU LeuvenLeuvenBelgium
| | - Friedl Sinnaeve
- Department of Orthopaedic SurgeryUniversity Hospitals KU LeuvenLeuvenBelgium
| | - Hazem Wafa
- Department of Orthopaedic SurgeryUniversity Hospitals KU LeuvenLeuvenBelgium
| | - Marleen Renard
- Department of Paediatric Hemato‐OncologyUniversity Hospitals KU LeuvenLeuvenBelgium
| | - Mari FCM van den Hout
- Department of PathologyMaastricht University Medical Center+MaastrichtThe Netherlands
| | - Astrid Vernemmen
- Department of PathologyMaastricht University Medical Center+MaastrichtThe Netherlands
| | - Louis Libbrecht
- Department of PathologyCliniques Universitaires Saint‐LucBrusselsBelgium
- Department of PathologyAZ GroeningeKortrijkBelgium
| | - An‐Katrien De Roo
- Department of PathologyCliniques Universitaires Saint‐LucBrusselsBelgium
- Institute of Experimental and Clinical ResearchUCLouvainBrusselsBelgium
| | - Filomena Mazzeo
- Institute of Experimental and Clinical ResearchUCLouvainBrusselsBelgium
- Breast ClinicKing Albert II Cancer Institute, Cliniques Universitaires Saint‐LucBrusselsBelgium
- Department of Medical OncologyKing Albert II Cancer Institute, Cliniques Universitaires Saint‐LucBrusselsBelgium
| | - Cédric van Marcke
- Institute of Experimental and Clinical ResearchUCLouvainBrusselsBelgium
- Breast ClinicKing Albert II Cancer Institute, Cliniques Universitaires Saint‐LucBrusselsBelgium
- Department of Medical OncologyKing Albert II Cancer Institute, Cliniques Universitaires Saint‐LucBrusselsBelgium
| | - Karen Deraedt
- Department of PathologyZiekenhuis Oost‐LimburgGenkBelgium
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Galvan RC, Opinaldo PV. Fibrosarcomatous Dermatofibrosarcoma Protuberans of the Head. Cureus 2024; 16:e60110. [PMID: 38860065 PMCID: PMC11164572 DOI: 10.7759/cureus.60110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2024] [Indexed: 06/12/2024] Open
Abstract
This article highlights the case of a 37-year-old male who presented with a recurrent, exponentially enlarging head mass, emphasizing the diagnostic and therapeutic challenges associated with a very rare type of tumor, fibrosarcomatous dermatofibrosarcoma protuberans (DFSP) of the head. Our patient presented with a rapidly growing head mass, initially diagnosed as a spindle cell tumor, and was managed with surgical excision and skin flap grafting. Follow-up revealed relapse and interval development of hemiparesis and hemisensory loss. MRI revealed tumor recurrence, with compression of the right parietal lobe and superior sagittal sinus. Histopathology revealed stroma with fascicles of spindle cells homogenous to fibrillar cytoplasm, with oval vesicular nuclei. Immunohistochemical staining showed positivity for CD34 and SMA. Oral chemotherapy with imatinib 800 mg/day was started. Follow-up imaging showed a marked reduction in the size of the tumor and resolution of the compression of the underlying brain parenchyma with cystic degeneration and decreased contrast enhancement. Future plans include possible surgical tumor debulking and/or radiation therapy. Although extremely rare, awareness of this tumor, with a multi-disciplinary approach to the management of the case, is vital to maximize treatment outcomes.
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Affiliation(s)
- Renato C Galvan
- Neurology, Quirino Memorial Medical Center, Quezon City, PHL
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Arias Rivera AS, Nesme Vara M, Brener Chaoul M, De La Rosa Abaroa MA, Padilla Longoria R. A Giant Malignant Solitary Fibrous Tumor of the Pancreas: A Case Report and Review of the Literature. Cureus 2024; 16:e61467. [PMID: 38953073 PMCID: PMC11215300 DOI: 10.7759/cureus.61467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2024] [Indexed: 07/03/2024] Open
Abstract
We present a case report of a giant solitary fibrous tumor (SFT) with a review of the literature and discuss its biological features and diagnosis. A 43-year-old man presented to our emergency department with abdominal pain and distension with an evolution of two days. Contrast-enhanced computed tomography (CT) showed a large, well-circumscribed semisolid mass (12 cm x 10 cm x 12 cm) localized in the pancreatic head. The histological diagnosis obtained by endoscopic ultrasound-guided trans-duodenal tumor biopsy with fine-needle aspiration showed proliferating short spindle-shaped cells, suggesting a mesenchymal neoplasia of low grade. We proceeded to a Whipple surgical technique. The histopathological study of the resected tumor confirmed proliferating spindle-shaped cells in the tissue, and one mitotic figure was observed in 10 high-power fields (HPFs). Immunostaining was positive for CD34 and STAT-6. The histological diagnosis was a malignant pancreatic SFT. In the six months posterior to the surgical procedure, the patient has been free of recurrent disease. Preoperative diagnosis is difficult and requires comprehensive evidence including clinical, immunohistochemistry, and histological features. Since there are currently no recognized best practices, we advise total surgical excision and careful clinical monitoring.
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40
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Taha M, Alamri GE, Almuyidi HM, Alnashri LO, Almarhabi MO, Alessi RM, Alzubaidi ST, Alamri AE. Assessment of Knowledge and Awareness Levels of Lipoma and Simple Surgical Excision Among Adults in Makkah Region, Saudi Arabia. Cureus 2024; 16:e59727. [PMID: 38841003 PMCID: PMC11151806 DOI: 10.7759/cureus.59727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Background Lipoma is a soft tissue tumor primarily composed of fat cells. These slow-growing, painless, subcutaneous nodules can occur in any place in the body where fat is present. Our study aims to assess the awareness, knowledge, and attitudes of Makkah region inhabitants regarding lipomas and the surgical excision method. Methodology This study used a cross-sectional methodology to evaluate the general public's knowledge regarding lipomas and the surgical excision method using a self-administered questionnaire in the Makkah region from January to April 2024. Results A total of 367 participants were included, with the majority (56.10%) aged between 18 and 29 years. The survey revealed that 48.50% had heard about lipomas, 42.80% lacked any knowledge about them, and 26.70% acquired their information via social media. Furthermore, 31.60% believed it to affect both genders equally, 46.60% admitted uncertainty, 20.40% correctly identified that lipomas can occur at any age, and 39.80% were uncertain. Overall, 57.20% correctly identified lipomas as benign tumors composed of fat cells. Opinions diverged on whether lipomas cause pain, with 46.90% being uncertain. Moreover, 25.90% of respondents thought that surgery was the sole option for removing a lipoma, while 38.10% recognized the risk of lipoma recurrence after surgical removal. Overall, 85.60% reported never being diagnosed with a lipoma, while 4.10% had been diagnosed, predominantly with single lipomas 6.00%. There were significant differences in the participants' marital status, with widowed people exhibiting the greatest awareness level, followed by single people. Conclusions Our study findings indicate a moderate level of awareness about lipomas among residents of the Makkah region. However, there are significant gaps in understanding various aspects of lipomas, including their characteristics, treatment options, and demographic distribution.
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Affiliation(s)
- Medhat Taha
- Department of Anatomy, Umm Al-Qura University, Al-Qunfudhah, SAU
| | - Ghada E Alamri
- Department of Medicine, College of Medicine, Umm Al-Qura University, Al-Qunfudhah, SAU
| | - Hanan M Almuyidi
- Department of Medicine, College of Medicine, Umm Al-Qura University, Al-Qunfudhah, SAU
| | - Laila O Alnashri
- Department of Medicine, College of Medicine, Umm Al-Qura University, Al-Qunfudhah, SAU
| | - Mona O Almarhabi
- Department of Medicine, College of Medicine, Umm Al-Qura University, Al-Qunfudhah, SAU
| | - Reham M Alessi
- Department of Medicine, College of Medicine, Umm Al-Qura University, Al-Qunfudhah, SAU
| | - Sarah T Alzubaidi
- Department of Medicine, College of Medicine, Umm Al-Qura University, Al-Qunfudhah, SAU
| | - Abdullah E Alamri
- General Surgery, South Qunfudhah General Hospital, Al-Qunfudhah, SAU
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Dhaliwal D, Sayyadioskoie S, Siatecka H, Hunt C, Diwan AH. A Tale of Two Tumors: A Collision Tumor of Atypical Fibroxanthoma and Basal Cell Carcinoma. Am J Dermatopathol 2024; 46:309-311. [PMID: 38574065 DOI: 10.1097/dad.0000000000002694] [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: 04/06/2024]
Abstract
ABSTRACT A collision tumor is an infrequent phenomenon characterized by the presence of 2 histologically distinct tumor types (either benign or malignant) occurring within the same specific anatomical site. We describe a rare case of co-occurrence of basal cell carcinoma and atypical fibroxanthoma presenting as a single lesion on the scalp in a 76-year-old man. The lesion was clinically suspicious for basal cell carcinoma and biopsied. Histologic examination showed 2 distinct tumors, one with basaloid cells and the other one with pleomorphic spindle cells colliding and growing together. Immunohistochemical stains were crucial in establishing the diagnosis. This presentation is exceedingly rare and requires additional evaluation for diagnosis.
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Affiliation(s)
- Dilshad Dhaliwal
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX
| | | | - Hanna Siatecka
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX
| | | | - A Hafeez Diwan
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX
- Department of Dermatology, Baylor College of Medicine, Houston, TX; and
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Blaiech W, Ben Othmen M, Ouahchi I, Alaya M, Belkacem O, Hmida W, Jaidane M. Recurrent paratesticular liposarcoma: a case report. Ann Med Surg (Lond) 2024; 86:3103-3108. [PMID: 38694355 PMCID: PMC11060281 DOI: 10.1097/ms9.0000000000001949] [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: 01/30/2024] [Accepted: 03/04/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction and importance Paratesticular liposarcoma (PTL) is a rare condition, with fewer than 200 cases reported worldwide. It is a malignant tumor that originates from fat tissue with high risk of recurrence. Herein, the authors present a contralateral recurrence of a treated PTL. To the best of the authors' knowledge, in the current literature, there are few cases reported with recurrent PTL. Case presentation The authors report the case of a 62-year-old man who presented with a rapidly growing painless right hemiscrotal swelling. Clinical and radiographic evidence suggested the presence of two paratesticular tumors. The patient underwent a radical orchidectomy with resection of the two tumors through an inguinal approach. The histologic examination revealed a sclerosing, well-differentiated liposarcoma. The decision of the multidisciplinary consultation meeting was not to do adjuvant treatment. A follow-up of 12 months showed recurrence of the contralateral scrotum revealed by an FDG-PET/scan. Clinical discussion PTL, a rare spermatic cord tumor, affects adults aged 50-60, often presenting with scrotal swelling. Diagnosis involves ultrasound, computed tomography, and magnetic resonance imaging. Surgical intervention, including radical orchiectomy and adjuvant radiotherapy, is common for management, while the role of chemotherapy is inconclusive. High-grade subtypes carry a higher recurrence risk. Conclusion PTL is often misdiagnosed preoperatively. It is typically managed through radical orchidectomy, which includes wide excision and high ligation to ensure free surgical margins and avoid recurrence. The role of adjuvant therapy remains debatable. Despite a generally favorable prognosis, long-term follow-up is crucial because of the elevated risk of recurrence.
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Affiliation(s)
| | | | - Ines Ouahchi
- Department of Cytogenetic and Reproductive Biology, Farhat Hached University Teaching Hospital, Sousse, Tunisia
| | - Meriam Alaya
- Department of Pathology, Sahloul University Hospital
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Hammad R, Nobre L, Ryall S, Arnoldo A, Siddaway R, Bennett J, Tabori U, Hawkins C. The Clinical Utility of a Tiered Approach to Pediatric Glioma Molecular Characterization for Resource-Limited Settings. JCO Glob Oncol 2024; 10:e2300269. [PMID: 38754050 DOI: 10.1200/go.23.00269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/09/2024] [Accepted: 02/23/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE Molecular characterization is key to optimally diagnose and manage cancer. The complexity and cost of routine genomic analysis have unfortunately limited its use and denied many patients access to precision medicine. A possible solution is to rationalize use-creating a tiered approach to testing which uses inexpensive techniques for most patients and limits expensive testing to patients with the highest needs. Here, we tested the utility of this approach to molecularly characterize pediatric glioma in a cost- and time-sensitive manner. METHODS We used a tiered testing pipeline of immunohistochemistry (IHC), customized fusion panels or fluorescence in situ hybridization (FISH), and targeted RNA sequencing in pediatric gliomas. Two distinct diagnostic algorithms were used for low- and high-grade gliomas (LGGs and HGGs). The percentage of driver alterations identified, associated testing costs, and turnaround time (TAT) are reported. RESULTS The tiered approach successfully characterized 96% (95 of 99) of gliomas. For 82 LGGs, IHC, targeted fusion panel or FISH, and targeted RNA sequencing solved 35% (29 of 82), 29% (24 of 82), and 30% (25 of 82) of cases, respectively. A total of 64% (53 of 82) of samples were characterized without targeted RNA sequencing. Of 17 HGG samples, 13 were characterized by IHC and four were characterized by targeted RNA sequencing. The average cost per sample was more affordable when using the tiered approach as compared with up-front targeted RNA sequencing in LGG ($405 US dollars [USD] v $745 USD) and HGGs ($282 USD v $745 USD). The average TAT per sample was also shorter using the tiered approach (10 days for LGG, 5 days for HGG v 14 days for targeted RNA sequencing). CONCLUSION Our tiered approach molecularly characterized 96% of samples in a cost- and time-sensitive manner. Such an approach may be feasible in neuro-oncology centers worldwide, particularly in resource-limited settings.
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Affiliation(s)
- Rawan Hammad
- Haematology Department, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
- Division of Pediatric Haematology Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Liana Nobre
- Division of Pediatric Haematology Oncology, The Hospital for Sick Children, Toronto, Canada
- Division of Hematology, Oncology and Palliative Care, Department of Pediatrics, University of Alberta & Stollery Children's Hospital, Edmonton, Canada
| | - Scott Ryall
- Division of Pathology, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Canada
| | - Anthony Arnoldo
- Division of Pathology, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
| | - Robert Siddaway
- Division of Pathology, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Canada
| | - Julie Bennett
- Division of Pediatric Haematology Oncology, The Hospital for Sick Children, Toronto, Canada
- The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Canada
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Uri Tabori
- Division of Pediatric Haematology Oncology, The Hospital for Sick Children, Toronto, Canada
- The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Cynthia Hawkins
- Division of Pathology, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
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Lee JH, Gwon MR, Kim JI, Hwang SY, Seong SJ, Yoon YR, Kim M, Kim H. Alterations in Plasma Lipid Profile before and after Surgical Removal of Soft Tissue Sarcoma. Metabolites 2024; 14:250. [PMID: 38786727 PMCID: PMC11123356 DOI: 10.3390/metabo14050250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/11/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
Soft tissue sarcoma (STS) is a relatively rare malignancy, accounting for about 1% of all adult cancers. It is known to have more than 70 subtypes. Its rarity, coupled with its various subtypes, makes early diagnosis challenging. The current standard treatment for STS is surgical removal. To identify the prognosis and pathophysiology of STS, we conducted untargeted metabolic profiling on pre-operative and post-operative plasma samples from 24 STS patients who underwent surgical tumor removal. Profiling was conducted using ultra-high-performance liquid chromatography-quadrupole time-of-flight/mass spectrometry. Thirty-nine putative metabolites, including phospholipids and acyl-carnitines were identified, indicating changes in lipid metabolism. Phospholipids exhibited an increase in the post-operative samples, while acyl-carnitines showed a decrease. Notably, the levels of pre-operative lysophosphatidylcholine (LPC) O-18:0 and LPC O-16:2 were significantly lower in patients who experienced recurrence after surgery compared to those who did not. Metabolic profiling may identify aggressive tumors that are susceptible to lipid synthase inhibitors. We believe that these findings could contribute to the elucidation of the pathophysiology of STS and the development of further metabolic studies in this rare malignancy.
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Affiliation(s)
- Jae-Hwa Lee
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea; (J.-H.L.); (M.-R.G.); (S.-J.S.); (Y.-R.Y.)
- BK21 FOUR KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Mi-Ri Gwon
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea; (J.-H.L.); (M.-R.G.); (S.-J.S.); (Y.-R.Y.)
- Clinical Omics Institute, School of Medicine, Kyungpook National University, Daegu 41405, Republic of Korea
| | - Jeung-Il Kim
- Department of Orthopaedic Surgery and Biomedical Research Institute, School of Medicine, Pusan National University, Busan 49241, Republic of Korea;
| | - Seung-young Hwang
- Pharmacokinetics Laboratory, Clinical Trial Center, Pusan National University Hospital, Busan 49241, Republic of Korea;
| | - Sook-Jin Seong
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea; (J.-H.L.); (M.-R.G.); (S.-J.S.); (Y.-R.Y.)
- BK21 FOUR KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
- Clinical Omics Institute, School of Medicine, Kyungpook National University, Daegu 41405, Republic of Korea
- Department of Clinical Pharmacology and Therapeutics, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
| | - Young-Ran Yoon
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea; (J.-H.L.); (M.-R.G.); (S.-J.S.); (Y.-R.Y.)
- BK21 FOUR KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
- Clinical Omics Institute, School of Medicine, Kyungpook National University, Daegu 41405, Republic of Korea
- Department of Clinical Pharmacology and Therapeutics, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
| | - Myungsoo Kim
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea;
| | - Hyojeong Kim
- Department of Internal Medicine, Division of Hemato-Oncology, Maryknoll Hospital, Busan 48972, Republic of Korea
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Jiménez Mascuñán C, Martínez Martínez A, Ríos Pelegrina R, Láinez Ramos-Bossini AJ. Epidural angioleiomyoma: an extraordinary cause of compressive myelopathy-MRI findings with histopathological correlation. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024:10.1007/s00586-024-08265-y. [PMID: 38647603 DOI: 10.1007/s00586-024-08265-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/15/2024] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Angioleiomyomas are benign mesenchymal tumors usually located in the limbs, with anecdotal reports in the spine. We present an atypical case of an epidural spine angioleiomyoma presenting with compressive myelopathy symptoms. The diagnosis was suggested based on MRI findings, and subsequently confirmed histopathologically. RESULTS This is the first known occurrence of pure spinal epidural angioleiomyoma as a source of compressive myelopathy. The imaging presentation, especially the 'dark reticular sign' on MRI, was crucial in suggesting the diagnosis despite the atypical location CONCLUSION: This report serves to raise awareness among clinicians and radiologists about including angioleiomyoma in differential diagnoses for spinal epidural lesions with indicative MRI features. The favorable outcome after surgical intervention underscores the necessity of swift and accurate diagnosis followed by appropriate treatment for such uncommon spinal tumors.
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Affiliation(s)
- Carlos Jiménez Mascuñán
- Department of Radiology, Hospital Universitario Virgen de Las Nieves, Avda. Fuerzas Armadas, 2, 18014, Granada, Spain
- Advanced Medical Imaging Group (TeCe22), Biosanitary Institute of Granada (Ibs.GRANADA), 18016, Granada, Spain
| | - Alberto Martínez Martínez
- Department of Radiology, Hospital Universitario Virgen de Las Nieves, Avda. Fuerzas Armadas, 2, 18014, Granada, Spain
- Advanced Medical Imaging Group (TeCe22), Biosanitary Institute of Granada (Ibs.GRANADA), 18016, Granada, Spain
| | - Rosa Ríos Pelegrina
- Department of Pathology, Hospital Universitario Virgen de Las Nieves, 18014, Granada, Spain
- Advanced Medical Imaging Group (TeCe22), Biosanitary Institute of Granada (Ibs.GRANADA), 18016, Granada, Spain
| | - Antonio Jesús Láinez Ramos-Bossini
- Department of Radiology, Hospital Universitario Virgen de Las Nieves, Avda. Fuerzas Armadas, 2, 18014, Granada, Spain.
- Advanced Medical Imaging Group (TeCe22), Biosanitary Institute of Granada (Ibs.GRANADA), 18016, Granada, Spain.
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Sagar M, Sunar D, Konkimalla A, Das S. Rare presentation of solitary fibrous tumour in the floor of the mouth. BMJ Case Rep 2024; 17:e258608. [PMID: 38649243 PMCID: PMC11043717 DOI: 10.1136/bcr-2023-258608] [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] [Indexed: 04/25/2024] Open
Abstract
A male in his 20s, a tobacco chewer, presented to the outpatient department with a history of painless, slowly progressive swelling in the floor of the mouth. After a thorough history and clinical examination, MRI was done and the tumour was completely excised. Histopathological examination revealed the mass to be a solitary fibrous tumour, confirmed with immunohistochemical markers. On subsequent follow-ups, the patient was found to be asymptomatic with no clinical signs of recurrence.
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Affiliation(s)
- Milind Sagar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Diwash Sunar
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Abhilash Konkimalla
- Department of Otorhinolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Sumanta Das
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Ishikawa M, Nakamura K, Kawano R, Hayashi H, Ikeda T, Saito M, Niida Y, Sasaki J, Okuda H, Ishihara S, Yamaguchi M, Shimada H, Isobe T, Yuza Y, Yoshimura A, Kuroda H, Yukisawa S, Aoki T, Takeshita K, Ueno S, Nakazawa J, Sunakawa Y, Nohara S, Okada C, Nishimiya K, Tanishima S, Nishihara H. Clinical and Diagnostic Utility of Genomic Profiling for Digestive Cancers: Real-World Evidence from Japan. Cancers (Basel) 2024; 16:1504. [PMID: 38672586 PMCID: PMC11048180 DOI: 10.3390/cancers16081504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/12/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
The usefulness of comprehensive genomic profiling (CGP) in the Japanese healthcare insurance system remains underexplored. Therefore, this large-scale study aimed to determine the usefulness of CGP in diagnosing digestive cancers. Patients with various cancer types recruited between March 2020 and October 2022 underwent the FoundationOne® CDx assay at the Keio PleSSision Group (19 hospitals in Japan). A scoring system was developed to identify potentially actionable genomic alterations of biological significance and actionable genomic alterations. The detection rates for potentially actionable genomic alterations, actionable genomic alterations, and alterations equivalent to companion diagnosis (CDx), as well as the signaling pathways associated with these alterations in each digestive cancer, were analyzed. Among the 1587 patients, 547 had digestive cancer. The detection rates of potentially actionable genomic alterations, actionable genomic alterations, and alterations equivalent to CDx were 99.5%, 62.5%, and 11.5%, respectively. APC, KRAS, and CDKN2A alterations were frequently observed in colorectal, pancreatic, and biliary cancers, respectively. Most digestive cancers, except esophageal cancer, were adenocarcinomas. Thus, the classification flowchart for digestive adenocarcinomas proposed in this study may facilitate precise diagnosis. CGP has clinical and diagnostic utility in digestive cancers.
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Affiliation(s)
- Marin Ishikawa
- Genomics Unit, Keio Cancer Center, Keio University School of Medicine, Integrated Medical Research Building 3-S5, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (R.K.); (H.H.); (S.T.); (H.N.)
| | - Kohei Nakamura
- Genomics Unit, Keio Cancer Center, Keio University School of Medicine, Integrated Medical Research Building 3-S5, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (R.K.); (H.H.); (S.T.); (H.N.)
| | - Ryutaro Kawano
- Genomics Unit, Keio Cancer Center, Keio University School of Medicine, Integrated Medical Research Building 3-S5, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (R.K.); (H.H.); (S.T.); (H.N.)
| | - Hideyuki Hayashi
- Genomics Unit, Keio Cancer Center, Keio University School of Medicine, Integrated Medical Research Building 3-S5, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (R.K.); (H.H.); (S.T.); (H.N.)
| | - Tatsuru Ikeda
- Department of Cancer Genome Medical Center, Hakodate Goryoukaku Hospital, 38-3, Goryoukakucho, Hakodate-shi 040-8611, Hokkaido, Japan;
| | - Makoto Saito
- Department of Genetic Medicine, Ibaraki Prefectural Center Hospital, 6528, Koibuchi, Kasama-shi 309-1793, Ibaraki, Japan;
| | - Yo Niida
- Center for Clinical Genomics, Kanazawa Medical University Hospital, 1-1, Daigaku, Uchinada 920-0293, Ishikawa, Japan;
| | - Jiichiro Sasaki
- Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara-shi 252-0329, Kanagawa, Japan;
| | - Hiroyuki Okuda
- Department of Medical Oncology, Keiyukai Sapporo Hospital, 1-1 Minami, Hondori 9, Chome, Shiroishi-ku, Sapporo 003-0026, Hokkaido, Japan;
| | - Satoshi Ishihara
- Cancer Genome Diagnosis and Treatment Center, Central Japan International Medical Center, 1-1 Kenkonomachi, Minokamo-shi 505-0010, Gifu, Japan;
| | - Masatoshi Yamaguchi
- Division of Clinical Genetics, Faculty of Medicine, University of Miyazaki Hospital, 5200 Kihara, Kiyotake-cho, Miyazaki-shi 889-1692, Miyazaki, Japan;
| | - Hideaki Shimada
- Department of Surgery and Clinical Oncology, Toho University Graduate School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan;
| | - Takeshi Isobe
- Cancer Genome Medical Center, Shimane University Hospital, 89-1, Enya-cho, Izumo-shi 693-8501, Shimane, Japan;
| | - Yuki Yuza
- Department of Hematology and Oncology, Tokyo Metropolitan Children’s Medical Center, 2-8-29 Musashidai, Fuchu-shi 183-8561, Tokyo, Japan;
| | - Akinobu Yoshimura
- Department of Clinical Oncology Director, Outpatient Chemotherapy Center, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan;
| | - Hajime Kuroda
- Department of Pathology, Tokyo Women’s Medical University, Adachi Medical Center, 4-33-1 Kohta, Adachi-ku, Tokyo 123-8558, Japan;
| | - Seigo Yukisawa
- Department of Medical Oncology, Saiseikai Utsunomiya Hospital, 911-1, Takebayashi, Utsunomiya-shi 321-0974, Tochigi, Japan;
| | - Takuya Aoki
- Department of Clinical Oncology, Tokyo Medical University Hachioji Medical Center, 1163, Tatemachi, Hachioji-shi 193-0998, Tokyo, Japan;
| | - Kei Takeshita
- Department of Clinical Genetics, Tokai University Hospital, 143, Shimokasuya, Isehara-shi 259-1193, Kanagawa, Japan;
| | - Shinichi Ueno
- Oncology Center, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima-shi 890-0075, Kagoshima, Japan;
| | - Junichi Nakazawa
- Department of Medical Oncology, Kagoshima City Hospital, 37-1, Uearatacho, Kagoshima-shi 890-8760, Kagoshima, Japan;
| | - Yu Sunakawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki 216-8511, Kanagawa, Japan;
| | - Sachio Nohara
- Biomedical Informatics Department, Communication Engineering Center, Mitsubishi Electric Software Corporation, Fuji Techno-Square, 5-4-36 Tsukaguchi-Honmachi, Amagasaki-shi 661-0001, Hyogo, Japan; (S.N.); (C.O.); (K.N.)
| | - Chihiro Okada
- Biomedical Informatics Department, Communication Engineering Center, Mitsubishi Electric Software Corporation, Fuji Techno-Square, 5-4-36 Tsukaguchi-Honmachi, Amagasaki-shi 661-0001, Hyogo, Japan; (S.N.); (C.O.); (K.N.)
| | - Ko Nishimiya
- Biomedical Informatics Department, Communication Engineering Center, Mitsubishi Electric Software Corporation, Fuji Techno-Square, 5-4-36 Tsukaguchi-Honmachi, Amagasaki-shi 661-0001, Hyogo, Japan; (S.N.); (C.O.); (K.N.)
| | - Shigeki Tanishima
- Genomics Unit, Keio Cancer Center, Keio University School of Medicine, Integrated Medical Research Building 3-S5, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (R.K.); (H.H.); (S.T.); (H.N.)
- Biomedical Informatics Department, Communication Engineering Center, Mitsubishi Electric Software Corporation, Fuji Techno-Square, 5-4-36 Tsukaguchi-Honmachi, Amagasaki-shi 661-0001, Hyogo, Japan; (S.N.); (C.O.); (K.N.)
| | - Hiroshi Nishihara
- Genomics Unit, Keio Cancer Center, Keio University School of Medicine, Integrated Medical Research Building 3-S5, 35, Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (R.K.); (H.H.); (S.T.); (H.N.)
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Kim DS, Yoon YI, Kim BK, Choudhury A, Kulkarni A, Park JY, Kim J, Sinn DH, Joo DJ, Choi Y, Lee JH, Choi HJ, Yoon KT, Yim SY, Park CS, Kim DG, Lee HW, Choi WM, Chon YE, Kang WH, Rhu J, Lee JG, Cho Y, Sung PS, Lee HA, Kim JH, Bae SH, Yang JM, Suh KS, Al Mahtab M, Tan SS, Abbas Z, Shresta A, Alam S, Arora A, Kumar A, Rathi P, Bhavani R, Panackel C, Lee KC, Li J, Yu ML, George J, Tanwandee T, Hsieh SY, Yong CC, Rela M, Lin HC, Omata M, Sarin SK. Asian Pacific Association for the Study of the Liver clinical practice guidelines on liver transplantation. Hepatol Int 2024; 18:299-383. [PMID: 38416312 DOI: 10.1007/s12072-023-10629-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/18/2023] [Indexed: 02/29/2024]
Abstract
Liver transplantation is a highly complex and challenging field of clinical practice. Although it was originally developed in western countries, it has been further advanced in Asian countries through the use of living donor liver transplantation. This method of transplantation is the only available option in many countries in the Asia-Pacific region due to the lack of deceased organ donation. As a result of this clinical situation, there is a growing need for guidelines that are specific to the Asia-Pacific region. These guidelines provide comprehensive recommendations for evidence-based management throughout the entire process of liver transplantation, covering both deceased and living donor liver transplantation. In addition, the development of these guidelines has been a collaborative effort between medical professionals from various countries in the region. This has allowed for the inclusion of diverse perspectives and experiences, leading to a more comprehensive and effective set of guidelines.
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Affiliation(s)
- Dong-Sik Kim
- Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young-In Yoon
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Beom Kyung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | | | - Jun Yong Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jongman Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Jin Joo
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - YoungRok Choi
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jeong-Hoon Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ho Joong Choi
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki Tae Yoon
- Department of Internal Medicine, Pusan National University College of Medicine, Yangsan, Republic of Korea
| | - Sun Young Yim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Cheon-Soo Park
- Department of Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Deok-Gie Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hae Won Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Won-Mook Choi
- Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Eun Chon
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Woo-Hyoung Kang
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jinsoo Rhu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Geun Lee
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yuri Cho
- Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Ilsan, Republic of Korea
| | - Pil Soo Sung
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Han Ah Lee
- Department of Internal Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Ji Hoon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Si Hyun Bae
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Mo Yang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Mamun Al Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Soek Siam Tan
- Department of Medicine, Hospital Selayang, Batu Caves, Selangor, Malaysia
| | - Zaigham Abbas
- Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Ananta Shresta
- Department of Hepatology, Alka Hospital, Lalitpur, Nepal
| | - Shahinul Alam
- Crescent Gastroliver and General Hospital, Dhaka, Bangladesh
| | - Anil Arora
- Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital New Delhi, New Delhi, India
| | - Ashish Kumar
- Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital New Delhi, New Delhi, India
| | - Pravin Rathi
- TN Medical College and BYL Nair Hospital, Mumbai, India
| | - Ruveena Bhavani
- University of Malaya Medical Centre, Petaling Jaya, Selangor, Malaysia
| | | | - Kuei Chuan Lee
- Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jun Li
- College of Medicine, Zhejiang University, Hangzhou, China
| | - Ming-Lung Yu
- Department of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | | | | | | | | | - H C Lin
- Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Masao Omata
- Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan
- University of Tokyo, Bunkyo City, Japan
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Petropoulou T, Evangelou K, Polydorou A. Sigmoid Colon Intraluminal Obstruction by a Detached Recurrent Ascending Colon Liposarcoma. Cureus 2024; 16:e58065. [PMID: 38738041 PMCID: PMC11088451 DOI: 10.7759/cureus.58065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 05/14/2024] Open
Abstract
Primary liposarcoma of the colon is extremely rare in the literature. We present a case of a 51-year-old male patient with recurrent ascending colon liposarcoma, which caused obstructive ileus, just a few days prior to his scheduled elective operation and led us to expedite his surgery. The procedure was scheduled to be a robotic right colectomy. After finishing the operation and extracting the specimen, the tumour could not be detected; hence, an exploratory laparotomy was performed. Findings were a large tumour in the sigmoid colon, causing complete obstruction. Sigmoidectomy was performed, in order to remove the tumour. To our knowledge, this is the first case published in the literature, reporting a colonic tumour detachment, displacement and causing distal bowel occlusion. This event highlights the importance of careful intraoperative inspection in patients with known intraluminal bowel malignancies that present with signs and symptoms of obstruction and emphasises the need for further research on the risk factors for tumour detachment and subsequent bowel occlusion.
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Affiliation(s)
- Thalia Petropoulou
- Robotic Colorectal Surgery, Aretaieio University Hospital, National and Kapodistrian University of Athens, Athens, GRC
- Colon and Rectal Surgery, Euroclinic Athens, Athens, GRC
| | - Kyriacos Evangelou
- Faculty of Medicine, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Andreas Polydorou
- Surgery, Aretaieio University Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
- Colon and Rectal Surgery, Euroclinic Athens, Athens, GRC
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50
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Derfoufi J, Omari M, Najioui Y, Haloui A, Al Jarroudi O, Bennani A, Brahmi SA, Afqir S. Metastatic Epithelioid Hemangioendothelioma of the Bone: A Case Report and Literature Review. Cureus 2024; 16:e58378. [PMID: 38756281 PMCID: PMC11097234 DOI: 10.7759/cureus.58378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Epithelioid hemangioendothelioma (EHE) is an extremely rare vascular tumor, which can pose a diagnostic dilemma. It affects women more than men and is mainly found in the liver, lung, and bone. To date, there are no known predisposing factors. Limited data are available on the management of EHE at metastatic stages. The only optimal treatments to prevent metastatic dissemination are surgical resection and amputation in addition to radiotherapy at early stages. The oncologist in this rare entity plays an important role in the guided and standardized management of this disease, especially for advanced stages. In this article, we report the case of a 74-year-old patient admitted with swelling on the outer aspect of the right calf associated with pain and total functional impairment of the limb. The diagnosis favored a high-risk vascular tumor resembling EHE, confirmed by bone (tibia) and soft tissue biopsy. The patient underwent staging investigations, revealing diffuse metastases to the liver, bones, and lungs. The objective of this article is to advocate for oncological intervention in this entity, particularly in the advanced stages of the disease. Despite its rarity, the advancement of clinical trials and therapeutic recommendations remains crucial for optimal treatment.
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Affiliation(s)
- Jihane Derfoufi
- Medical Oncology, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Mohammed First University, Oujda, MAR
| | - Mouhsine Omari
- Medical Oncology, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Mohammed First University, Oujda, MAR
| | - Younesse Najioui
- Pathology, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Mohammed First University, Oujda, MAR
| | - Anass Haloui
- Pathology, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Mohammed First University, Oujda, MAR
| | - Ouissam Al Jarroudi
- Medical Oncology, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Mohammed First University, Oujda, MAR
| | - Amal Bennani
- Anatomopathology, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Oujda, MAR
| | | | - Said Afqir
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
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