Prominent Intracytoplasmic Crystals in Alveolar Soft Part Sarcoma (ASPS): An Aid in Cytological Diagnosis

Lingual alveolar soft part sarcoma with absent TFE3 rearrangement

Background

Lingual ASPS is extremely rare and aggressive tumor. rearrangement is typically detected in ASPS patients using FISH analysis.

Aim

To present the clinical, histopathological, and radiological features of lingual Alveolar Soft Part Sarcoma.

Method

A 30‐year‐old male presented with a painless, slowly growing mass of the tongue. Initial impression was of benign vascular lesion. Later, the patient became symptomatic as the mass progressed in size, which necessitated further investigations.

Result

A lip‐split, mandibulotomy was performed for the excision of the tumor and revealed an alveolar soft part sarcoma with PAS‐positive, diastase resistant intracytoplasmic granules. However, molecular analysis using FISH was negative for TFE3 rearrangement. Patient underwent partial glossectomy with postoperative radiotherapy.

Conclusion

Clinical and pathological correlation of ASPS is very useful to reach a proper diagnosis.

Alveolar soft part sarcoma of uterine cervix in a postmenopausal woman: a case report and review of literature

We report a case of alveolar soft part sarcoma (ASPS) in a 68-year-old woman's uterine cervix. Macroscopic observation revealed an unencapsulated lesion confined to the cervical stroma, measuring 10 mm in diameter. Microscopic examination showed large, round or polygonal tumor cells, arranging in a well-defined nests pattern with scanty vascular stroma. Immunohistochemistry was performed. Tumor cells showed positivity for Ki-67 (2%), TFE-3, CD68, and myoD1 (cytoplasm) , while negative for HNF1β, CD10, RCC, PAX-8, CK7, CK18, CK8, CR, EMA, HMB-45, S-100, CgA, and Syn. Periodic acid-Schiff stain after diastase digestion (PAS-D) had revealed rod-like or rhomboid crystals of some cells. The diagnosis of ASPS was confirmed. ASPS was a rare soft tissue malignancy in female reproductive system. After a detailed study of the reported cases, we summarized some clinicopathological differences between cervical and soft tissue ASPS.

Alveolar Soft Part Sarcoma with Unusual Cardiac Metastasis: A Case Report and Review of the Literature

Alveolar soft part sarcoma is a very uncommon soft tissue malignancy which accounts for <1% of soft tissue sarcoma. It is a malignant and highly vascular tumor arising most commonly in the musculature of the lower extremities, with metastasis primarily to the lungs, bones, and brain. Cardiac metastasis is very rare and only 5 cases have been reported in the literature so far. We report a case of a young woman with a history of surgically resected alveolar soft part sarcoma of left thigh who presented with persistent dry cough and was found to have a cardiac mass, which on biopsy proved to be alveolar soft part sarcoma.

Rare Case Report of Alveolar Soft Part Sarcoma of the Orbit

Alveolar soft part sarcoma (ASPS) is a rare but distinct soft tissue tumor with unique histopathological and electron microscopic features. Orbital involvement is rare with only few reports published in the literature. ASPS have an indolent clinical course, but it is known to metastasize. Primary modality of treatment is surgery followed by adjuvant treatment. This case is a unique presentation with orbital mass with on and off bleeding. This is the largest orbital ASPS for which orbital exenteration was performed.

Identification of target genes of cediranib in alveolar soft part sarcoma using a gene microarray

The aim of the present study was to identify the target genes of cediranib and the associated signaling pathways in alveolar soft part sarcoma (ASPS). A microarray dataset (GSE32569) was obtained from the Gene Expression Omnibus database. The R software package was used for data normalization and screening of differentially expressed genes (DEGs). The Database for Annotation, Visualization and Integrated Discovery was used to perform Gene Ontology analysis. Gene Set Enrichment Analysis was performed to obtain the up- and downregulated pathways in ASPS. The Distant Regulatory Elements of co-regulated genes database was used to identify the transcription factors (TFs) that were enriched in the signaling pathways. A protein-protein interaction (PPI) network was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins database and was visualized using Cytoscape software. A total of 71 DEGs, including 59 upregulated genes and 12 downregulated genes, were identified. Gene sets associated with ASPS were enriched primarily in four signaling pathways: The phenylalanine metabolism pathway, the mitogen-activated protein kinase (MAPK) signaling pathway, the taste transduction pathway and the intestinal immune network for the production of immunoglobulin A. Furthermore, 107 TFs were identified to be enriched in the MAPK signaling pathway. Certain genes, including those coding for Fms-like tyrosine kinase 1, kinase insert domain receptor, E-selectin and platelet-derived growth factor receptor D, that were associated with other genes in the PPI network, were identified. The present study identified certain potential target genes and the associated signaling pathways of cediranib action in ASPS, which may be helpful in understanding the efficacy of cediranib and the development of new targets for cediranib.

Cryoablation Combined with Iodine-125 Implantation in the Treatment of Cardiac Metastasis from Alveolar Soft Part Sarcoma: A Case Report

Objectives

A 36-year-old Asian man was referred to our hospital with cardiac metastasis. He had a history of alveolar soft part sarcoma and initially underwent resection in 2005.

Methods

After exposing the tumor by thoracotomy, cryoablation was performed under ultrasound guidance. This treatment was combined with iodine-125 seed implantation to treat the cardiac metastasis.

Results

The patient had an uneventful recovery, and his cardiac function shows no obvious abnormalities. Imaging techniques suggest that cardiac metastasis was well controlled, and the patient is still alive 12 months after treatment.

Conclusions

Tumor cryoablation, combined with iodine seed implantations, may be regarded as a means of palliative treatment.

Alveolar soft-part sarcoma in the left forearm with cardiac metastasis: A case report and literature review

Alveolar soft-part sarcoma (ASPS) is an uncommon soft-tissue neoplasm, which is commonly found in the deep soft tissues of the extremities, with a propensity for recurrence and metastasis. However, the metastasis of ASPS to the heart is exceedingly rare. The present study reports such a rare case with cardiac metastasis. Using computed tomography, a 37-year-old man was diagnosed with brain, lung and spleen metastases from a previously treated ASPS in the left forearm. Cardiac metastasis was then diagnosed 1 month later. Despite chemotherapy and palliative whole-brain radiotherapy, the patient succumbed to the disease shortly after. This case suggests that the widespread metastases and cardiac involvement of ASPS may result in a poor outcome.