Clinical and Pathological Characteristics of Soft Tissue Sarcomas: A Retrospective Study From a Developing Country

Scalp myiasis associated with soft tissue sarcoma lesion: a case report and review of relevant literature

BACKGROUND

Sarcophagidae is one of the main fly families that is attracted to open wounds, ulcers, lesions, and other injuries for depositing their larvae. The presence of larvae of flies in human tissues makes myiasis. Myiasis on the scalp could be more frightening in comparison with myiasis on the other parts of the body. It is a rare myiasis case that shows the ability of myiasis agents to attack various parts of the body. On the other hand, reporting of myiasis cases by Sarcophagidae larvae is not common due to difficulties in their identification. This study aimed to emphasize the importance of Sarcohagidae larvae in producing myiasis by describing the first case of soft tissue sarcoma infestation and provides a review of human myiasis by larvae of the Sarcophagidae family during 2010-2023 and also a review of wound myiasis cases associated with malignancy during 2000-2023.

CASE PRESENTATION

A case of sarcoma cancer myiasis is reported on the scalp of a 43-year-old man who referred to one of Tehran's hospitals for surgical treatment of cancer. Before surgery, insect larvae were observed in the area of ​​sarcoma. The larvae were isolated, examined morphologically, and identified as Sarcophaga spp.

CONCLUSIONS

Myiasis has been considered as a neglected disease. Publishing of myiasis cases could be useful to alert health policy-makers about its danger and appearance in the community. It is not usual but can be expected even on the scalp of the human head. Exact daily supervision and dressing of the wound could be recommended to prevent cutaneous myiasis.

Epidemiology, pathological characteristics and survival of retroperitoneal soft‑tissue sarcomas compared with non‑retroperitoneal soft tissue sarcomas

Retroperitoneal soft-tissue sarcomas (RPS) are rare forms of mesenchymal tumors that account for ~0.15% of all malignancies. The purpose of the present study was to determine the differences between RPS and non-RPS anatomopathological and clinical features and to analyze whether the hazard ratio for short-term mortality differs between patients with RPS and non-RPS, after adjusting for differences in baseline anatomopathological and clinical features. The Veneto Cancer Registry, a high-resolution population-based dataset spanning the regional population, was used as a data source for the analysis. The current analysis focuses on all incident cases of soft-tissue sarcoma recorded by the Registry from January 1, 2017 to December 31, 2018. A bivariate analysis was carried out to compare demographic and clinical characteristics in RPS and non-RPS. Short-term mortality risk was analyzed by primary tumor site. The significance of variations in survival by site group was determined using Kaplan-Meier curves and the Log-rank test. Finally, Cox regression was used to assess the hazard ratio for survival by sarcoma group. RPS accounted for 22.8% of the total sample (92 out of 404 cases). The mean age at diagnosis was 67.6 years for RPS vs. 63.4 for non-RPS; 41.3% of RPS were >150 mm vs. 5.5% for non-RPS. Stages III and IV were more prevalent in RPS (53.2 vs. 35.6%), despite the fact that, in both groups, advanced stages are the most common onset at diagnosis. Regarding surgical margins, the present study showed that R0 is the most prevalent in non-RPS (48.7%), while R1-R2 is the most frequent in patients with RPS (39.1%). The 3-year mortality rate for retroperitoneum was 42.9 vs. 25.7%. Comparing RPS and non-RPS, the multivariable Cox model showed a hazard ratio of 1.58 after adjusting for all other prognostic factors. RPS clinical and anatomopathological characteristics differ from those of non-RPS. Overall, despite adjusting for other prognostic factors, the retroperitoneum site was an independent prognostic factor associated with a worse overall survival in sarcoma patients compared with other sites.

Global cancer surgery in low-resource settings: A strengths, weaknesses, opportunities, and threats analysis

Global cancer surgery is an essential and complex component of oncologic care. This study aims to describe global cancer surgery literature since the 2015 Lancet Commission on Global Surgery and Cancer Surgery and perform a strengths, weaknesses, opportunities, and threats (SWOT) analysis. A systematic search was performed in PubMed of global cancer surgery articles. Themes were extracted from the included studies based on the following criteria: (1) performed in low- or low-middle-income countries, (2) published during or after 2015, (3) published in peer-reviewed journals, (4) written in the English language, and (5) accessible to the authors. Themes were further grouped into strengths, weaknesses, opportunities, and threats (SWOT analysis). The search strategy identified 154 articles published from 1992 to 2022. Forty-six articles were included in the qualitative synthesis and SWOT analysis. Recurring themes included local epidemiologic studies, local innovations and feasibility studies, prioritizing quality of life outcomes, multidisciplinary team approaches, limited resources, health system gaps, lack of economic analyses, diverse cancer management strategies and priorities, inter-setting collaboration, research expansion, the coronavirus disease 2019 pandemic, and unchecked technological advancements. These strengths, weaknesses, opportunities, and threats were described and related to the themes of research, surgical systems strengthening, economics and financing, and political framing of the 2015 Lancet Commission on Global Cancer Surgery. SWOT analyses of global cancer surgery may be helpful in suggesting future strategies for this expanding field. PLAIN LANGUAGE SUMMARY: Cancer surgery is a resource-intensive yet essential component of cancer care. In the face of projected growth of cancer burden, the present gap in cancer surgery care in low-resource settings with stressed health care and surgical infrastructure risks further exacerbation. We present a strengths, weaknesses, opportunities, and threats analysis of recent global cancer surgery literature pertaining to low-resource settings.