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Guérin R, Menard AL, Angot E, Piton N, Vera P, Schwarz L, Sabourin JC, Laé M, Thiébaut PA. An unusual case of primary splenic soft part alveolar sarcoma: case report and review of the literature with emphasis on the spectrum of TFE3-associated neoplasms. Diagn Pathol 2024; 19:62. [PMID: 38643139 PMCID: PMC11031972 DOI: 10.1186/s13000-024-01483-4] [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] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/02/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Alveolar soft part sarcoma is a rare tumour of soft tissues, mostly localized in muscles or deep soft tissues of the extremities. In rare occasions, this tumour develops in deep tissues of the abdomen or pelvis. CASE PRESENTATION In this case report, we described the case of a 46 year old man who developed a primary splenic alveolar soft part sarcoma. The tumour displayed typical morphological alveolar aspect, as well as immunohistochemical profile notably TFE3 nuclear staining. Detection of ASPSCR1 Exon 7::TFE3 Exon 6 fusion transcript in molecular biology and TFE3 rearrangement in FISH confirmed the diagnosis. CONCLUSION We described the first case of primary splenic alveolar soft part sarcoma, which questions once again the cell of origin of this rare tumour.
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Affiliation(s)
- René Guérin
- Department of Pathology, Rouen University Hospital, Rouen, France
| | | | - Emilie Angot
- Department of Pathology, Rouen University Hospital, Rouen, France
| | - Nicolas Piton
- Department of Pathology, Rouen University Hospital, Rouen, France
| | - Pierre Vera
- Department of Nuclear Medecine, Centre Henri Becquerel, Rouen, France
| | - Lilian Schwarz
- Department of Digestive Surgery, Rouen University Hospital, Rouen, France
| | | | - Marick Laé
- Department of Pathology, Centre Henri Becquerel, Rouen, France
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2
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Taylor AS, Mannan R, Pantanowitz L, Chinnaiyan AM, Dhanasekaran SM, Hrycaj S, Cao X, Chan MP, Lucas D, Wang XM, Mehra R. Evaluation of TRIM63 RNA in situ hybridization (RNA-ISH) as a potential biomarker for alveolar soft-part sarcoma (ASPS). Med Oncol 2024; 41:76. [PMID: 38393424 PMCID: PMC10891236 DOI: 10.1007/s12032-024-02305-9] [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] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/17/2024] [Indexed: 02/25/2024]
Abstract
Alveolar soft-part sarcoma (ASPS) is a rare soft tissue tumor with a broad morphologic differential diagnosis. While histology and immunohistochemistry can be suggestive, diagnosis often requires exclusion of other entities followed by confirmatory molecular analysis for its characteristic ASPSCR1-TFE3 fusion. Current stain-based biomarkers (such as immunohistochemistry for cathepsin K and TFE3) show relatively high sensitivity but may lack specificity, often showing staining in multiple other entities under diagnostic consideration. Given the discovery of RNA in situ hybridization (RNA-ISH) for TRIM63 as a sensitive and specific marker of MiTF-family aberration renal cell carcinomas, we sought to evaluate its utility in the workup of ASPS. TRIM63 RNA-ISH demonstrated high levels (H-score greater than 200) of expression in 19/20 (95%) cases of ASPS (average H-score 330) and was weak or negative in cases of paraganglioma, clear cell sarcoma, rhabdomyosarcoma, malignant epithelioid hemangioendothelioma, as well as hepatocellular and adrenal cortical carcinomas. Staining was also identified in tumors with known subsets characterized by TFE3 alterations such as perivascular epithelioid cell neoplasm (PEComa, average H-score 228), while tumors known to exhibit overexpression of TFE3 protein without cytogenetic alterations, such as melanoma and granular cell tumor, generally showed less TRIM63 ISH staining (average H-scores 147 and 96, respectively). Quantitative assessment of TRIM63 staining by RNA-ISH is potentially a helpful biomarker for tumors with molecular TFE3 alterations such as ASPS.
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Affiliation(s)
- Alexander S Taylor
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA
| | - Rahul Mannan
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - Liron Pantanowitz
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA
| | - Arul M Chinnaiyan
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
- Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
- Howard Hughes Medical Institute, Ann Arbor, MI, USA
| | - Saravana M Dhanasekaran
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - Steven Hrycaj
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA
| | - Xuhong Cao
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA
| | - May P Chan
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA
| | - David Lucas
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA
| | - Xiao-Ming Wang
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA.
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA.
| | - Rohit Mehra
- Department of Pathology, University of Michigan Medical School, 2800 Plymouth Road, Building 35, Ann Arbor, MI, 48109, USA.
- Michigan Center for Translational Pathology, Ann Arbor, MI, USA.
- Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI, USA.
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3
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Zhang Y, Huang Y, Qin Y, Yang N, Yang P, Li N, Feng Z. Alveolar soft part sarcoma: a clinicopathological and immunohistochemical analysis of 26 cases emphasizing risk factors and prognosis. Diagn Pathol 2024; 19:23. [PMID: 38291475 PMCID: PMC10826116 DOI: 10.1186/s13000-024-01450-z] [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] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/21/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE This study aimed to investigate the clinicopathological features and prognostic indicators of alveolar soft part sarcoma (ASPS). METHODS The characteristics of 26 ASPS patients diagnosed at our hospital between January 2011 and January 2019 were retrospectively analysed. RESULTS The data for 12 male and 14 female patients, with a median age of 27.5 years, were assessed. The clinical symptoms mainly included painless enlarged masses in deep soft tissues. ASPS had a characteristic pathological morphology. Twenty-four patients were positive for TFE3, and TFE3 gene rearrangement was detected in 12 patients. Among the 26 patients who completed follow-up, 14 had metastasis, 1 had local recurrence, and 7 died. Kaplan-Meier survival analysis revealed that prognosis was significantly correlated with sex, tumour size and metastasis (P < 0.05). Multivariate Cox regression analysis revealed that sex and metastasis were independent prognostic risk factors for patients with ASPS (P < 0.05). CONCLUSION ASPS is a rare soft tissue sarcoma of unknown origin that occurs in young people, has a slow but metastatic course, and is associated with a poor 5-year survival rate among patients with metastasis. ASPS has character TFE3 protein and gene expression, and the diagnosis is relatively specific. The diagnosis requires comprehensive analysis of clinical history, histological morphology, and immunohistochemistry.
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Affiliation(s)
- Yi Zhang
- Department of Pathology, Bengbu Medical College, Anhui, China
| | - Yuchen Huang
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Yanzi Qin
- Department of Pathology, Bengbu Medical College, Anhui, China
| | - Ningning Yang
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Panpan Yang
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Nan Li
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Zhenzhong Feng
- Department of Pathology, Bengbu Medical College, Anhui, China.
- Department of Pathology, The Second Affiliated Hospital of Anhui Medical University, Anhui, China.
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Fujiwara T, Kunisada T, Nakata E, Nishida K, Yanai H, Nakamura T, Tanaka K, Ozaki T. Advances in treatment of alveolar soft part sarcoma: an updated review. Jpn J Clin Oncol 2023; 53:1009-1018. [PMID: 37626447 PMCID: PMC10632598 DOI: 10.1093/jjco/hyad102] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Alveolar soft part sarcoma is a rare neoplasm of uncertain histogenesis that belongs to a newly defined category of ultra-rare sarcomas. The neoplasm is characterized by a specific chromosomal translocation, der (17) t(X; 17)(p11.2;q25), that results in ASPSCR1-TFE3 gene fusion. The natural history of alveolar soft part sarcoma describes indolent behaviour with slow progression in deep soft tissues of the extremities, trunk and head/neck in adolescents and young adults. A high rate of detection of distant metastasis at presentation has been reported, and the most common metastatic sites in decreasing order of frequency are the lung, bone and brain. Complete surgical resection remains the standard treatment strategy, whereas radiotherapy is indicated for patients with inadequate surgical margins or unresectable tumours. Although alveolar soft part sarcoma is refractory to conventional doxorubicin-based chemotherapy, monotherapy or combination therapy using tyrosine kinase inhibitors and immune checkpoint inhibitors have provided antitumor activity and emerged as new treatment strategies. This article provides an overview of the current understanding of this ultra-rare sarcoma and recent advancements in treatments according to the clinical stage of alveolar soft part sarcoma.
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Affiliation(s)
- Tomohiro Fujiwara
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Toshiyuki Kunisada
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Eiji Nakata
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Kenji Nishida
- Department of Pathology, Okayama University Hospital, Okayama, Japan
| | - Hiroyuki Yanai
- Department of Pathology, Okayama University Hospital, Okayama, Japan
| | - Tomoki Nakamura
- Department of Orthopaedic Surgery, Mie University, Tsu, Japan
| | - Kazuhiro Tanaka
- Department of Advanced Medical Sciences, Oita University, Yufu, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
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Daneshpajouhnejad P, Morrison C, Zhao X, Daniel RE, Schwartz L, Cooper K, Zhang P, Lal P. Primary Alveolar Soft-Part Sarcoma (ASPS) of the Prostate: Report of a Deceptive Case. Int J Surg Pathol 2023; 31:1359-1363. [PMID: 36694389 DOI: 10.1177/10668969221149135] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Alveolar soft-part sarcoma (ASPS) is a rare soft tissue tumor that primarily involves the extremities. We report a case of a 30-year-old never-smoker man who presented with hematuria, dysuria, and constipation at an outside hospital. He was diagnosed with and treated for multiple episodes of urinary tract infection. However, he continued to have voiding symptoms for which a cystoscopy was performed and revealed a bladder neck mass. He underwent transurethral resection of a bladder tumor and was diagnosed with muscle-invasive urothelial carcinoma, nested variant, at an outside hospital. Subsequent to this diagnosis he transferred his care to our center. In-house imaging revealed a large vascular mass involving the prostate and pushing against the bladder base. Prostate needle biopsies were performed and revealed an epithelioid neoplasm with a nested growth pattern composed of cells with a moderate amount of eosinophilic cytoplasm, mildly pleomorphic nuclei, and occasional prominent nucleoli. Since the findings were not classic for urothelial carcinoma or for prostate cancer, we included a wider differential of poorly differentiated carcinoma, sarcoma, and paraganglioma. A wide panel of keratin stains was negative, ETS (erythroblast transformation-specific)-related gene highlighted an extensive vascular network and neuroendocrine stains were all negative. A transcription factor E3 fluorescent in-situ hybridization was positive and subsequently, an ASPSCR1 gene rearrangement was demonstrated. The outside hospital transurethral resection of bladder tumor was obtained for review and the tumor was morphologically similar to that seen on the in-house prostate needle biopsies. Based on the above findings a final diagnosis of primary ASPS of the prostate with involvement of the bladder was made. The patient was later diagnosed with bilateral lung metastases. He was treated with pazopanib, radiation therapy, and cystoprostatectomy and is symptom-free on a 15-month follow-up.
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Affiliation(s)
- Parnaz Daneshpajouhnejad
- Department of Pathology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Casey Morrison
- Department of Pathology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Xiaofeng Zhao
- Department of Pathology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Reba E Daniel
- Department of Pathology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Lauren Schwartz
- Department of Pathology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Kumarasen Cooper
- Department of Pathology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Paul Zhang
- Department of Pathology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Priti Lal
- Department of Pathology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
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Huang SW, Huang HY, Lin H. Alveolar soft part sarcoma of the uterine corpus: A 13-year follow-up case report and review of the literature. Taiwan J Obstet Gynecol 2023; 62:769-773. [PMID: 37679012 DOI: 10.1016/j.tjog.2023.07.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Accepted: 05/16/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVE Female genital alveolar soft part sarcoma (ASPS) is rare and has a favourable prognosis compared to ASPS from other sites. We reported our experience to manage a case with uterine corpus ASPS (UC ASPS) and conducted a literature review on prognosis of ASPS from different sites of female genital tract. CASE REPORT This report represented a 33-year-old woman who had UC ASPS. She received tumor excision with uterine preservation and had the longest follow-up time (155 months) without recurrence in the literature. CONCLUSION UC ASPS has better prognosis than ASPS from the uterine cervix, the low uterine segment, vulvovaginal area and perineum. We recommended conservative treatment for young women with UC ASPS.
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Affiliation(s)
- Szu-Wei Huang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsuan-Ying Huang
- Department of Anatomic Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hao Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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7
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Rao S, Jain P, Chaurasia K, Beniwal M, Sadashiva N, Kulanthaivelu K, Santosh V. Primary Intracranial Alveolar Soft Part Sarcoma: A Report of 3 Cases. Int J Surg Pathol 2023; 31:1146-1151. [PMID: 36803131 DOI: 10.1177/10668969231152573] [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] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Alveolar soft part sarcoma (ASPS) commonly involves extremities and head and neck regions. Primary intracranial ASPS is rare. We report a series of 3 primary intracranial ASPS. These were not suspected clinically and histopathology with immunohistochemistry proved to be diagnostic in all 3 tumors.
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Affiliation(s)
- Shilpa Rao
- Departments of Neuropathology, Neuroimaging and Intervention Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Parul Jain
- Departments of Neuropathology, Neuroimaging and Intervention Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Kavish Chaurasia
- NIIR, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Manish Beniwal
- Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Nishanth Sadashiva
- Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Vani Santosh
- Departments of Neuropathology, Neuroimaging and Intervention Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
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Dermarkarian CR, Duckwiler G, Thompson LDR, Krantz KB, Feldman KA. Reply: Retro-orbital alveolar softpart sarcoma in a 76-year-old female: case report and review of the literature. Can J Ophthalmol 2023; 58:168. [PMID: 36632834 DOI: 10.1016/j.jcjo.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023]
Affiliation(s)
| | - Gary Duckwiler
- Department of Interventional Neuroradiology, University of California-Los Angeles, Los Angeles, CA
| | | | - Kenneth B Krantz
- Department of Ophthalmology, Kaiser Permanente-South Bay, Harbor City, CA
| | - Kenneth A Feldman
- Department of Ophthalmology, University of CAornia-Irvine, Irvine, CA; Head and Neck Pathology Consultations, Woodland Hills, CA.
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Belliveau MJ. Re: Retro-orbital alveolar soft-part sarcoma in a 76-year-old female: case report and review of the literature. Can J Ophthalmol 2023; 58:168. [PMID: 36634907 DOI: 10.1016/j.jcjo.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023]
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Aksionau A, Dela Cruz NE, Meram AT, Cuellar-Saenz H, Aveni JR, Takei H. Lingual Alveolar Soft Part Sarcoma in a 78-Year-Old Woman: A Case Report and Comprehensive Review of the Literature from 1952 to 2022. Head Neck Pathol 2023; 17:265-274. [PMID: 36303014 PMCID: PMC10063713 DOI: 10.1007/s12105-022-01505-x] [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: 07/26/2022] [Accepted: 10/13/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Alveolar soft part sarcoma (ASPS) is a rare translocation-related soft tissue sarcoma, occurring mainly in the limbs and trunk in young adults and adolescents. ASPS is rarely seen in the head and neck and one fourth of those cases described are tongue primary. Given its nonspecific symptoms, clinical findings, and rarity in this location, lingual ASPS (L-ASPS) has been reported to be commonly misdiagnosed as various benign tumors, leading to adverse outcomes. METHODS We report a case of L-ASPS occurring in the oldest (78 years) female patient published to date and comprehensively review the literature from 1952 to 2022. RESULTS She presented with a slow-growing (2-year duration) tongue mass, measuring 3.5 cm on palpation. Intraoperative frozen section could not render the definitive diagnosis. The pathological findings of the tumor were characteristic of ASPS with eosinophilic polygonal cells in an organoid/nested pattern, rich sinusoidal capillaries, and TFE3 immunoreactivity, except for the strong diffuse aberrant cytoplasmic CD68 immunoexpression and absence of intracytoplasmic crystalline inclusions on PAS with diastase. After TFE3 gene rearrangement had been identified with fluorescent in-situ hybridization, reflex testing confirmed a rearrangement of TFE3 gene with the known fusion partner ASPSCR1. CONCLUSIONS ASPS should be included in the differential diagnoses in cases of any slow-growing lingual masses (especially vascular ones) with non-specific clinical pictures, regardless of the patient's age.
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Affiliation(s)
- Aliaksandr Aksionau
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, 1501 Kings Hwy, Shreveport, LA, 71103, USA.
| | | | - Andrew T Meram
- Department of Oral & Maxillofacial Surgery, LSU Health Shreveport, Shreveport, LA, USA
| | | | | | - Hidehiro Takei
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, 1501 Kings Hwy, Shreveport, LA, 71103, USA
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Bartoš V, Sejnová D, Skálová A, Béder I. Alveolar soft part sarcoma in a child - a case report. Klin Onkol 2023; 36:396-400. [PMID: 37877532 DOI: 10.48095/ccko2023396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
BACKGROUND Alveolar soft part sarcoma (ASPS) is a very rare mesenchymal malignancy of uncertain origin. It mostly affects young people, with about a quarter of cases being diagnosed in children. CASE An 11-year-old girl had a painless subcutaneous "lump" in the left elbow area. Imaging exams revealed a solid soft-tissue intramuscular mass of suspicious appearance. A surgical excision of lesion was performed. The biopsy consisted of a lobular tumor measuring 35 × 20 × 12 mm. Histology revealed an epithelioid-cell population arranged in organoid pseudoalveolar pattern. It immunohistochemically expressed TFE3 and harbored the ASPSCR1:: TFE3 gene fusion. A diagnosis of ASPS was established. Subsequently, a wide re-excision of the scar was performed without microscopic residual tumor. The patient is currently without evidence of local recurrence or metastasis. CONCLUSION ASPS is considered an aggressive and prognostically unfavorable chemoresistant neoplasm. Children have a better prognosis compared to adults. Early detection of tumor in a localized stage with complete surgical removal remains a mainstay therapeutic option. Due to its tendency to late metastases, a long-term thorough follow-up of the patient is necessary.
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12
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Dermarkarian CR, Duckwiler G, Thompson LDR, Krantz KB, Feldman KA. Retro-orbital alveolar soft-part sarcoma in a 76-year-old female: case report and review of the literature. Can J Ophthalmol 2022; 57:e208-e210. [PMID: 35472298 DOI: 10.1016/j.jcjo.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/09/2022] [Accepted: 03/19/2022] [Indexed: 11/27/2022]
Affiliation(s)
| | - Gary Duckwiler
- University of California-Los Angeles, Los Angeles, Calif
| | | | | | - Kenneth A Feldman
- University of California-Irvine. Irvine, Calif; Kaiser Permanente-South Bay. Harbor City, Calif.
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13
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Argani P, Wobker SE, Gross JM, Matoso A, Fletcher CD, Antonescu CR. PEComa-like Neoplasms Characterized by ASPSCR1-TFE3 Fusion: Another Face of TFE3-related Mesenchymal Neoplasia. Am J Surg Pathol 2022; 46:1153-1159. [PMID: 35848761 PMCID: PMC9298479 DOI: 10.1097/pas.0000000000001894] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Identical TFE3-related gene fusions may be found in renal cell carcinoma and mesenchymal neoplasms such as alveolar soft part sarcoma and TFE3-rearranged perivascular epithelioid cell tumor (PEComa). Among mesenchymal neoplasms, the ASPSCR1-TFE3 gene fusion has previously been described only in alveolar soft part sarcoma. We report 3 unusual mesenchymal neoplasms harboring the ASPSCR1-TFE3 gene fusion, the morphologic phenotype of which more closely matches PEComa rather than alveolar soft part sarcoma. All 3 neoplasms occurred in females ranging in age from 18 to 34 years and were located in the viscera (kidney, bladder, and uterus). All 3 contained nests of epithelioid cells bounded by fibrovascular septa. However, all were associated with hyalinized stroma, tight nested architecture, mixed spindle cell and epithelioid pattern, clear cytoplasm, and lacked significant discohesion. Overall, morphologic features closely resembled PEComa, being distinct from the typical alveolar soft part sarcoma phenotype. While none of the neoplasms labeled for HMB45, cytokeratin, or PAX8 all showed positivity for TFE3 and cathepsin K, and all except 1 were positive for smooth muscle actin. One patient developed a liver metastasis 7 years after nephrectomy. These cases bridge the gap between 2 TFE3-rearranged neoplasms, specifically alveolar soft part sarcoma and Xp11 translocation PEComa, highlighting the relatedness and overlap among Xp11 translocation neoplasms. While most TFE3-rearranged neoplasms can be confidently placed into a specific diagnostic category such as alveolar soft part sarcoma, PEComa, or Xp11 translocation renal cell carcinoma, occasional cases have overlapping features, highlighting the potential role that the cell of origin and the specific gene fusion play in the phenotype of these neoplasms.
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Affiliation(s)
- Pedram Argani
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Sara E. Wobker
- Departments of Pathology and Laboratory Medicine and Urology, University of North Carolina, Chapel Hill, NC, USA
| | - John M. Gross
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Andres Matoso
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Urology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Lee CJ, Modave E, Boeckx B, Kasper B, Aamdal S, Leahy MG, Rutkowski P, Bauer S, Debiec-Rychter M, Sciot R, Lambrechts D, Wozniak A, Schöffski P. Correlation of Immunological and Molecular Profiles with Response to Crizotinib in Alveolar Soft Part Sarcoma: An Exploratory Study Related to the EORTC 90101 "CREATE" Trial. Int J Mol Sci 2022; 23:ijms23105689. [PMID: 35628499 PMCID: PMC9145625 DOI: 10.3390/ijms23105689] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 02/06/2023] Open
Abstract
Alveolar soft part sarcoma (ASPS) is a rare subtype of soft tissue sarcoma characterized by an unbalanced translocation, resulting in ASPSCR1-TFE3 fusion that transcriptionally upregulates MET expression. The European Organization for Research and Treatment of Cancer (EORTC) 90101 “CREATE” phase II trial evaluated the MET inhibitor crizotinib in ASPS patients, achieving only limited antitumor activity. We performed a comprehensive molecular analysis of ASPS tissue samples collected in this trial to identify potential biomarkers correlating with treatment outcome. A tissue microarray containing 47 ASPS cases was used for the characterization of the tumor microenvironment using multiplex immunofluorescence. DNA isolated from 34 available tumor samples was analyzed to detect recurrent gene copy number alterations (CNAs) and mutations by low-coverage whole-genome sequencing and whole-exome sequencing. Pathway enrichment analysis was used to identify diseased-associated pathways in ASPS sarcomagenesis. Kaplan–Meier estimates, Cox regression, and the Fisher’s exact test were used to correlate histopathological and molecular findings with clinical data related to crizotinib treatment, aiming to identify potential factors associated with patient outcome. Tumor microenvironment characterization showed the presence of PD-L1 and CTLA-4 in 10 and 2 tumors, respectively, and the absence of PD-1 in all specimens. Apart from CD68, other immunological markers were rarely expressed, suggesting a low level of tumor-infiltrating lymphocytes in ASPS. By CNA analysis, we detected a number of broad and focal alterations. The most common alteration was the loss of chromosomal region 1p36.32 in 44% of cases. The loss of chromosomal regions 1p36.32, 1p33, 1p22.2, and 8p was associated with shorter progression-free survival. Using whole-exome sequencing, 13 cancer-associated genes were found to be mutated in at least three cases. Pathway enrichment analysis identified genetic alterations in NOTCH signaling, chromatin organization, and SUMOylation pathways. NOTCH4 intracellular domain dysregulation was associated with poor outcome, while inactivation of the beta-catenin/TCF complex correlated with improved outcome in patients receiving crizotinib. ASPS is characterized by molecular heterogeneity. We identify genetic aberrations potentially predictive of treatment outcome during crizotinib therapy and provide additional insights into the biology of ASPS, paving the way to improve treatment approaches for this extremely rare malignancy.
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Affiliation(s)
- Che-Jui Lee
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium; (C.-J.L.); (A.W.)
| | - Elodie Modave
- VIB Center for Cancer Biology, VIB and Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; (E.M.); (B.B.); (D.L.)
| | - Bram Boeckx
- VIB Center for Cancer Biology, VIB and Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; (E.M.); (B.B.); (D.L.)
| | - Bernd Kasper
- Sarcoma Unit, Interdisciplinary Tumor Center, Mannheim University Medical Center, 68167 Mannheim, Germany;
| | - Steinar Aamdal
- Department of Oncology, Oslo University Hospital, 0315 Oslo, Norway;
| | | | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 00-001 Warsaw, Poland;
| | - Sebastian Bauer
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, 45147 Essen, Germany;
| | - Maria Debiec-Rychter
- Department of Human Genetics, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium;
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium;
| | - Diether Lambrechts
- VIB Center for Cancer Biology, VIB and Department of Human Genetics, KU Leuven, 3000 Leuven, Belgium; (E.M.); (B.B.); (D.L.)
| | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium; (C.-J.L.); (A.W.)
| | - Patrick Schöffski
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, 3000 Leuven, Belgium; (C.-J.L.); (A.W.)
- Department of General Medical Oncology, Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +32-1634-1019
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Hirose K, Naniwa K, Usami Y, Kohara M, Uchihashi T, Tanaka S, Yamada S, Iwamoto Y, Murakami S, Oya K, Fukuda Y, Hori Y, Morii E, Toyosawa S. Primary Alveolar Soft Part Sarcoma of Cheek: Report of a Case and Review of the Literature. Head Neck Pathol 2021; 15:1426-1431. [PMID: 33840045 PMCID: PMC8633199 DOI: 10.1007/s12105-021-01324-6] [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: 02/21/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcoma characterized by an alveolar or organoid arrangement of polygonal tumour cells separated by fibrovascular septa. A specific fusion gene [ASPS critical region 1 (ASPSCR1)-TFE3] was detected in ASPS. Despite being a slow-growing tumour without pain and dysfunction, ASPS is characterized by early metastasis, which leads to poor prognosis. Herein, we report a rare case of primary ASPS of the cheek harbouring ASPSCR1 (exon 7)-TFE3 (exon 5) fusion gene in a 21 year-old woman. This tumour was a well-circumscribed, smooth, round mass that was clinically suspected as a benign tumour. However, histologically, it was observed that the polygonal tumour cells were arranged in solid and alveolar growth patterns. Post-operative examination of the whole body excluded the possibility of metastasis at other sites. Thus, careful immunohistochemical and genetic analyses, as well as whole-body examination, demonstrated that the tumour was a primary ASPS of the cheek.
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Affiliation(s)
- Katsutoshi Hirose
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Kohei Naniwa
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Yu Usami
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Masaharu Kohara
- Department of Pathology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Toshihiro Uchihashi
- Department of Oral and Maxillofacial Surgery 1, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
- Unit of Dentistry, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Susumu Tanaka
- Department of Oral and Maxillofacial Surgery 1, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Saori Yamada
- Department of Oral and Maxillofacial Surgery 1, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Yuri Iwamoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Shumei Murakami
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Kaori Oya
- Clinical Laboratory, Osaka University Dental Hospital, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Yasuo Fukuda
- Clinical Laboratory, Osaka University Dental Hospital, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Yumiko Hori
- Department of Pathology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Satoru Toyosawa
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871 Japan
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Abstract
RATIONALE Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue neoplasm with controversial histogenesis. ASPS accounts for 0.5% to 1% of all soft tissue sarcomas. Because of its rarity, ASPS is easily misdiagnosed, increasing the risk of incorrect treatment. PATIENT CONCERNS A 6-year-old female patient presented with a history of a 2.0 × 2.5 × 3.0-cm mass in the deep soft tissues of her right lower extremity. DIAGNOSES Histopathological features indicated the diagnosis of ASPS. Microscopically, a diffuse arrangement of tumor cells or pseudoalveolar architectures separated by thin and well-vascularized fibrous septa were observed. Immunohistochemical staining of the tumor cells indicated positivity for transcription factor E3, myogenic determination factor 1, and periodic acid-Schiff-diastase (PAS-D) and showed a Ki-67 proliferating index of approximately 20%. INTERVENTIONS The patient underwent enlarged resection of the tumor and was treated with radiotherapy. OUTCOMES During the 3-year follow-up, the patient has remained in good condition, with no symptom recurrence, distant metastatic spread, or significant toxicity during or after treatment. The patient remains under regular surveillance. LESSONS Its low incidence, lack of characteristic clinical manifestations, and atypical location often lead to ASPS misdiagnosis and subsequent incorrect treatment. Nuclear expression of transcription factor E3 is of diagnostic value for ASPS. At present, there is no consensus on the treatment for ASPS. In-depth pathological analysis is needed to better understand the characteristics of this tumor.
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Affiliation(s)
- Bin Wang
- Department of Radiation Oncology
| | | | | | - Limei Qu
- Department of Pathology, The First Hospital of Jilin University, Changchun, China
| | - Lingbin Meng
- Department of Internal Medicine, Florida Hospital, Orlando, Florida
| | - Ying Xin
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, China
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17
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Abstract
RATIONALE Alveolar soft part sarcoma (ASPS) is a very rare soft tissue sarcoma. ASPS often occurs in deep soft tissues of the lower extremities, and develops into metastatic diseases. Chemotherapy is considered to be ineffective in patients with ASPS, which constitutes a very important clinical challenge. The strategy for ASPS treatment still requires clarification in order to improve survival outcome. Patients concerns: A 19-year-old female patient presented with a 5-year history of painless lump in the left knee and 4-day cough. Her previous medical history was unremarkable. Menstruation and family history were also normal in this patient, whose physical examination and laboratory test results showed no abnormalities. DIAGNOSIS ASPS was confirmed by clinical manifestations, radiological data and pathological diagnosis of the biopsy of left knee. INTERVENTIONS AND OUTCOMES This patient received circulating tumor DNA detection and only a mutation of the SMARCA4 gene was detected. The patient received sunitinib treatment (37.5 mg once daily) for 15 months and showed partial regression of lung metastatic lesions and stabilization of brain metastases. She achieved 15 months of progression free survival. CONCLUSIONS Sunitinib is effective for the treatment of advanced ASPS with lung and brain metastases. The current patient had long-term progression free survival under sunitinib administration.
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Affiliation(s)
- Chenyang Ye
- Cancer Institute (Key Laboratory of Cancer Prevention & Intervention, National Ministry of Education; Provincial Key Laboratory of Molecular Biology in Medical Sciences), Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou
| | - Ji Wang
- Department of Surgical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University
- Biomedical Research Center and Key Laboratory of Biotherapy of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Wenshan Li
- Department of Thoracic Surgery, Second Affiliated Hospital
| | - Mingjing Yuan
- Department of Thoracic Surgery, Second Affiliated Hospital
| | - Ying Chai
- Department of Thoracic Surgery, Second Affiliated Hospital
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18
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Nava-Castañeda Á, Tovilla-Canales JL, Zuazo F, Rodríguez-Cabrera L, Garnica-Hayashi L. Alveolar soft part sarcoma of the orbit, a case report of a rare tumor. Nepal J Ophthalmol 2017; 9:70-73. [PMID: 29022959 DOI: 10.3126/nepjoph.v9i1.17538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Alveolar Soft Part Sarcoma is a rare malignant tumor of uncertain histogenesis, representing 0.5-1% of all soft tissue tumors. It occurs predominantly in head and neck regions, especially the orbit and the tongue, in infants, causing no specific symptoms for an extended period of time. CASE A four year old girl was brought to consultation because of persistent swelling of her left upper and lower eyelid for the past six months. A 4 mm proptosis was noted on her left eye with significant upwards displacement of the globe. A firm, not pulsating and non tender mass was palpated, and motility examination revealed deficient abduction and infraduction. Visual acuity was 20/40 and 1/200 in the right and left eye, respectively. The computed tomography revealed an extraconal mass on the inferotemporal aspect of the left orbit, with no bony erosion or globe invasion. An excisional biopsy was made, finding a tumor with nests of clusters of large polygonal cells, separated by fibrous septa and a sinusoidal vascular channel. An Alveolar Soft Part Sarcoma was diagnosed. Our patient had a favorable post-operative follow up, and oncologic evaluations have not shown metastasis or local recurrences. Observations and Conclusions: Alveolar Soft Part Sarcoma is a rare malignant tumor of indolent course, but with propensity to distant metastases, making early diagnose and long term follow up necessary.
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19
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Peters SM, Perrino MA, Yoon AJ, Philipone EM. Alveolar soft part sarcoma metastatic to the mandible: A report and review of literature. J Stomatol Oral Maxillofac Surg 2017; 118:379-382. [PMID: 28774857 DOI: 10.1016/j.jormas.2017.07.004] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/26/2017] [Accepted: 07/11/2017] [Indexed: 11/19/2022]
Abstract
Alveolar soft part sarcoma (ASPS) is a rare neoplasm constituting less than 1% of all soft tissue sarcomas. It tends to occur in the deep soft tissues of the lower extremities, however approximately 5-12% of cases are primary to the head and neck region. ASPS metastatic to the oral cavity is rare, with only four documented cases in the literature. Here, we present the case of a 29-year-old woman with ASPS metastatic to the mandible. To the best of our knowledge, this represents only the 5th documented case of ASPS metastatic to the oral cavity, and more specifically, the 3rd documented case of mandibular metastasis.
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Affiliation(s)
- S M Peters
- Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, 630, West 168th Street, PH15W-1562, 10032 New York, NY, United States
| | - M A Perrino
- Division of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine, 630, West 168th Street, PH15W-1562, 10032 New York, NY, United States
| | - A J Yoon
- Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, 630, West 168th Street, PH15W-1562, 10032 New York, NY, United States
| | - E M Philipone
- Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, 630, West 168th Street, PH15W-1562, 10032 New York, NY, United States.
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20
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Affiliation(s)
- Kaustubh Mulay
- National Reporting Centre for Ophthalmic Pathology (NRCOP), Centre For Sight, Hyderabad, India
| | - Sonal S Chougule
- Oculoplastics, Facial Aesthetics and Ocular Oncology, Centre For Sight, Hyderabad, India
| | - Santosh G Honavar
- Oculoplastics, Facial Aesthetics and Ocular Oncology, Centre For Sight, Hyderabad, India
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21
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Lyu D, Yang H, Chen F. [Alveolar soft part sarcoma of the head and neck: clinical and imaging features in two cases]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 50:956-958. [PMID: 26888006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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22
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Patil R. From the other side. Med Econ 2015; 92:21-22. [PMID: 26298985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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23
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Chen X, Zhang Y, Gan W, Ye Q, Yang J, Guo H, Li D. [Application of fluorescence in-situ hybridization polyclonal probes in diagnosis of alveolar soft part sarcoma]. Zhonghua Bing Li Xue Za Zhi 2014; 43:767-768. [PMID: 25582257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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24
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Isozumi T, Kidooka M, Lee H, Fukao S, Ito S, Minamikawa T. [Stepwise improvement of visual field after preoperative embolization and tumor resection of cerebral metastasis of alveolar soft part sarcoma]. Brain Nerve 2013; 65:1515-1520. [PMID: 24323936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report a patient with a brain metastasis from an alveolar soft part sarcoma (ASPS) of the thigh whose visual field defect was resolved in a stepwise manner after preoperative embolization and tumor resection. A 29-year-old man who had undergone surgery to remove an ASPS situated in the thigh developed headaches and homonymous hemianopsia. His visual field defect was evaluated using a Goldmann perimeter. He was found to have a large, well-circumscribed mass in the right occipital lobe. This mass was visible on brain computed tomography and magnetic resonance imaging and was strongly and homogeneously enhanced following contrast administration. Selective angiography revealed a hypervascular mass supplied by branches of the right middle cerebral artery, and preoperative particulate embolization was performed to reduce intraoperative bleeding. A tumor-supplying branch of the middle cerebral artery was superselectively catheterized. For embolization, polyvinyl alcohol (PVA) particles of 90-180 μm in diameter were used. The visual field defect partially improved soon after the preoperative embolization. Surgical resection was performed 3 days after embolization, and the tumor was completely excised by a right occipital craniotomy. Preoperative embolization made the surgical resection easier. Intraoperative bleeding was easily controlled. The pathological diagnosis was ASPS. The intratumoral-embolized vessels were filled with PVA particles. After resection, the patient progressed well with further improvement in visual field function. Rapid improvement of the visual field can be used as an indicator of successful embolization without complications. (Received: July 16, 2013, Accepted: September 5, 2013).
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25
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Wang HW, Dai W, Qin XJ, Zhang CP. A new clinical manifestation for cheek alveolar soft-part sarcoma: a case report and review of the literature. J Oral Maxillofac Surg 2013; 72:817-22. [PMID: 24342574 DOI: 10.1016/j.joms.2013.10.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 10/22/2013] [Accepted: 10/24/2013] [Indexed: 10/26/2022]
Abstract
Alveolar soft part sarcoma (ASPS) is a rare, histologically distinct, soft tissue malignancy with nonspecific clinical features usually described as a nonulcerated, painless, expanding mass. It has a pseudoalveolar appearance with clustered polygonal cells lacking central cohesion. It accounts for approximately 0.5 to 1% of all soft tissue sarcomas. It has a strong predilection for adolescents and young adults 15 to 35 years old, with a female predominance. In general, ASPS grows slowly, with a predilection for the trunk and extremities and rarely in the head and neck region. A literature review found only 11 cases of cheek ASPS that have been reported since 1952. This report describes the case of an unusually rapidly growing mass in the cheek of a 36-year-old woman. The superficial location of the mass led to early detection and treatment.
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Affiliation(s)
- Hong-wei Wang
- Postgraduate, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Dai
- Associate Professor, Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology, China Medical University, Shenyang, Liaoning, China
| | - Xing-jun Qin
- Associate Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Chen-ping Zhang
- Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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26
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Abstract
Alveolar soft part sarcoma (ASPS) is a rare malignant soft-tissue neoplasm of unknown histogenesis. The two main sites of occurrence are the lower extremities in adults and the head and neck in children. We report the first case of pleural ASPS occurring in a 58-yr-old man who presented with progressive dyspnea. A computed tomographic scan of the thorax revealed a large enhancing pleural mass with pleural effusion in the left hemithorax. Wide excision of the pleural mass was performed. Histologically, the tumor consisted of organoid nests of large polygonal cells, the cytoplasm of which had eosinophilic and D-PAS positive granules. Immunohistochemical staining showed that the tumor cell nuclei were positive for transcription factor 3 (TFE3). The pleural ASPS with multiple bone metastases recurred 1 yr after surgery and the patient died of acute pulmonary embolism 1.5 yr after diagnosis.
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Affiliation(s)
- Hyeong Uk Ju
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kwang Won Seo
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Yangjin Jegal
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jong-Joon Ahn
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Young Jik Lee
- Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Young Min Kim
- Department of Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Chulho Oak
- Department of Internal Medicine, Kosin University Gospel Hospital, University of Kosin College of Medicine, Busan, Korea
| | - Seung Won Ra
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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27
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Damm DD. Tongue nodule. Granular cell tumor. Gen Dent 2010; 58:345-347. [PMID: 20591783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Douglas D Damm
- Department of Oral Health Sciences, Division of Oral Pathology, College of Dentistry, University of Kentucky, Lexington, USA
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28
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Mu YL, Liu M, Shi M, Zhao XB, Yin FB, Tang CS, Yelian FD. Clinical analysis of alveolar soft-tissue sarcoma of the uterine cervix: a case report. Chin Med J (Engl) 2010; 123:1612-1614. [PMID: 20819522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Affiliation(s)
- Yu-lan Mu
- Department of Obstetrics and Gynecology, Provincial Hospital affiliated to Shandong University, Jinan, Shandong 250021, China
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29
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Hillyer S, Vicens JC, Levinson H, Bhayani R, Mesea L, Chaudhry R, Fayans E, Fogler R. Alveolar soft-part sarcoma of the tongue in a 17-month-old. Ear Nose Throat J 2009; 88:E4-E9. [PMID: 19826991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Alveolar soft-part sarcoma (ASPS) is a rare and often fatal tumor. Overall survival rates have been reported to be 62% after 5 years, 42% after 10 years, and 18% after 20 years. ASPS accounts for 5% of all pediatric soft-tissue sarcomas other than rhabdomyosarcomas. In children, ASPS rarely occurs in the oral cavity, and to the best of our knowledge, only 12 cases of ASPS of the tongue occurring during the first decade of life have been previously reported in the literature. Because of the rarity of lingual ASPS in children, no specific treatment protocols have been developed, which makes its management difficult. We report a new case of lingual ASPS in a young child. Our patient was a 17-month-old girl whose tumor was located at the base of the tongue. She was successfully treated with surgical excision without adjuvant radiation or chemotherapy. Postoperatively, she has remained disease-free during 4 years of follow-up.
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Affiliation(s)
- Shahab Hillyer
- Department of Surgery, Brookdale University Hospital, Brooklyn, NY 11212, USA.
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30
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Abstract
Alveolar soft part sarcoma (ASPS) is a rare soft-tissue sarcoma, commonly occurring in children and adolescents. The tumor mostly involves the lower extremities. The prognosis of the patient depends on whether there is metastasis. We present a 19-year-old female with ASPS in her right lower leg. Grayscale and color Doppler ultrasound showed a well-defined hypoechoic lesion with hypervascularity and very low resistive index (RI). Magnetic resonance imaging revealed iso signal intensity to muscle on T1-weighted images, high signal intensity to muscle on T2-weighted images with signal voids, and good enhancement after gadolinium administration. In a mass with hypervascularity and very low RI on sonography and hypervascularity with flow voids on magnetic resonance imaging, ASPS should be considered.
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Affiliation(s)
- Yi-Chen Lai
- Department of Radiology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C
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31
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Aisner SC, Beebe K, Blacksin M, Mirani N, Hameed M. Primary alveolar soft part sarcoma of fibula demonstrating ASPL-TFE3 fusion: a case report and review of the literature. Skeletal Radiol 2008; 37:1047-51. [PMID: 18594808 DOI: 10.1007/s00256-008-0540-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2008] [Revised: 04/01/2008] [Accepted: 05/22/2008] [Indexed: 02/02/2023]
Abstract
Alveolar soft part sarcoma is a rare soft tissue tumor typically affecting young adults. These tumors are most often seen in the deep soft tissues of the extremities and patients generally present with advanced disease. Primary bone involvement is extremely rare and has only been reported in seven cases. This is the first case of alveolar soft part sarcoma in bone documenting the ASPL-TFE3 gene product. Herein, we report a rare presentation of alveolar soft part sarcoma presenting as a primary bone neoplasm involving the proximal fibula in a 41-year-old woman.
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Affiliation(s)
- Seena C Aisner
- Department of Pathology, New Jersey Medical School-University Hospital, 150 Bergen Street, UHE 155, Newark, NJ 07103, USA.
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Affiliation(s)
- M Runge
- Service de Radiologie B, CHU Jean Minjoz, 3, boulevard Fleming, 25030 Besançon Cedex.
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Shaddix KK, Fakhre GP, Nields WW, Steers JL, Hewitt WR, Menke DM. Primary alveolar soft-part sarcoma of the liver: anomalous presentation of a rare disease. Am Surg 2008; 74:43-46. [PMID: 18274427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Alveolar soft-part sarcoma is a highly vascular soft-tissue tumor that is uniformly malignant. It comprises less than 1 per cent of all soft-tissue sarcomas. Patients with alveolar soft-part sarcoma most frequently are aged 15 to 35 years, and the soft tissues of the lower extremities typically are affected. In the pediatric population, it most frequently occurs in the head and neck and particularly affects the tongue and orbit. Alveolar soft-part sarcoma has been described as a primary lesion in the trunk, upper extremities, and retroperitoneum; more novel locations include the mediastinum, female genital tract, stomach, bone, and larynx. Numerous case reports describe alveolar soft-part sarcoma in diverse anatomic locations, but this report is, to our knowledge, the first documentation of primary alveolar soft-part sarcoma of the liver. We describe a 47-year-old woman with such a manifestation. Despite surgical resection and numerous chemotherapeutic regimens, this patient had widespread metastasis and died approximately 2 years after the diagnosis was established.
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Affiliation(s)
- Kyle K Shaddix
- Department of Surgery, Mayo Clinic, Jacksonville, Florida 32224, USA
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Günay C, Atalar H, Kaygusuz G, Yildiz Y, Sağlik Y. [Alveolar soft part sarcoma of the extremities: an evaluation of four cases]. Acta Orthop Traumatol Turc 2007; 41:326-331. [PMID: 18180565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We presented four patients (3 women, 1 man; mean age 40 years; range 20 to 56 years) who had alveolar soft part sarcoma in the left arm, right elbow, right tibia, and left thigh, respectively. All the patients presented with a mass. Two patients had lung metastasis at the time of diagnosis. T1- and T2-weighted magnetic resonance images of all the patients showed a soft tissue lesion with hyperintense signal changes and heterogeneous contrast enhancement. Diagnoses were made by histopathologic examination of biopsy samples. All the patients received chemotherapy. Surgical resection was performed in three patients. Two patients with involvement of the left arm and right elbow died within three years after diagnosis. One patient with involvement of the left thigh developed lung and brain metastases at the end of postoperative eight years. One patient with tibial involvement remained disease-free during 10 months of follow-up.
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Affiliation(s)
- Cüneyd Günay
- Fatih Universitesi Tip Fakültesi Hastanesi Ortopedi ve Travmatoloji Anabilim Dali.
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Strunk T, Bastian PJ, Ellinger J, Biermann K, Müller SC. [Aggressive course of a malignant alveolar soft tissue sarcoma]. Urologe A 2007; 46:1422-4. [PMID: 17641862 DOI: 10.1007/s00120-007-1509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Alveolar soft part sarcoma is a rare soft tissue tumor. Most patients who are affected by this sarcoma are between 15 and 35 years old. The tumor is characterized by its uncommon location of metastasis. Publications concerning this sarcoma subform are rare and the best therapeutic procedure is not yet clear. Surgical excision, radiation and chemotherapy are performed, whereas complete surgical excision achieves the best results in long-term follow-up. We report a patient's history who rapidly died of his sickness despite the low initial tumor stage.
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MESH Headings
- Abdominal Neoplasms/diagnosis
- Abdominal Neoplasms/pathology
- Abdominal Neoplasms/radiotherapy
- Abdominal Neoplasms/surgery
- Aged
- Capillaries/pathology
- Diagnosis, Differential
- Disease Progression
- Fatal Outcome
- Humans
- Lymph Node Excision
- Lymph Nodes/pathology
- Lymphatic Metastasis/pathology
- Lymphoma, Non-Hodgkin/pathology
- Male
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/radiotherapy
- Neoplasm Recurrence, Local/surgery
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/radiotherapy
- Neoplasms, Second Primary/surgery
- Radiotherapy, Adjuvant
- Retreatment
- Sarcoma, Alveolar Soft Part/diagnosis
- Sarcoma, Alveolar Soft Part/pathology
- Sarcoma, Alveolar Soft Part/radiotherapy
- Sarcoma, Alveolar Soft Part/surgery
- Testicular Neoplasms/pathology
- Tomography, X-Ray Computed
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Affiliation(s)
- T Strunk
- Klinik und Poliklinik für Urologie, Medizinische Einrichtungen der Universität Bonn, 53127 Bonn.
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Kasashima S, Minato H, Kobayashi M, Ueda Y, Oda Y, Hashimoto S, Inoue M. Alveolar soft part sarcoma of the endometrium with expression of CD10 and hormone receptors. APMIS 2007; 115:861-5. [PMID: 17614855 DOI: 10.1111/j.1600-0463.2007.apm_635.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Alveolar soft part sarcoma (ASPS) is a rare tumor of uncertain histogenesis, mainly localized in the extremities. ASPS originating in the uterine corpus is quite rare; only eight such cases have been reported in the literature. We here present another case of ASPS found in the endometrium in a 50-year-old woman. Metastatic malignant tumor, including ASPS from other organs, was excluded by physical examination and imaging modalities. Thallium 201 was only localized in the uterus. The tumor showed characteristic histological features of ASPS: alveolar architecture with fibrovascular septa and abundant eosinophilic granular cytoplasm with periodic acid-Schiff-positive crystalline material. Diffuse nuclear immunoreactivity for TFE3, a marker recently reported to be specific for ASPS, further supported the diagnosis of ASPS. Interestingly, this tumor was negative for myogenic markers, but positive for CD10, progesterone receptor, and estrogen receptor. These immunohistochemical results and the tumor location suggest a possible link between endometrial stromal cells and the development of this tumor.
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Affiliation(s)
- Satomi Kasashima
- Pathology Section, Kanazawa University Hospital, Ishikawa, Japan
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Abstract
Alveolar soft-part sarcoma (ASPS) is a rare, distinctive sarcoma, typically occurring in young patients. Although it displays a relatively indolent clinical course, the ultimate prognosis is poor and is often characterised by late metastases. Recently, our understanding of the genetic events underlying the pathogenesis of ASPS has greatly increased. The historical, histopathological, ultrastructural, immunohistochemical and genetic aspects of ASPS are reviewed in this article.
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Affiliation(s)
- A L Folpe
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Minnesota, USA.
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Ishikawa M, Ishizuka O, Nakayama T, Kobayashi S, Igawa Y, Nishizawa O, Sugimoto K, Yamashita T, Matsushita T. Alveolar soft-part sarcoma of the retroperitoneum. Int J Urol 2006; 13:1355-7. [PMID: 17010020 DOI: 10.1111/j.1442-2042.2006.01551.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 33-year-old woman was referred to Iida Municipal Hospital because of left back pain. Computed tomography showed a tumor (17 x 11 x 10 cm) in the left retroperitoneal space. T1- and T2-weighted magnetic resonance imaging showed an inhomogeneous mass with marginal blood vessels. The tumor was resected via lumbar oblique incision with the thoraco-abdominal approach. The tumor weighed 1800 g and consisted of nests of 5-100 large, loosely arranged, polygonal cells, surrounded by capillaries, resembling alveoli. The tumor cells were rich in cytoplasm, containing periodic acid-Schiff- and diastase-positive granules and typical crystals. The pathological diagnosis was alveolar soft-part sarcoma (ASPS). Alveolar soft-part sarcoma is a rare soft-tissue tumor that accounts for approximately 0.5-1% of soft-tissue sarcomas. Such tumors originating in the retroperitoneal space are extremely rare. Herein is reported a case of ASPS of the retroperitoneum with radiological and pathological findings.
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Affiliation(s)
- Masakuni Ishikawa
- Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan
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Zamani F, Jabbari M, Alimohamadi SM, Shakeri R, Rostami Z, Abedi B, Hormazdi M, Malekzadeh R. Primary alveolar soft part sarcoma of chest wall: a case report and review of the literature. MedGenMed 2006; 8:2. [PMID: 17406145 PMCID: PMC1781299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Affiliation(s)
- Farhad Zamani
- GI and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mosadegh Jabbari
- Department of Nephrology, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ramin Shakeri
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zohreh Rostami
- Department of Nephrology, Iran University of Medical Sciences, Tehran, Iran
| | - Behnoush Abedi
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Hormazdi
- Department of Pathology, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Afshar AR, Abbasi F. Photoclinic. Primary alveolar soft part sarcoma of bone. Arch Iran Med 2006; 9:175-6, 181. [PMID: 16649367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Affiliation(s)
- Ahmad-Reza Afshar
- Department of Orthopedics, Urmia University of Medical Sciences, Iran.
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Affiliation(s)
- Yasumori Koguchi
- Department of Orthopaedics, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu-machi, Tochigi, 321-0293, Japan
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Kim HS, Lee HK, Weon YC, Kim HJ. Alveolar soft-part sarcoma of the head and neck: clinical and imaging features in five cases. AJNR Am J Neuroradiol 2005; 26:1331-5. [PMID: 15956492 PMCID: PMC8149073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND AND PURPOSE Alveolar soft-part sarcoma (ASPS) of the head and neck is an extremely rare malignancy. Although the clinical and imaging features of this tumor have been reported, a periodic review of unusual tumors is useful. The purpose of this study was to describe the clinical and imaging features of ASPS of the head and neck. METHODS Between January 1990 and May 2004 at our institution, five head and neck ASPS were diagnosed in five patients (two male and three female patients; age range, 4-22 years). Clinical and imaging findings were reviewed retrospectively. Imaging studies consisted of contrast material-enhanced CT (in four patients), MR imaging (in four patients), and digital subtraction angiography (in two patients). RESULTS The locations of the tumor were tongue in two cases, larynx in one case, buccal space in one case, and paravertebral space in one case. This tumor appeared as a large lobulating-contoured mass with high signal intensity and flow voids on T2-weighted images and showed strong enhancement on contrast-enhanced CT and MR images. Preoperative angiography showed high vascularity. Wide surgical excisions were performed in four cases. Mean follow-up periods were 16 months (range, 6-30 months), and no recurrence was noted except for the laryngeal case. CONCLUSION ASPS should be included in the differential diagnosis of head and neck tumor when a slow-growing, large mass with high signal intensity and flow voids on T2-weighted images and strong enhancement on contrast-enhanced CT or MR image is seen, particularly in young female patients.
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Affiliation(s)
- Ho Sung Kim
- Department of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea
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Abstract
A 10-year-old girl with gradual-onset proptosis in her left eye was diagnosed with orbital alveolar soft-part sarcoma. The tumor and the contiguous medial rectus muscle in the left eye were excised and compensatory strabismus procedures were performed. Five years postoperatively, she has central binocular vision with no evidence of tumor recurrence.
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Affiliation(s)
- Arif O Khan
- Department of Pediatrics, King Khaled Eye Specialist Hospital, Riyadlh, Saudi Arabia
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45
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Affiliation(s)
- Wai-Man Chan
- Chinese University of Hong Kong, Shatin, People's Republic of China
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Abstract
OBJECTIVE To present a paediatric case of alveolar soft part sarcoma on the glabella. CASE A 10-year-old female patient with a slowly growing painful and pruritic mass between her brows. During surgical excision of the mass, it was seen that the mass was firmly adherent to the periosteum. Extended surgical removal with the underlying periosteum was carried out. The pathological result was alveolar soft part sarcoma which was immunohistochemically positive for vimentin and showed focal desmin positivity. The patient had no evidence of distant metastases on screening. CONCLUSION Total surgical excision of the tumour in due time before metastases should be the mainstay of treatment. A high index of suspicion, both during diagnosis and surgery, should be maintained by the clinician.
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Affiliation(s)
- Taner Yilmaz
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Hacettepe University, Hacettepe, Ankara 06100, Turkey.
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Abstract
Alveolar soft part sarcoma is a malignant soft part tumor the etiology of which has not yet been clarified. Histopathological examinations show an alveolar or pseudoglandular pattern. PAS-positive, diastase resistant intraplasmic inclusion bodies are characteristic for this tumor which occurs in the head and neck region; mainly the tongue and the orbita. Primary therapy includes total resection which can later be combined with radiotherapy or chemotherapy. The present study involves a 17 year old patient. We totally removed the tumor and then used radiotherapy. The postoperative examinations over 3 years showed neither local recurrence nor distant metastases.
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Affiliation(s)
- E Inci
- Hals-Nasen-Ohren-Klinik der Medizinischen Fakultät Cerrahpasa, Istanbul, Türkei.
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Ozaki K, Oda H, Hatada K, Sakai K, Takahashi K, Miida T, Higuma N. Highly vascular pelvic tumor causing high-output heart failure because of massive arteriovenous shunting: a case report. Circ J 2003; 67:554-5. [PMID: 12808277 DOI: 10.1253/circj.67.554] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 53-year-old Japanese woman underwent investigation of her heart murmur. A continuous abdominal bruit was heard. Blood gas analysis and chest X-ray showed congestive heart failure. Enhanced computed tomography of the pelvis showed a 10 x 4 cm hypervascular tumor in the retroperitoneal space. Cardiac catheterization disclosed a cardiac output of 13.2 L/min and a step-up of oxygen at the right common iliac vein. Abdominal aortic angiography showed an extremely vascular pelvic tumor and rapid filling of the inferior vena cava. This is a rare case of a highly vascular pelvic tumor causing high-output heart failure because of th massive arteriovenous shunting.
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Affiliation(s)
- Kazuyuki Ozaki
- Department of Cardiology, Niigata City General Hospital, Japan.
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Aiken AH, Stone JA. Alveolar soft-part sarcoma of the tongue. AJNR Am J Neuroradiol 2003; 24:1156-8. [PMID: 12812945 PMCID: PMC8149009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Alveolar soft-part sarcoma is a rare, aggressive malignancy of uncertain histologic origin with a propensity for vascular invasion and distant metastasis. This neoplasm may mimic benign vascular neoplasms or malformations but careful evaluation of the unique imaging features on CT scans, MR images, and angiograms lead to the correct diagnosis. We present a case of alveolar soft-part sarcoma of the tongue and emphasize its radiologic and clinical features.
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Affiliation(s)
- Ashley H Aiken
- Department of Radiology, Medical College of Georgia, Augusta, GA 30912, USA
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Nair A, Pai DR, Jagdish S, Krishnan R. Alveolar soft part sarcoma: a unique tumor with disputed histogenesis. Indian J Cancer 2003; 40:82-3. [PMID: 14716125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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