1
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Niba EET, Awano H, Nishimura N, Koide H, Matsuo M, Shinohara M. Differential metabolic secretion between mdx mouse-derived spindle cell sarcomas and rhabdomyosarcomas drives tumor type development. Am J Physiol Cell Physiol 2024. [PMID: 38646787 DOI: 10.1152/ajpcell.00523.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 04/10/2024] [Indexed: 04/23/2024]
Abstract
The dystrophin (DMD) gene is recognized for its significance in Duchenne muscular dystrophy (DMD), a lethal and progressive skeletal muscle disease. Some DMD patients, as well as model mice with muscular dystrophy (mdx), spontaneously develop various types of tumors, among which rhabdomyosarcoma (RMS) is the most prominent. By contrast, spindle cell sarcoma (SCS) has rarely been reported in patients or mdx mice. In this study, we aimed to use metabolomics to better understand the rarity of SCS development in mdx mice. Gas chromatography-mass spectrometry was employed to compare the metabolic profiles of spontaneously developed SCS and RMS tumors from mdx mice, and metabolite supplementation assays and silencing experiments were used to assess the effects of metabolic differences in SCS tumor-derived cells. The levels of 75 metabolites exhibited differences between RMS and SCS, 25 of which were significantly altered. Further characterization revealed downregulation of non-essential amino acids, including alanine, in SCS tumors. Alanine supplementation enhanced the growth, epithelial-mesenchymal transition, and invasion of SCS cells. Reduction of intracellular alanine via knockdown of the alanine transporter Slc1a5 reduced the growth of SCS cells. Lower metabolite secretion and reduced proliferation of SCS tumors may explain the lower detection rate of SCS in mdx mice. Targeting of alanine depletion pathways may have potential as a novel treatment strategy.
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Affiliation(s)
- Emma Eko Tabe Niba
- Laboratory of Molecular and Biochemical Research, Biomedical Research Core facilities, Juntendo University, Bunkyo-ku,, Tokyo, Japan
| | - Hiroyuki Awano
- Organization for Research Initiative and Promotion, Tottori University Hospital, Japan
| | | | | | | | - Masakazu Shinohara
- Division of Epidemiology, Kobe University Graduate School of Medicine, Kobe, Japan; The Integrated Center for Mass Spectrometry, Kobe University Graduate School of Medicine, Kobe, KOBE, Japan
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2
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Ghrewati M, Mahmoud A, Mohtadi M, Russo J, Alnabulsi M, Ismail M, Kumar M. Spindle Cell Carcinoma Presenting as a Massive Pleural Effusion. Cureus 2024; 16:e54526. [PMID: 38516459 PMCID: PMC10956378 DOI: 10.7759/cureus.54526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
The lung's sarcomatoid carcinomas (SC) are a heterogeneous sporadic group of non-small cell lung carcinomas (NSCLCs) and are very challenging to diagnose and treat. Spindle cell carcinoma (SpCC) is a very rare subset of this group. Hence, the prognosis and treatments are unclear due to the limited literature available. The presentation of this cancer varies based on the site of the neoplasm and the complications and metastases observed at the time of diagnosis. Here, we report a 73-year-old man who presented to the emergency room after two months of worsening dyspnea and fatigue. Chest X-ray showed an extensive left-sided pleural effusion. A computed tomography (CT) scan of the chest showed a pleural-based mass that came back as SpCC, for which he was referred to a university hospital.
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Affiliation(s)
- Moutaz Ghrewati
- Oncology, St. Joseph's University Medical Center, Paterson, USA
| | - Anas Mahmoud
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Malina Mohtadi
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Joseph Russo
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Mohammad Alnabulsi
- Pulmonary and Critical Care, St. Joseph's University Medical Center, Paterson, USA
| | - Mourad Ismail
- Pulmonary and Critical Care, St. Joseph's University Medical Center, Paterson, USA
| | - Mehandar Kumar
- Oncology, St. Joseph's University Medical Center, Paterson, USA
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3
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Miyaki C, Wu K, Nye D, Ramdin N. A Rare Case of Spindle Cell Sarcoma With Rare Asymptomatic Cerebellar Metastasis. Cureus 2024; 16:e54766. [PMID: 38523942 PMCID: PMC10961104 DOI: 10.7759/cureus.54766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Sarcomas are one of the rarest cancers, occurring in less than 1% of all adult malignancies. Spindle cell sarcomas are one subset of soft tissue sarcomas that are even less commonly reported in the literature due to the scarcity of cases, especially with the presence of brain metastases. We present a case of an adult male who presented with non-specific exertional dyspnea and chest pain, which was found to have spindle cell sarcoma with cerebellar metastasis.
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Affiliation(s)
- Candace Miyaki
- Internal Medicine, Geisinger Medical Center, Danville, USA
| | - Kathie Wu
- Palliative Care, Penn State Health, Hershey, USA
| | - David Nye
- Internal Medicine, Geisinger Medical Center, Danville, USA
| | - Nadia Ramdin
- Oncology, Geisinger Medical Center, Danville, USA
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4
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Koshyk O, Dehner CA, van den Hout MFCM, Bempt IV, Sciot R, Huang HY, Agaimy A, Din NU, Klubíčková N, Mosaieby E, Skálová A, Michalová K, Schöffski P, Oliveira AM, Halling KC, Gupta S, Gross JM, Nin JWM, Michal M, Folpe AL, Kosemehmetoglu K, Torres-Mora J, Michal M. EWSR1::POU2AF3(COLCA2) Sarcoma: An Aggressive, Polyphenotypic Sarcoma With a Head and Neck Predilection. Mod Pathol 2023; 36:100337. [PMID: 37742928 DOI: 10.1016/j.modpat.2023.100337] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/25/2023] [Accepted: 09/15/2023] [Indexed: 09/26/2023]
Abstract
EWSR1::POU2AF3 (COLCA2) sarcomas are a recently identified group of undifferentiated round/spindle cell neoplasms with a predilection for the head and neck region. Herein, we report our experience with 8 cases, occurring in 5 men and 3 women (age range, 37-74 years; median, 60 years). Tumors involved the head/neck (4 cases), and one each the thigh, thoracic wall, fibula, and lung. Seven patients received multimodal therapy; 1 patient was treated only with surgery. Clinical follow-up (8 patients; range, 4-122 months; median, 32 months) showed 5 patients with metastases (often multifocal, with a latency ranging from 7 to 119 months), and 3 of them also with local recurrence. The median local recurrence-free and metastasis-free survival rates were 24 months and 29 months, respectively. Of the 8 patients, 1 died of an unknown cause, 4 were alive with metastatic disease, 1 was alive with unresectable local disease, and 2 were without disease. The tumors were composed of 2 morphologic subgroups: (1) relatively bland tumors consisting of spindled to stellate cells with varying cellularity and fibromyxoid stroma (2 cases) and (2) overtly malignant tumors composed of nests of "neuroendocrine-appearing" round cells surrounded by spindled cells (6 cases). Individual cases in the second group showed glandular, osteogenic, or rhabdomyoblastic differentiation. Immunohistochemical results included CD56 (4/4 cases), GFAP (5/8), SATB2 (4/6), keratin (AE1/AE3) (5/8), and S100 protein (4/7). RNA sequencing identified EWSR1::POU2AF3 gene fusion in all cases. EWSR1 gene rearrangement was confirmed by fluorescence in situ hybridization in 5 cases. Our findings confirm the head/neck predilection and aggressive clinical behavior of EWSR1::POU2AF3 sarcomas and widen the morphologic spectrum of these rare lesions to include relatively bland spindle cell tumors and tumors with divergent differentiation.
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Affiliation(s)
- Olena Koshyk
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Medical Laboratory CSD, Ltd, Kyiv, Ukraine
| | - Carina A Dehner
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Mari F C M van den Hout
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Isabelle Vanden Bempt
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Hsuan-Ying Huang
- Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Nasir Ud Din
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Natálie Klubíčková
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic
| | - Elaheh Mosaieby
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic
| | - Alena Skálová
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic
| | - Květoslava Michalová
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic
| | - Patrick Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; Department of Oncology, KU Leuven, Laboratory of Experimental Oncology, Leuven, Belgium
| | - Andre M Oliveira
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Kevin C Halling
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Sounak Gupta
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - John M Gross
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Johanna W M Nin
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Michal Michal
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic
| | - Andrew L Folpe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | | | - Jorge Torres-Mora
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Michael Michal
- Department of Pathology, Charles University, Faculty of Medicine in Plzeň, Czech Republic; Bioptical Laboratory, Ltd, Plzeň, Czech Republic.
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5
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Bunajem F, Al Taei T, Mujbel N, Al Shaikh A, Al Mail S. Malignant Solitary Fibrous Tumor of the Inguinal Region: A Case Report. Cureus 2023; 15:e47123. [PMID: 38022005 PMCID: PMC10648524 DOI: 10.7759/cureus.47123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
A solitary fibrous tumor (SFT) is a rare spindle cell neoplasm in adults, usually found in the pleural and thoracic cavities. We report an interesting case of a malignant solitary fibrous tumor in a 64-year-old male who presented with a history of swelling in his right inguinal region that gradually increased in size during the past three years. Computed tomography (CT) and magnetic resonance imaging (MRI) scans of the abdomen and pelvis showed a rounded solid mass originating from the right inguinal canal suggestive of sarcoma. Elective excision of the mass was done under general anesthesia with histopathology confirming the diagnosis of high-grade spindle cell sarcoma in keeping with a malignant solitary fibrous tumor. Postoperatively, the patient had no complications and was discharged on postoperative day 4. The patient was then treated with radiotherapy. He remained free of recurrence for two years postoperatively.
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Affiliation(s)
| | - Tareq Al Taei
- Radiology, Salmaniya Medical Complex, Busaiteen, BHR
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6
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Qian XQ, Chen LL, Zhu CK, Chen YX, Wan XY. Case report: Squamous cell carcinoma and spindle cell sarcoma (SCS) arising in a mature cystic teratoma of the ovary. Front Surg 2023; 10:1193994. [PMID: 37448530 PMCID: PMC10336541 DOI: 10.3389/fsurg.2023.1193994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Objective Malignant transformation of mature ovarian teratoma is a rare phenomenon, mainly occurring in postmenopausal period. Squamous cell carcinoma accounts for 80% of all malignant transformations. Sarcoma transformation is much less common and tends to imply a poorer prognosis and aggressiveness. Case report We report a case of undifferentiated sarcoma with squamous cell carcinoma in a mature cystic teratoma of the ovary in a 36-year-old woman. The tumor shows epithelial and stromal components. This is a unique report of a benign teratoma of the ovary with malignant transformation, showing epithelial and sarcomatous components. This young woman presented with abdominal distension and a rapidly enlarging ovario-derived pelvic mass with a slightly elevated CA199 tumor marker of 115.9 U/ml. The woman underwent transabdominal excision of the left ovarian cyst on October 20, 2020. During the operation, rapid freezing pathological examination did not indicate malignancy. The postoperative paraffin pathology revealed undifferentiated sarcoma with squamous cell carcinoma (from mature cystic teratoma malignancy), and she finally received comprehensive staging surgery. Postoperative paraffin pathology showed no residual cancer in uterus and other tissues, and all lymph nodes were negative. The patient was finally diagnosed with ovarian malignant tumor IC1 stage (high-grade spindle cell sarcoma complicated with squamous cell carcinoma). Chemotherapy was completed three times after surgery, and no signs of recurrence were found after follow-up. Conclusion The preoperative diagnosis and intraoperative rapid freezing examination of malignant transformation of mature teratoma of ovary are challenging.
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Affiliation(s)
- Xue-Qian Qian
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Li-Li Chen
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chang-Kun Zhu
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ya-Xia Chen
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiao-Yun Wan
- Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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7
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Mejbel HA, Harada S, Stevens TM, Huang X, Netto GJ, Mackinnon AC, Al Diffalha S. Spindle Cell Sarcoma of the Uterus Harboring MEIS1::NCOA1 Fusion Gene and Mimicking Endometrial Stromal Sarcoma. Int J Surg Pathol 2023; 31:227-232. [PMID: 35477326 DOI: 10.1177/10668969221098081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
MEIS1::NCOA1/2 sarcomas are a newly recognized group of exceedingly rare low-grade spindle cell sarcomas that often involve the genitourinary and gynecologic tracts. Due to its deceptively low-grade morphology and the non-specific immunoprofile, these neoplasms may pose a diagnostic challenge by histologically mimicking other entities such as endometrial stromal sarcoma, smooth muscle tumor, or uterine perivascular epithelioid cell tumor (PEComa). Histologically, MEIS1::NCOA1/2 sarcomas typically show spindle cell proliferation with hyperchromatic nuclei and a generalized cytologic uniformity, arranged in short fascicles and exhibiting alternating zones of hypo- and hypercellularity. Among the previously reported cases, molecular analysis revealed the MEIS1::NCOA2 fusion as the most commonly detected fusion gene, whereas the MEIS1::NCOA1 fusion gene has been reported in only a single case that involved kidney. Herein we report the first case of uterine sarcoma harboring the MEIS1::NCOA1 fusion gene that was initially misclassified as low-grade endometrial stromal sarcoma, demonstrating its clinicopathologic features, and highlighting the essential role of molecular pathology to arrive at the accurate diagnosis that may alter disease classification and inform therapy.
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Affiliation(s)
- Haider A Mejbel
- Division of Genomics Diagnostics and Bioinformatics, Molecular Genetics Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shuko Harada
- Division of Genomics Diagnostics and Bioinformatics, Molecular Genetics Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Pathology, Division of Anatomic Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Todd M Stevens
- O'Neal Comprehensive Cancer Center, 189178The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Xiao Huang
- O'Neal Comprehensive Cancer Center, 189178The University of Alabama at Birmingham, Birmingham, AL, USA
| | - George J Netto
- Division of Genomics Diagnostics and Bioinformatics, Molecular Genetics Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA.,O'Neal Comprehensive Cancer Center, 189178The University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Pathology, Division of Anatomic Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alexander C Mackinnon
- Division of Genomics Diagnostics and Bioinformatics, Molecular Genetics Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Pathology, Division of Anatomic Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sameer Al Diffalha
- O'Neal Comprehensive Cancer Center, 189178The University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Pathology, Division of Anatomic Pathology, 9968The University of Alabama at Birmingham, Birmingham, AL, USA
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8
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Muacevic A, Adler JR, Salvatore J, Lau MW. Difficulty in Diagnosing Rare Cardiac Tumors: A Case Series. Cureus 2023; 15:e33367. [PMID: 36751182 PMCID: PMC9897718 DOI: 10.7759/cureus.33367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/05/2023] Open
Abstract
Primary cardiac tumors are rare because metastatic lesions from distant sites account for most masses. We are reporting two cases of malignant intracardiac masses with their diagnostic dilemma. Our first patient is a 72-year-old male with a pertinent history of desmoplastic and spindle cell melanoma who presented after his surveillance positron emission tomography (PET) scan showed a hypermetabolic lesion in the inferior pericardium. The initial impression for this mass is recurrent malignant melanoma. After an initial negative endometrial biopsy, the patient underwent debulking surgery, and pathology revealed high-grade spindle cell sarcoma. The patient underwent chemotherapy but had a disease progression and ultimately elected hospice care. Our second patient is a 75-year-old male with a history of stage IB adenocarcinoma of the lung who presented with progressive dyspnea. An echocardiogram revealed a moderate-sized left ventricular mass. Initial assessment based on tumor morphology and location suggested possible cardiac sarcoma. However, the patient's subsequent cardiac biopsy revealed small cell carcinoma, likely of primary cardiac origin, as no other primary nidus of the tumor was seen. Based on this result, the patient has been started on carboplatin, etoposide, and atezolizumab and responded well as of the writing of this manuscript. Given the rarity of malignant primary cardiac tumors and their variable clinical presentation, intracardiac masses are often diagnosed incidentally. In addition, given the high risk of biopsy for intracardiac masses, a presumptive diagnosis is rendered via imaging techniques. However, most of these tumors have no pathognomonic imaging findings, and their diagnosis relies heavily on physician interpretation and experience. Our case series illustrated the unpredictable nature of noninvasive methods and that even endometrial biopsy can return a false negative. Therefore, it is essential to be persistent in obtaining a pathological diagnosis, especially if the clinical picture is unclear. While these more invasive methods present the challenge of identifying whether the procedure is truly needed and locating a skilled operator, it could change the diagnosis entirely and open the patient up to new therapies.
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9
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Fujikawa T, Uemura S, Yoshida M, Hyodo S, Kozaki A, Saito A, Kishimoto K, Ishida T, Mori T, Uematsu A, Morita K, Hatakeyama T, Tamura A, Yamamoto N, Komatsu M, Soejima T, Hasegawa D, Kosaka Y. Spindle cell sarcoma with KIAA1549-BRAF resembling infantile fibrosarcoma morphologically: A case report and literature review. Oncol Lett 2022; 24:452. [PMID: 36380878 PMCID: PMC9650595 DOI: 10.3892/ol.2022.13572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/18/2022] [Indexed: 11/24/2022] Open
Abstract
Infantile fibrosarcoma (IFS) commonly harbors ETS variant transcription factor 6 (ETV6)-neurotrophic receptor tyrosine kinase 3 (NTRK3) fusion. However, the recent accessibility to clinical next-generation sequencing (NGS) has revealed ETV6-NTRK3 negative spindle cell sarcomas resembling IFS morphologically, involving NTRK1/2, MET, RET and BRAF. The present report describes a pediatric case of spindle cell sarcoma with KIAA1549-BRAF resembling IFS morphologically. A 20-month-old female patient was referred to Kobe Children's Hospital (Kobe, Japan) for the treatment of intrathoracic spindle cell sarcoma. Pathologically, the intrathoracic tumor cells were composed of spindle cells with focal hemagiopericytomatous pattern. In immunohistochemistry analysis, the intrathoracic tumor cells focally expressed desmin and WT-1 and were negative for pan-tropomyosin receptor kinase (TRK), S-100 and CD34. Fluorescence in situ hybridization analysis for ETV6 and capicua transcriptional repressor revealed negative split signals. Although the patient was initially diagnosed with IFS morphologically, KIAA1549-BRAF fusion transcript was detected by comprehensive genomic profiling with NGS using intrathoracic tumor tissues and confirmed by reverse transcription-PCR. Chemotherapy induced a reduction in the tumor size. At present, the patient is alive with the disease and has been receiving therapy for 8 months since the initiation of chemotherapy. Review of BRAF-altered spindle cell sarcomas resembling IFS morphologically revealed the inconsistency in immunohistochemical expression patterns and the diversity of BRAF fusion genes and mutations. Therefore, the elucidation of genomic profiling by NGS may assist in making an appropriate diagnosis and selecting novel alternative therapies in ETV6-NTRK3-negative spindle cell sarcomas resembling IFS morphologically.
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Affiliation(s)
- Tomoko Fujikawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Suguru Uemura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan,Correspondence to: Dr Suguru Uemura, Department of Hematology and Oncology, Kobe Children's Hospital, Minatojima-minanimachi 1-6-7, Chuo-ku, Kobe, Hyogo 650-0047, Japan, E-mail:
| | - Makiko Yoshida
- Department of Pathology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Sayaka Hyodo
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Aiko Kozaki
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Kenji Kishimoto
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Ayano Uematsu
- Department of Surgery, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Keiichi Morita
- Department of Surgery, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Tadashi Hatakeyama
- Department of Surgery, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Akihiro Tamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Nobuyuki Yamamoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Masato Komatsu
- Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Toshinori Soejima
- Department of Radiation Oncology, Kobe Proton Center, Kobe, Hyogo 650-0047, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
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10
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Georgantzoglou N, Aghighi M, Cote G, Hung YP, Kerr DA, Pettus J, Linos K. Primary Spindle Cell Sarcoma of the Lung with MGA::NUTM1 Fusion: An Extremely Rare Case of a Potentially Emerging Entity and Review of the Literature. Int J Surg Pathol 2022; 30:931-938. [PMID: 35388715 DOI: 10.1177/10668969221092125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Originally described in a rare subset of poorly differentiated squamous cell carcinomas termed NUT carcinomas, NUTM1 rearrangements are now known to characterize a wide spectrum of neoplasms including sarcomas, poromas/porocarcinomas, unclassified adnexal carcinomas and pediatric acute lymphoblastic leukemia. The advent of next-generation sequencing (NGS) has led to the identification of a multitude of novel fusion partners in addition to BRD4, which was initially reported in the majority of NUT carcinomas. NUTM1-rearranged sarcomas usually harbor fusions with the MAD gene family (MXD1, MXD4, MGA) and present as spindle cell proliferations in diverse locations in patients of all ages. Herein, we present a very rare case of spindle cell sarcoma of the lung, which harbored a NUTM1::MGA fusion and offer a comprehensive update of the recent data.
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Affiliation(s)
- Natalia Georgantzoglou
- Department of Pathology and Laboratory Medicine, 22916Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Maryam Aghighi
- Department of Pathology, 21640Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Gregory Cote
- Department of Hematology/Oncology, 2348Massachusetts General Hospital, Boston, MA, USA
| | - Yin P Hung
- Department of Pathology, 2348Massachusetts General Hospital, Boston, MA, USA
| | - Darcy A Kerr
- Department of Pathology and Laboratory Medicine, 22916Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.,Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Jason Pettus
- Department of Pathology and Laboratory Medicine, 22916Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.,Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Konstantinos Linos
- Department of Pathology and Laboratory Medicine, 22916Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.,Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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11
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Yeung MCF, Lam AYL, Shek TWH. Novel MAP4::RAF1 Fusion in a Primary Bone Sarcoma: Expanding the spectrum of RAF1 Fusion Sarcoma. Int J Surg Pathol 2022; 30:682-688. [PMID: 35156861 DOI: 10.1177/10668969221080059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Soft tissue tumors with RAF1 fusion had been emerging as a group of tumors with peculiar histology and immunoprofile. While a case series and rare case reports of RAF1 translocated sarcoma had been reported, to our knowledge a primary bone tumor with RAF1 translocation and fusion partner with MAP4 had not been described in the literature. The patient was a 60-year-old lady, with strong family history of breast cancer, who presented with pathological fracture of right humerus. X-ray revealed a 9.7 cm juxta-articular lesion of the proximal humerus, which was expansile and lytic with a non-sclerotic well defined border distally, radiologically suggestive of a giant cell tumor of bone. Excision was performed after initial biopsy. Histology showed a monomorphic low grade spindle cell lesion with prominent hyalinized stroma. Immunohistochemistry demonstrated diffuse CD34 staining, with focal staining for S100. Gene sequencing for histone 3 H3 genes was negative for hotspot mutation. Targeted RNA-seq sequencing revealed the presence of MAP4::RAF1 fusion, which was confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) and fluorescence in-situ hybridization (FISH) break-apart probes involving both genes. The overall features were consistent with a primary bone sarcoma with RAF1 fusion. This report expanded the spectrum of RAF1 fusion sarcoma and was the first report documenting its primary occurrence in bone.
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Affiliation(s)
- Maximus C F Yeung
- 71020Department of Pathology, The University of Hong Kong, Queen Mary Hospital, HKSAR
| | - Albert Y L Lam
- 71020Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, HKSAR
| | - Tony W H Shek
- 71020Department of Pathology, The University of Hong Kong, Queen Mary Hospital, HKSAR
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12
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Gambarotti M, Righi A, Sbaraglia M, Cocchi S, Benini S, Magagnoli G, Frisoni T, Palmerini E, Picci P, Dei Tos AP. Primary Malignant Peripheral Nerve Sheath Tumors of Bone: A Clinicopathologic Reappraisal of 8 Cases. Hum Pathol 2022; 122:92-102. [PMID: 35176251 DOI: 10.1016/j.humpath.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 11/30/2022]
Abstract
Primary spindle cell and pleomorphic sarcomas of bone represent an exceedingly rare group of mesenchymal malignancies that include "soft tissue" histotypes, as malignant peripheral nerve sheath tumour. Outside the head and neck region, only 36 cases of primary malignant peripheral nerve sheath tumour of bone have been described. We retrieved from our archives eight cases of primary malignant peripheral nerve sheath tumour of bone arising outside the head and neck region, describing their clinical, radiological, and morphologic features. Our series, in which all but one patient died of diseases after a median of seven months, confirms that primary malignant peripheral nerve sheath tumours of bone are aggressive tumours. Pathologists should be aware of this rare histotype. More aggressive and active adjuvant treatments should be investigated.
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Affiliation(s)
- Marco Gambarotti
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Alberto Righi
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, 40136, Italy.
| | - Marta Sbaraglia
- Department of Pathology, Azienda Ospedale-Università Padova, Padua, 35121, Italy
| | - Stefania Cocchi
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Stefania Benini
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Giovanna Magagnoli
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Tommaso Frisoni
- Department of Orthopaedic Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Emanuela Palmerini
- Osteoncology, Soft Tissue and Bone Sarcomas, Innovative Therapy Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Piero Picci
- Department of Pathology, IRCCS, Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Angelo Paolo Dei Tos
- Department of Pathology, Azienda Ospedale-Università Padova, Padua, 35121, Italy; Department of Medicine, University of Padua School of Medicine, Padua, 35121, Italy
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13
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Lei K, Rajagopal T. A Large Benign Solitary Fibrous Tumor in the Pelvis: A Unique Group. Cureus 2021; 13:e18164. [PMID: 34707948 PMCID: PMC8530770 DOI: 10.7759/cureus.18164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 11/09/2022] Open
Abstract
Solitary fibrous tumors (SFTs) are a rare type of sarcoma and ubiquitous in nature, occurring anywhere in the body. Although only a few hundred cases have been described so far, certain histological features, such as hypercellularity and high mitotic index, have been associated with a more malignant course. Tumor sizes larger than 10 cm have also been associated with higher recurrence rates. There are clinical recommendations for two distinct patient groups, those with small and benign SFTs or those with large and malignant SFTs. There are few that acknowledge the unique group of those with large but benign tumors. A case involving a 62-year-old man who underwent surgical resection of a large but benign solitary fibrous tumor of the pelvis is described.
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Affiliation(s)
- Karen Lei
- General Surgery, California Northstate University, College of Medicine, Elk Grove, USA
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14
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Ish P, Das A, Gupta N, Srikanth JK, Batra S, Chakrabarti S. A mediastinal mass with abdominal and pulmonary presentation. Adv Respir Med 2021; 88:362-363. [PMID: 32869272 DOI: 10.5603/arm.2020.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/20/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Pranav Ish
- Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, India, New Delhi, India.
| | - Abanti Das
- Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, India, New Delhi, India
| | - Nitesh Gupta
- Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, India, New Delhi, India
| | - Juvva Kishan Srikanth
- Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, India, New Delhi, India
| | - Sakshi Batra
- Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, India, New Delhi, India
| | - Shibdas Chakrabarti
- Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi, India, New Delhi, India
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15
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Pedroso A, Beckert L. Spindle cell sarcoma: a rare cause of a spontaneous pneumothorax. Respirol Case Rep 2021; 9:e00709. [PMID: 33532073 PMCID: PMC7829631 DOI: 10.1002/rcr2.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/15/2020] [Accepted: 12/28/2020] [Indexed: 11/08/2022] Open
Abstract
Secondary spontaneous pneumothoraces are associated with a variety of lung disorders. Malignancy is a rare cause of a pneumothorax and rarely the presenting feature. Cavitating primary tumours are less frequent causes of pneumothoraces than secondary tumours. We present the case of an asymptomatic spontaneous pneumothorax in a 71-year-old never-smoking woman. Her right apical pneumothorax was diagnosed by chance on a chest radiograph for a fall. Her final diagnosis was a primary spindle cell sarcoma of the pleura. This case demonstrates the need to explore the underlying causes of a non-resolving pneumothorax. The early diagnosis of her sarcoma allowed curative treatment.
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Affiliation(s)
- Ana Pedroso
- Department of Respiratory MedicineCanterbury District Health BoardChristchurchNew Zealand
- Serviço de MedicinaHospital de São Francisco Xavier (Centro Hospitalar Lisboa Ocidental)LisboaPortugal
| | - Lutz Beckert
- Department of Respiratory MedicineCanterbury District Health BoardChristchurchNew Zealand
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16
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Chima NR, Osman M, Sokos GG, Bianco C, Caccamo M. Beyond the Diagnosis of Group IV Pulmonary Hypertension: Chronic Thromboembolic Pulmonary Hypertension Mimickers. JACC Case Rep 2020; 2:1999-2003. [PMID: 34317097 PMCID: PMC8299125 DOI: 10.1016/j.jaccas.2020.05.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/15/2020] [Accepted: 05/29/2020] [Indexed: 11/10/2022]
Abstract
We present 3 patients with similar clinical presentation of group IV pulmonary hypertension but with totally different diagnoses. This case series highlights the need to keep a broad differential diagnosis and to utilize more diverse imaging modalities for the diagnosis of group IV pulmonary hypertension. (Level of Difficulty: Beginner.).
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Affiliation(s)
- Noor Rehman Chima
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
| | - Mohammed Osman
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
| | - George G. Sokos
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
| | - Christopher Bianco
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
| | - Marco Caccamo
- Heart and Vascular Institute, West Virginia University, Morgantown, West Virginia
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17
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Abstract
EWSR1-SMAD3-positive fibroblastic tumor is a recently characterized neoplasm with distinct clinicopathologic features and recurrent EWSR1-SMAD3 gene fusion. ESFT typically presents as a small, painless tumor in extremity subcutaneous tissues. Their behavior is benign, although they are prone to local recurrence. They typically comprise two components: intersecting fascicles of overlapping, uniform plump spindle cells, and less cellular hyalinized areas containing stippled calcifications. Immunohistochemically, the cells consistently show diffuse ERG nuclear expression, while other markers are negative. The morphology of this neoplasm can lead to histologic confusion with both benign and malignant soft tissue tumors, including monophasic synovial sarcoma, malignant peripheral nerve sheath tumor, and spindle cell sarcoma, not otherwise specified. Correct identification of ESFT is critical, most importantly to avoid unnecessary overtreatment as sarcoma.
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Affiliation(s)
| | | | - Robin L Jones
- The Royal Marsden, London, UK.,The Institute of Cancer Research, London, UK
| | - Vaiyapuri P Sumathi
- 4970Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.,University of Birmingham, Birmingham, UK
| | - Khin Thway
- The Royal Marsden, London, UK.,The Institute of Cancer Research, London, UK
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18
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Wang S, Guan J, Liu M, Li S, Jiang C. Solitary fibrous tumor in the subcutaneous soft tissues of the left abdominal wall: A case report. Clin Case Rep 2019; 7:1370-1373. [PMID: 31360490 PMCID: PMC6637379 DOI: 10.1002/ccr3.2217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/16/2019] [Accepted: 04/30/2019] [Indexed: 12/31/2022] Open
Abstract
Solitary fibrous tumor (SFT) derived from the abdominal wall is rare. We report a case of SFT in the abdominal wall. When abdominal computed tomography reveals soft-tissue mass and analysis of preoperative needle biopsy reveals spindle cell tumor, the possibility of SFT should be considered.
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Affiliation(s)
- Shuanhu Wang
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Bengbu Medical CollegeBengbuChina
| | - Jiajia Guan
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Bengbu Medical CollegeBengbuChina
| | - Mulin Liu
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Bengbu Medical CollegeBengbuChina
| | - Shiqing Li
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Bengbu Medical CollegeBengbuChina
| | - Congqiao Jiang
- Department of Gastrointestinal SurgeryThe First Affiliated Hospital of Bengbu Medical CollegeBengbuChina
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19
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Linde KJ, Kelleher TR, Perry JA. Biological implant-associated granulomatous inflammation resulting in secondary hypercalcemia and azotemia in a dog. Clin Case Rep 2018; 6:1801-1806. [PMID: 30214767 PMCID: PMC6132143 DOI: 10.1002/ccr3.1661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/03/2018] [Accepted: 06/05/2018] [Indexed: 12/29/2022] Open
Abstract
Implant associated granulomatous inflammation causing hypercalcemia can occur following use of commercial xenogeneic pericardial tissue patches in dogs. Removal of the implant can result in resolution of the hypercalcemia, suggesting a causal relationship between the tissue reaction to a xenogeneic implant and development of hypercalcemia.
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20
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Frakulli R, Cammelli S, Salvi F, Balestrini D, Baldissera A, Degli Esposti C, Martelli O, Abate M, Piaoli A, Ferrari S, Morganti AG, Frezza GP. Unusual case of spindle cell sarcoma metastases to right ventricle: a case report and a literature review. Ann Transl Med 2017; 5:344. [PMID: 28936438 DOI: 10.21037/atm.2017.05.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cardiac metastases from sarcoma are uncommon. Due to their rarity there is not a standard of care. However, complete cardiac metastases resection is the best option but most of patients has widespread disease. In these patients palliative radiotherapy (RT) might improve symptoms and prevent further cardiac function decline. Here we present the case of a symptomatic 30-year-old woman with spindle cell sarcoma metastasis of right ventriculum and widespread disease. The patient received radiotherapy to the heart with palliative intent. Cardiac metastases represent a challenging clinic problem. Treatment should be individualized in a multidisciplinary setting, when possible surgery seems to be the best options. However, radiotherapy even in case of widespread disease can improve clinical control symptoms by reducing the mass effect.
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Affiliation(s)
- Rezarta Frakulli
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Silvia Cammelli
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Fabrizio Salvi
- Radiation Oncology Unit, Bellaria Hospital, Bologna, Italy
| | | | | | | | | | - Massimo Abate
- Chemotherapy Unit, Istituto Ortopedico Rizzoli, via Pupilli, 1, 40136 Bologna, Italy
| | - Anna Piaoli
- Chemotherapy Unit, Istituto Ortopedico Rizzoli, via Pupilli, 1, 40136 Bologna, Italy
| | - Stefano Ferrari
- Chemotherapy Unit, Istituto Ortopedico Rizzoli, via Pupilli, 1, 40136 Bologna, Italy
| | - Alessio G Morganti
- Radiation Oncology Center, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
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21
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Kamaleshwaran KK, Pattabiraman V, Mehta S, Mohanan V, Shinto AS. Spindle cell sarcoma of pulmonary artery mimicking thromboembolism with lung metastasis detected in fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography. Indian J Nucl Med 2014; 29:249-51. [PMID: 25400365 PMCID: PMC4228589 DOI: 10.4103/0972-3919.142631] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pulmonary artery sarcoma (PAS), although rare, must be considered in the differential diagnosis of pulmonary thromboembolism (PTE). This tumor is highly malignant and the prognosis is very poor. As much as the standardized uptake values (SUVs) at fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) have helped in differentiating between benign and malignant tumors, visualization of a low-attenuation filling defect within a pulmonary artery on contrast-enhanced chest computed tomography (CT) can be suggestive of a malignancy, such as PAS, if the lesion shows high FDG uptake at PET. We present a case of PAS that showed high FDG uptake on integrated FDG PET/CT and with lung metastasis. Patient underwent endoscopic bronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA), which confirmed spindle cell sarcoma.
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Affiliation(s)
- Koramadai Karuppusamy Kamaleshwaran
- Department of Nuclear Medicine and Positron Emission Tomography/Computed Tomography, Kovai Medical Centre and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - Vr Pattabiraman
- Department of Pulmonology, Kovai Medical Centre and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - Sangita Mehta
- Department of Pathology, Kovai Medical Centre and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - Vyshakh Mohanan
- Department of Nuclear Medicine and Positron Emission Tomography/Computed Tomography, Kovai Medical Centre and Hospital Limited, Coimbatore, Tamil Nadu, India
| | - Ajit Sugunan Shinto
- Department of Nuclear Medicine and Positron Emission Tomography/Computed Tomography, Kovai Medical Centre and Hospital Limited, Coimbatore, Tamil Nadu, India
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22
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Garg A, Mooney J, Amado Escañuela MG, Mathur A, Goyal V, Nanda NC. Transthoracic echocardiographic assessment of spindle cell sarcoma of the pulmonary artery in a child. Echocardiography 2014; 31:385-7. [PMID: 24606227 DOI: 10.1111/echo.12529] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
In this report, we present a case of spindle cell sarcoma of the pulmonary artery diagnosed by transthoracic echocardiography. To the best of our knowledge, this case is the youngest reported case of pulmonary artery sarcoma (PAS) to date. PAS is frequently confused for pulmonary embolism; in this case, echocardiographic findings allowed for differentiation between pulmonary embolism and solid tumor.
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