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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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Zhang Z, Lu Y, Shi C, Chen M, He X, Zhang H. Pediatric dermatofibrosarcoma protuberans: A clinicopathologic and genetic analysis of 66 cases in the largest institution in Southwest China. Front Oncol 2023; 13:1017154. [PMID: 36776313 PMCID: PMC9916051 DOI: 10.3389/fonc.2023.1017154] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/02/2023] [Indexed: 01/28/2023] Open
Abstract
Background Dermatofibrosarcoma protuberans (DFSP) is an uncommon cutaneous tumor in children. Most published articles are sporadic or small series and lack systematically molecular analyses. The aim of our study is to better understand the clinicopathologic and genetic features of these rare lesions. Methods All patients diagnosed with DFSP aged ≤ 18 years were retrospectively reviewed from January 2006 to May 2022. Results A total of 66 cases (32 male and 34 female patients) were identified, with ages ranging from 0.3 to 18 years (median, 13 years). Tumor locations predominantly occurred on the trunk (38/66, 57.6%), followed by the extremities (20/66, 30.3%) and head/neck (8/66, 12.1%). Histological findings revealed classic (41/66, 62.1%), myxoid (4/66, 6.1%), pigmented (6/66, 9.1%), plaque-like (3/66, 4.5%), giant cell fibroblastoma (GCF; 6/66, 9.1%), and fibrosarcomatous (6/66, 9.1%) variants of DFSP. Immunochemistry revealed minority tumors (9/66, 13.6%) showing patchy or negative staining for CD34. Fluorescence in situ hybridization (FISH) indicated that 49 of 53 tested cases including all detected biopsy specimens (11/11) contained COL1A1-PDGFB fusion, in which the average copy number gain of COL1A1-PDGFB was 0.68. There were four cases negative for COL1A1-PDGFB rearrangement, one of which was found to harbor a novel COL3A1-PDGFB fusion by next-generation sequencing (NGS). Treatment for 63 patients comprised 40 marginal excisions and 23 wide local excisions (WLEs), including 1 with imatinib therapy. Follow-up information was available on 49 patients with a duration of 12-161 months (median, 60 months). Fourteen patients developed tumor recurrence, all with initial marginal excisions. The others survived with no evidence of disease. Conclusions This study of pediatric DFSP indicates certain discrepancies in clinicopathologic characteristics between children and adults. The majority of pediatric DFSPs contain COL1A1-PDGFB fusion, the same as their adult counterparts. The COL3A1-PDGFB chimerism might be associated with the special morphology of GCF, which needs further investigation. FISH is valuable in biopsy tissues and cases with atypical CD34 immunostaining, while supplementary NGS could be helpful to identify the cytogenetically cryptic DFSP. Overall, an urgent accurate diagnosis is needed to formulate an optimal therapeutic strategy in the pediatric population.
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Affiliation(s)
- Zhang Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Lu
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Changle Shi
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Min Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Xin He
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Hongying Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
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CHIJIIWA YOSHIRO, NAGANO TOMOKO, NISHIO JUN. Superficial Angiomyxoma of the Wrist: Case Report and Literature Review. In Vivo 2023; 37:503-505. [PMID: 36593012 PMCID: PMC9843795 DOI: 10.21873/invivo.13107] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/16/2022] [Accepted: 11/24/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND/AIM Superficial angiomyxoma (SAM) is a rare benign soft-tissue tumor that usually occurs in the trunk, head and neck, and lower extremity of middle-aged adults. Herein, we describe an unusual case of SAM of the wrist, which was initially diagnosed as a ganglion cyst on imaging. CASE REPORT The patient was a 71-year-old man with no history of trauma who presented with a 2-year history of a palpable mass in the left wrist. Physical examination revealed a 2.5-cm, elastic hard, mobile, nontender mass. Magnetic resonance imaging revealed a well-defined mass with iso-signal intensity relative to skeletal muscle on T1-weighted sequences and very high signal intensity on T2-weighted fat-suppressed sequences. Subtle internal enhancement was seen following gadolinium administration. Complete excision was performed under general anesthesia with tourniquet control. Histologically, the lesion was composed of bland spindle to stellate-shaped cells in an abundant myxoid stroma. Immunohistochemically, the lesional cells were positive for CD34 but negative for S-100 protein, smooth-muscle actin, desmin, epithelial membrane antigen and pancytokeratin. These findings were consistent with a diagnosis of SAM. There was no clinical evidence of recurrence during a follow-up period of 3 months. CONCLUSION Although extremely rare, SAM should be considered in the differential diagnosis of a cyst-like solid lesion near small joints.
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Nakayama S, Nishio J, Aoki M, Koga K, Nabeshima K, Yamamoto T. GLUT-1 expression is helpful to distinguish myxofibrosarcoma from nodular fasciitis. Histol Histopathol 2023; 38:47-51. [PMID: 35792526 DOI: 10.14670/hh-18-490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Myxofibrosarcoma (MFS) is a fibroblastic/myofibroblastic neoplasm with a variably myxoid stroma. Histologically, MFS shows a wide spectrum of cellularity, pleomorphism and proliferative activity. Because of its variable morphology and lack of discriminatory markers, MFS can be difficult to distinguish from some benign soft-tissue tumors, especially nodular fasciitis (NF). Glucose transporter 1 (GLUT-1) is expressed in a variety of malignant mesenchymal tumors. In the current study, we evaluated GLUT-1 expression to determine its value in distinguishing MFS from NF. Tissue specimens from 14 MFS cases and 16 NF cases were sectioned and stained for GLUT-1 using immunohistochemistry. The percentage of GLUT-1-positive cells was scored as follows: 0 (no staining), 1+ (1-19%), 2+ (20-50%) and 3+ (>50%). Samples with a score of 1+ were defined as GLUT1-expressing samples. GLUT-1 expression was seen in all 14 MFS cases, whereas only 6 NF cases (37.5%) were positive for GLUT-1 and were scored 1+. Notably, 2-3+ GLUT-1 expression was found in 86% of MFS cases and 0% of NF cases. Our results indicate that GLUT-1 is a highly sensitive immunohistochemical marker for MFS and may be useful for the differential diagnosis of MFS and NF.
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Affiliation(s)
- Shizuhide Nakayama
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
| | - Jun Nishio
- Section of Orthopaedic Surgery, Department of Medicine, Fukuoka Dental College, Fukuoka, Japan
| | - Mikiko Aoki
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kaori Koga
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Pathological Diagnosis Center, Fukuoka Tokushukai Hospital, Fukuoka, Japan
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Xu Y, Gao H, Gao JL. Myoepithelioma-like tumor of the vulvar region: a case report in China and review of the literature. Diagn Pathol 2020; 15:3. [PMID: 31915021 PMCID: PMC6950797 DOI: 10.1186/s13000-019-0923-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/27/2019] [Indexed: 01/30/2023] Open
Abstract
Background Myoepithelioma-like tumor of the vulvar region (MELTVR) is a recently described mesenchymal neoplasm which typically arising in vulvar regions of adult women. Case presentation Here we report a case of a 65-year-old woman who presented with a 6-year history of subcutaneous mass in the vulvar region. The mass had recently increased in size continuously. Histologically, the tumor cells had an epithelioid to spindled shape. Epithelioid tumor cells proliferated singly or in a loosely cohesive manner with myxoid areas, while spindled tumor cells grew in diffuse sheets or storiform arrangements mainly in nonmyxoid areas. Immunohistochemically, the tumor cells were positive for vimentin, epithelial membrane antigen, calponin, and were partially mild to moderate positive for estrogen receptor, but completely negative for S100 protein, glial fibrillary acidic protein, CD34, desmin, SMA and cytokeratin. INI1/SMARCB1 expression was deficient. EWSR1 and FUS genes were intact tested by fluorescence in situ hybridization analysis. Based on these findings, we diagnose this case as MELTVR. The patient remained relapse-free after the lesion was widely excised during 8 months follow-up. Conclusions This disease should be included in the differential diagnostic list of vulvar tumors with epithelioid to spindled morphology. Recognition of its histopathological features and immunohistochemical reactivity will help to understand the tumor better.
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Affiliation(s)
- Yan Xu
- Department of Pathology, East Hospital, Tongji University, 1800 Yuntai Road, Pudong New District, Shanghai, 200120, China.,Central Laboratory, East Hospital, Tongji University, Shanghai, China
| | - Hui Gao
- Department of Pathology, East Hospital, Tongji University, 1800 Yuntai Road, Pudong New District, Shanghai, 200120, China.,Central Laboratory, East Hospital, Tongji University, Shanghai, China
| | - Jin-Li Gao
- Department of Pathology, East Hospital, Tongji University, 1800 Yuntai Road, Pudong New District, Shanghai, 200120, China. .,Central Laboratory, East Hospital, Tongji University, Shanghai, China.
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Fagerstedt KW, Salonen T, Zhao F, Kytölä S, Böhling T, Andersson LC. Establishment of a spontaneously transformed cell line (JU-PI) from a myxoinflammatory fibroblastic sarcoma. Tumour Biol 2018; 40:1010428318777936. [DOI: 10.1177/1010428318777936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Myxoinflammatory fibroblastic sarcoma is a soft-tissue neoplasm most frequently found in the distal extremities of middle-aged adults. Most myxoinflammatory fibroblastic sarcoma are low-grade tumors with propensity for local recurrence after incomplete removal. We report a myxoinflammatory fibroblastic sarcoma which developed in the foot of a 41-year-old male and showed an exceptionally aggressive course with metastatic spread and fatal outcome within 16 months. We managed to establish a spontaneously transformed continuous cell line, called JU-PI, from a metastatic lesion. The JU-PI cells have a sub-tetraploid karyotype including the 1;10 chromosomal translocation and amplification of the proximal end of 3p; these features are considered genetic signatures of myxoinflammatory fibroblastic sarcoma. Both the primary tumor and the JU-PI cells showed nuclear expression of the TFE3 transcription factor but TFE3-activating chromosomal rearrangements were not found. To our knowledge, JU-PI is the first established myxoinflammatory fibroblastic sarcoma cell line. JU-PI cells offer a tool for investigating the molecular oncology of myxoinflammatory fibroblastic sarcoma.
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Affiliation(s)
| | - Tarja Salonen
- HUSLAB and Helsinki University Hospital, Helsinki, Finland
| | - Fang Zhao
- Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Soili Kytölä
- HUSLAB and Helsinki University Hospital, Helsinki, Finland
| | - Tom Böhling
- Department of Pathology, University of Helsinki, Helsinki, Finland
- HUSLAB and Helsinki University Hospital, Helsinki, Finland
| | - Leif C Andersson
- Department of Pathology, University of Helsinki, Helsinki, Finland
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7
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Sun D, Wu Y, Liu Y, Yang J. Primary cardiac myxofibrosarcoma: case report, literature review and pooled analysis. BMC Cancer 2018; 18:512. [PMID: 29720127 PMCID: PMC5932848 DOI: 10.1186/s12885-018-4434-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 04/25/2018] [Indexed: 12/18/2022] Open
Abstract
Background Primary cardiac myxofibrosarcoma is a very rare cardiac malignancy. The majority of publications are limited to case reports. No pooled analyses of primary cardiac myxofibrosarcoma cases are available. Little clinical features and outcome patterns are acknowledged. The purpose of this study is to identify the clinical characteristics and prognostic factors of primary cardiac myxofibrosarcoma. Case presentation A case report of primary cardiac myxofibrosarcoma was presented, and a review of English language literatures of primary cardiac myxofibrosarcomas were performed electronically. Demographics, clinicopathologic data, therapy and follow-up were summarized. The median survival time and the mean survival time were calculated by Kaplan-Meier method. Survival distribution and overall survival were figured by log-rank test and cox proportional hazards models. We present a case, and retrospectively analyzed additional 30 patients derived from 24 isolated articles. The cohort consisted of 18 male and 13 female patients. The age was 41.87 ± 17.89 years. Some common features were found in clinical presentations, pathologic features, treatments and outcome patterns of primary cardiac myxofibrosarcoma. There were special features in echocardiography, histological and immunohistochemical examinations, which should be considered in diagnosis of primary cardiac myxofibrosarcoma. The median survival time/mean survival time (MST) was 14/32.66 months. The median survival time/mean survival time (MST) was 14/32.66 months. Compared to the other groups, the following groups had shorter survival characteristics, including age ≥ 40 years (14/11.79 months), female (14/26.26 months), mass diameter ≥ 40 mm (14/14.64 months), high-grade (2/11.81 months), and no post-treatment (14/28.09 months). Statistical analyses revealed that primary cardiac myxofibrosarcomas were more likely to present with local recurrences and dismal metastases. Tumors ≥ 40 mm in size (P = 0.055, HR = 6.79) or with high-grade (P = 0.063, HR = 11.45) had significantly worse prognosis. Conclusions Primary cardiac myxofibrosarcomas were more likely to present with local recurrences and dismal metastases. Echocardiography, together with histological method should be considered in ordinary diagnosis. Tumors ≥ 40 mm in size or with high-grade had significantly worse prognosis, which should be early diagnosed and treated with rational surgery.
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Affiliation(s)
- Dandan Sun
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, 110001, Liaoning Province, China.
| | - Yupeng Wu
- 2nd Department of Neurosurgery, The People's Hospital of China Medical University and The People's Hospital of Liaoning Province, Shenyang, 110016, Liaoning Province, China
| | - Yan Liu
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Jun Yang
- Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang, 110001, Liaoning Province, China
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8
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Matyakin EG, Ilkaev KD, Azizyan RI, Chuchkov VM, Anurova OA, Dronova EL, Gvetadze SR. [Fibromyxoid sarcoma of maxilla]. STOMATOLOGII︠A︡ 2017; 96:40-44. [PMID: 28617406 DOI: 10.17116/stomat201796340-44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The paper presents literature review and clinical case of patient with fibromyxoid sarcoma of maxilla illustrating diagnostic difficulties and efficacy of multidisciplinary treatment approach.
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Affiliation(s)
- E G Matyakin
- Blokhin Russian Cancer Research Center, Moscow, Russia
| | - K D Ilkaev
- Blokhin Russian Cancer Research Center, Moscow, Russia
| | - R I Azizyan
- Blokhin Russian Cancer Research Center, Moscow, Russia
| | - V M Chuchkov
- Blokhin Russian Cancer Research Center, Moscow, Russia
| | - O A Anurova
- Blokhin Russian Cancer Research Center, Moscow, Russia
| | - E L Dronova
- Blokhin Russian Cancer Research Center, Moscow, Russia; Blokhin Russian Cancer Research Center, Moscow, Russia; Blokhin Russian Cancer Research Center, Moscow, Russia
| | - Sh R Gvetadze
- Blokhin Russian Cancer Research Center, Moscow, Russia
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9
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Jagadesh N, Miller DH, Schenk W, Attia S, Sherman CE, Cortese C, May BC, Miller RC. Recurrent myxoinflammatory fibroblastic sarcoma: a case report. Clin Case Rep 2017; 5:871-875. [PMID: 28588829 PMCID: PMC5458025 DOI: 10.1002/ccr3.949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 02/09/2017] [Accepted: 03/15/2017] [Indexed: 12/15/2022] Open
Abstract
Myxoinflammatory fibroblastic sarcoma is a rare sarcoma which typically presents in the extremities and is treated by definitive surgery. In recurrent disease, the reported utilization of radiotherapy is increasing, and more modern techniques such as intensity‐modulated radiotherapy may be improving long‐term outcomes.
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Affiliation(s)
| | - Daniel H Miller
- Department of Radiation Oncology Mayo Clinic Jacksonville Florida
| | - William Schenk
- Department of Radiology Mayo Clinic Jacksonville Florida
| | - Steven Attia
- Department of Hematology/Oncology Mayo Clinic Jacksonville Florida
| | | | | | - Byron C May
- Department of Radiation Oncology Mayo Clinic Jacksonville Florida
| | - Robert C Miller
- Department of Radiation Oncology Mayo Clinic Jacksonville Florida
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Patel RB, Li T, Liao Z, Jaldeepbhai JA, Perera HAPNV, Muthukuda SK, Dhirubhai DH, Singh V, Du X, Yang J. Recent translational research into targeted therapy for liposarcoma. Stem Cell Investig 2017; 4:21. [PMID: 28447036 DOI: 10.21037/sci.2017.02.09] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 02/19/2017] [Indexed: 12/18/2022]
Abstract
Liposarcomas (LPS) are among the most common soft tissue sarcomas, originating from adipocytes. Treatment for LPS typically involves surgical resection and radiation therapy, while the use of conventional cytotoxic chemotherapy for unresectable or metastatic LPS remains controversial. This review summarizes the results of recent translational research and trials of novel therapies targeting various genetic and molecular aberrations in different subtypes of LPS. Genetic aberrations such as the 12q13-15 amplicon, genetic amplification of MDM2, CDK4, TOP2A, PTK7, and CHEK1, point mutations in CTNNB1, CDH1, FBXW7, and EPHA1, as the fusion of FUS-DDIT3/EWSR1-DDIT3 are involved in the pathogenesis LPS and represent potential therapeutic candidates. Tyrosine kinase inhibitors targeting MET, AXL, IGF1R, EGFR, VEGFR2, PDGFR-β and Aurora kinase are effective in certain types of LPS. Abnormalities in the PI3K/Akt signaling pathway deregulation of C/EBP-α and its partner PPAR-γ, and the interaction between calreticulin (CRT) and CD47 are also promising therapeutic targets. These promising new approaches may help to supplement existing treatments for LPS.
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Affiliation(s)
- Rashi Bharat Patel
- International Medical School, Tianjin Medical University, Tianjin 300061, China.,Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
| | - Ting Li
- Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China.,National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
| | - Zhichao Liao
- Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China.,National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
| | - Jivani Aakash Jaldeepbhai
- International Medical School, Tianjin Medical University, Tianjin 300061, China.,Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
| | - H A Pavanika N V Perera
- International Medical School, Tianjin Medical University, Tianjin 300061, China.,Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
| | - Sujani Kaushalya Muthukuda
- International Medical School, Tianjin Medical University, Tianjin 300061, China.,Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
| | - Dholiya Hardeep Dhirubhai
- International Medical School, Tianjin Medical University, Tianjin 300061, China.,Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
| | - Vaibhav Singh
- International Medical School, Tianjin Medical University, Tianjin 300061, China.,Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
| | - Xiaoling Du
- Department of Diagnostics, Tianjin Medical University, Tianjin 300061, China
| | - Jilong Yang
- International Medical School, Tianjin Medical University, Tianjin 300061, China.,Department of Bone and Soft Tissue Tumor, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China.,National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin 300060, China
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11
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Extraskeletal myxoid chondrosarcoma of the neck. OTOLARYNGOLOGY CASE REPORTS 2017. [DOI: 10.1016/j.xocr.2016.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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12
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De Vita A, Mercatali L, Recine F, Pieri F, Riva N, Bongiovanni A, Liverani C, Spadazzi C, Miserocchi G, Amadori D, Ibrahim T. Current classification, treatment options, and new perspectives in the management of adipocytic sarcomas. Onco Targets Ther 2016; 9:6233-6246. [PMID: 27785071 PMCID: PMC5067014 DOI: 10.2147/ott.s112580] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Sarcomas are a heterogeneous group of mesenchymal tumors arising from soft tissue or bone, with an uncertain etiology and difficult classification. Soft tissue sarcomas (STSs) account for around 1% of all adult cancers. Till date, more than 50 histologic subtypes have been identified. Adipocyte sarcoma or liposarcoma (LPS) is one of the most common STS subtypes, accounting for 15% of all sarcomas, with an incidence of 24% of all extremity STSs and 45% of all retroperitoneal STSs. The new World Health Organization classification system has divided LPS into four different subgroups: atypical lipomatous tumor/well-differentiated LPS, dedifferentiated LPS, myxoid LPS, and pleomorphic LPS. These lesions can develop at any location and exhibit different aggressive potentials reflecting their morphologic diversity and clinical behavior. Patients affected by LPS should be managed in specialized multidisciplinary cancer centers. Whereas surgical resection is the mainstay of treatment for localized disease, the benefits of adjuvant and neoadjuvant chemotherapy are still unclear. Systemic treatment, particularly chemotherapy, is still limited in metastatic disease. Despite the efforts toward a better understanding of the biology of LPS, the outcome of advanced and metastatic patients remains poor. The advent of targeted therapies may lead to an improvement of treatment options and clinical outcomes. A larger patient enrollment into translational and clinical studies will help increase the knowledge of the biological behavior of LPSs, test new drugs, and introduce new methodological studies, that is, on treatment response.
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Affiliation(s)
- Alessandro De Vita
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC
| | - Laura Mercatali
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC
| | - Federica Recine
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC
| | - Federica Pieri
- Pathology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Nada Riva
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC
| | - Chiara Liverani
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC
| | - Chiara Spadazzi
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC
| | - Giacomo Miserocchi
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC
| | - Dino Amadori
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC
| | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, FC
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Schmitz K, Schildhaus HU. [Molecular pathology of soft tissue tumors: Contribution to diagnosis and therapy prediction]. DER PATHOLOGE 2015; 36:126-36. [PMID: 25822596 DOI: 10.1007/s00292-015-0010-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Soft tissue tumors are often challenging for pathologists on the basis of morphology alone; therefore, tumor-specific chromosomal aberrations, such as translocations and fusions, amplifications or deletions can be diagnostically useful. Fluorescence in situ hybridization is widely used for the detection of most aberrations in routine diagnostics. Furthermore, reverse transcriptase PCR, sequencing and specific immunohistochemical assays are also applied. Next generation sequencing has already contributed to the identification of hitherto unknown aberrations. Molecular pathology is mainly used in sarcomas to discriminate between different tumor entities. In terms of personalized therapy and targeted treatment, molecular pathology can be utilized to detect predictive markers.
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Affiliation(s)
- K Schmitz
- Institut für Pathologie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland
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Guan Z, Yu X, Wang H, Wang H, Zhang J, Li G, Cao J, Teng L. Advances in the targeted therapy of liposarcoma. Onco Targets Ther 2015; 8:125-36. [PMID: 25609980 PMCID: PMC4293924 DOI: 10.2147/ott.s72722] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Liposarcoma (LPS) is the most common type of soft-tissue sarcoma. Complete surgical resection is the only curative means for localized disease; however, both radiation and conventional cytotoxic chemotherapy remain controversial for metastatic or unresectable disease. An increasing number of trials with novel targeted therapy of LPS have provided encouraging data during recent years. This review will provide an overview of the advances in our understanding of LPS and summarize the results of recent trials with novel therapies targeting different genetic and molecular aberrations for different subtypes of LPS.
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Affiliation(s)
- Zhonghai Guan
- Department of Surgical Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Xiongfei Yu
- Department of Surgical Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Haohao Wang
- Department of Surgical Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Haiyong Wang
- Department of Surgical Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Jing Zhang
- Department of Surgical Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Guangliang Li
- Department of Medicine Oncology, Zhejiang Cancer Hospital, Zhejiang, People's Republic of China
| | - Jiang Cao
- Clinical Research Center, The 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Lisong Teng
- Department of Surgical Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
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Dell'Aversana Orabona G, Iaconetta G, Abbate V, Piombino P, Romano A, Maglitto F, Salzano G, Califano L. Head and neck myxofibrosarcoma: a case report and review of the literature. J Med Case Rep 2014; 8:468. [PMID: 25547541 PMCID: PMC4320505 DOI: 10.1186/1752-1947-8-468] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 12/04/2014] [Indexed: 02/02/2023] Open
Abstract
Introduction Myxofibrosarcoma is the most common soft tissue sarcoma that occurs in late adult life, peaking in the seventh decade, and it is mainly encountered in the lower extremities. Myxofibrosarcoma of the head and neck are extremely rare. To the best of our knowledge, only 19 cases have been described in the head and neck so far. This is a literature review and retrospective chart review of our experience in head and neck myxofibrosarcoma treatment in our department. Case presentation In this case report we describe a 35-year-old Caucasian man who presented the first case of myxofibrosarcoma arising from the pterygopalatine fossa. The peculiar anatomical location and the extent in the midcheek region make this case a hard “challenge” for the surgeon, in order to guarantee wide surgical margins of resection. A total right maxillectomy was accomplished by means of the Weber-Ferguson approach, preserving the orbital floor. The excised portion was reconstructed using the free rectus abdominis myocutaneous flap. Postoperative radiotherapy was given to the area adjacent to the lesion, with a total dose of 60Gy. No relapse occurred in the 27-month postoperative follow-up. Conclusions The case described suggests the importance of combined surgical and adjuvant radiotherapy to avoid local and distant recurrences of the tumor. In our opinion, combined surgical and adjuvant radiotherapy followed by close clinical observation to search for a metastatic disease is advisable in all cases. Further studies are needed to confirm the efficacy of combined radio-chemotherapy for head and neck myxofibrosarcoma in terms of long-term disease-free survival.
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Affiliation(s)
| | | | - Vincenzo Abbate
- Department of Maxillofacial surgery, University of Naples "Federico II", Naples, Italy.
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Joseph CG, Hwang H, Jiao Y, Wood LD, Kinde I, Wu J, Mandahl N, Luo J, Hruban RH, Diaz LA, He TC, Vogelstein B, Kinzler KW, Mertens F, Papadopoulos N. Exomic analysis of myxoid liposarcomas, synovial sarcomas, and osteosarcomas. Genes Chromosomes Cancer 2013; 53:15-24. [PMID: 24190505 DOI: 10.1002/gcc.22114] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 09/09/2013] [Accepted: 09/10/2013] [Indexed: 02/03/2023] Open
Abstract
Bone and soft tissue sarcomas are a group of histologically heterogeneous and relatively uncommon tumors. To explore their genetic origins, we sequenced the exomes of 13 osteosarcomas, eight myxoid liposarcomas (MLPS), and seven synovial sarcomas (SYN). These tumors had few genetic alterations (median of 10.8). Nevertheless, clear examples of driver gene mutations were observed, including canonical mutations in TP53, PIK3CA, SETD2, AKT1, and subclonal mutation in FBXW7. Of particular interest were mutations in H3F3A, encoding the variant histone H3.3. Mutations in this gene have only been previously observed in gliomas. Loss of heterozygosity of exomic regions was extensive in osteosarcomas but rare in SYN and MLPS. These results provide intriguing nucleotide-level information on these relatively uncommon neoplasms and highlight pathways that help explain their pathogenesis.
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Affiliation(s)
- Christine G Joseph
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Heejung Hwang
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Yuchen Jiao
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Laura D Wood
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Isaac Kinde
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Jian Wu
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Nils Mandahl
- Department of Clinical Genetics, University and Regional Laboratories, Lund University, SE-22185 Lund, Sweden
| | - Jinyong Luo
- Ministry of Educations Key Laboratory of Clinical Diagnostic Medicine, Chongqinq 400046, China
| | - Ralph H Hruban
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Luis A Diaz
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Tong-Chuan He
- The University of Chicago Medical Center, Chicago, IL 60637
| | - Bert Vogelstein
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Kenneth W Kinzler
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Fredrik Mertens
- Department of Clinical Genetics, University and Regional Laboratories, Lund University, SE-22185 Lund, Sweden
| | - Nickolas Papadopoulos
- Ludwig Center, the Howard Hughes Medical Institutions, and the Departmentof Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
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Davidović R, Sopta J, Mandušić V, Krajnović M, Stanojević M, Tulić G, Dimitrijević B. p14(ARF) methylation is a common event in the pathogenesis and progression of myxoid and pleomorphic liposarcoma. Med Oncol 2013; 30:682. [PMID: 23918242 DOI: 10.1007/s12032-013-0682-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 07/26/2013] [Indexed: 02/03/2023]
Abstract
Liposarcoma represents the most frequent group of soft tissue sarcomas. The group can be divided into three different classes: (1) differentiated/undifferentiated (WDLPS/DDLPS), (2) myxoid/round cell (MLPS/RCLPS) and (3) pleomorphic liposarcoma (PLS). It has become apparent that p53-p14 and Rb-p16 pathways play important roles in the pathogenesis of various sarcoma types. Molecular studies of the genes involved in these two pathways showed wide variations between the liposarcoma subtypes or even within the same subtype. We sought to examine mutational status of p53 and methylation status of p16 (INK4a) /p14 (ARF) genes in primary and recurrent liposarcoma tumors. There were twelve myxoid (12/18, 66.7 %) and six pleomorphic liposarcoma (6/18, 33.3 %) samples. Immunohistochemical analysis revealed that p53 protein was overexpressed in 3/12 MLPS (25 %) and 6/6 PLS (100 %). Mutational analysis showed that 2/11 MLPS (18.2 %) and 2/6 PLS (33.3 %) contained mutated p53 gene. On the other hand, 3/18 samples (16.7 %) had methylated p16 promoter. However, the frequencies of the p14 (ARF) gene methylation were 83.3 % (10/12) and 50 % (3/6) in myxoid and pleomorphic group, respectively. Overall, 15 out of 18 (83.3 %) samples had either p53 gene mutation or methylated p14 (ARF) promoter. The results from the current study suggest significant impact of the p14 (ARF) gene methylation on the pathogenesis and progression of myxoid and to a lesser extent pleomorphic liposarcoma. Despite the limited number of samples, our study points to necessity of further investigation of p53-p14 and Rb-p16 pathways in liposarcoma.
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Affiliation(s)
- Radoslav Davidović
- Department for Radiobiology and Molecular Genetics, Institute of Nuclear Sciences Vinča, University of Belgrade, Mike Alasa 12-14, 11000, Belgrade, Serbia.
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Kim H, Hwangbo W, Ahn S, Kim S, Kim I, Kim CH. Myxoid liposarcoma with cartilaginous differentiation: a case study with cytogenetical analysis. KOREAN JOURNAL OF PATHOLOGY 2013; 47:284-8. [PMID: 23837023 PMCID: PMC3701826 DOI: 10.4132/koreanjpathol.2013.47.3.284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 08/31/2012] [Accepted: 09/04/2012] [Indexed: 12/19/2022]
Abstract
Myxoid liposarcoma is a subtype of liposarcoma. This specific subtype can be identified based on its characteristic histological and cytogenetical features. The tumor has a fusion transcript of the CHOP and TLS genes, which is caused by t(12;16)(q13;p11). Most of the fusion transcripts that have been identified fall into three categories, specifically type I (exons 7-2), type II (exons 5-2), and type III (exons 8-2). A total of seven myxoid liposarcomas associated with the rare phenomenon of cartilaginous differentiation have been documented in the literature. Currently, only one of these cases has been cytogenetically analyzed, and the analysis indicated that it was a type II TLS-CHOP fusion transcript in both the typical myxoid liposarcoma and cartilaginous areas. This study presents a second report of myxoid liposarcoma with cartilaginous differentiation, and includes a cytogenetical analysis of both the myxoid and cartilaginous areas.
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Affiliation(s)
- Hyunchul Kim
- Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Qiubei Z, Cheng L, Yaping X, Shunzhang L, Jingping F. Myxofibrosarcoma of the sinus piriformis: case report and literature review. World J Surg Oncol 2012; 10:245. [PMID: 23152982 PMCID: PMC3534627 DOI: 10.1186/1477-7819-10-245] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 09/21/2012] [Indexed: 01/07/2023] Open
Abstract
Myxofibrosarcoma is a common sarcoma in the extremities of older people, but is rare in the head and neck region. Here, we report the case of a 42-year-old male patient in whom myxofibrosarcoma generated from the sinus piriformis. Histopathologically, the tumor was characterized by spindle cellular proliferation with moderate cellular density in fibromyxoid stroma. Immunohistochemically, the tumor cells showed positive reactivity for vimentin, Ki-67, smooth muscle actin, and CD34, but negative staining for S-100. Based on these results, the tumor was diagnosed as a low-grade myxofibrosarcoma. Resection of the tumor was performed via a transcervical approach. The patient’s postoperative clinical course was uneventful and no local recurrence or distant metastasis has been found so far. The pathology, clinical characteristics, and treatment of myxofibrosarcoma are also reviewed.
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Affiliation(s)
- Zhu Qiubei
- Department of ear, nose and throat, Changzheng Hospital, No 415, Fengyang Road, Shanghai, Huangpu District, 200003, China
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Nishio J. Updates on the cytogenetics and molecular cytogenetics of benign and intermediate soft tissue tumors. Oncol Lett 2012; 5:12-18. [PMID: 23255885 DOI: 10.3892/ol.2012.1002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 10/04/2012] [Indexed: 12/20/2022] Open
Abstract
SOFT TISSUE TUMORS ARE CLASSIFIED ACCORDING TO THEIR HISTOLOGICAL RESEMBLANCE TO NORMAL ADULT TISSUES AND CAN BE GROUPED INTO THE FOLLOWING CATEGORIES BASED ON METASTATIC POTENTIAL: benign, intermediate (locally aggressive), intermediate (rarely metastasizing) and malignant. Over the past two decades, considerable progress has been made in our understanding of the genetic background of soft tissue tumors. Traditional laboratory techniques, such as cytogenetic analysis and fluorescence in situ hybridization (FISH), can be used for diagnostic purposes in soft tissue pathology practice. Moreover, cytogenetic and molecular studies are often necessary for prognostics and follow-up of soft tissue sarcoma patients. This review provides updated information on the applicability of laboratory genetic testing in the diagnosis of benign and intermediate soft tissue tumors. These tumors include nodular fasciitis, chondroid lipoma, collagenous fibroma (desmoplastic fibroblastoma), giant cell tumor of tendon sheath (GCTTS)/pigmented villonodular synovitis (PVNS), angiofibroma of soft tissue, myxoinflammatory fibroblastic sarcoma (MIFS) and ossifying fibromyxoid tumor (OFMT).
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Affiliation(s)
- Jun Nishio
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
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Nishio J, Naito M. FDG PET/CT and MR imaging of intramuscular myxoma in the gluteus maximus. World J Surg Oncol 2012; 10:132. [PMID: 22748070 PMCID: PMC3433341 DOI: 10.1186/1477-7819-10-132] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Accepted: 03/11/2012] [Indexed: 01/02/2023] Open
Abstract
Intramuscular myxoma is a rare benign soft tissue tumor which may be mistaken for other benign and low-grade malignant myxoid neoplasms. We present the case of a 63-year-old woman with an asymptomatic intramuscular myxoma discovered incidentally on a whole-body F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography. PET images showed a mild FDG uptake (maximum standardized uptake value, 1.78) in the left gluteus maximus. Subsequent magnetic resonance (MR) imaging revealed a well-defined ovoid mass with homogenous low signal intensity on T1-weighted sequences and markedly high signal intensity on T2-weighted sequences. Contrast-enhanced MR images showed heterogeneous enhancement throughout the mass. The diagnosis of intramuscular myxoma was confirmed on histopathology after surgical excision of the tumor. The patient had no local recurrence at one year follow-up. Our case suggests that intramuscular myxoma should be considered in the differential diagnosis of an oval-shaped intramuscular soft tissue mass with a mild FDG uptake.
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Affiliation(s)
- Jun Nishio
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
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