1
|
Hartley IR, Miller CB, Papadakis GZ, Bergwitz C, Del Rivero J, Blau JE, Florenzano P, Berglund JA, Tassone J, Roszko KL, Moran S, Gafni RI, Isaacs R, Collins MT. Targeted FGFR Blockade for the Treatment of Tumor-Induced Osteomalacia. N Engl J Med 2020; 383:1387-1389. [PMID: 32905668 PMCID: PMC7561341 DOI: 10.1056/nejmc2020399] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Iris R Hartley
- National Institute of Dental and Craniofacial Research, Bethesda, MD
| | | | | | | | | | - Jenny E Blau
- National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, MD
| | | | - Jason A Berglund
- University of Texas Health Science Center at Houston, Houston, TX
| | | | - Kelly L Roszko
- National Institute of Dental and Craniofacial Research, Bethesda, MD
| | | | - Rachel I Gafni
- National Institute of Dental and Craniofacial Research, Bethesda, MD
| | - Randi Isaacs
- Novartis Institutes of Biomedical Research, East Hanover, NJ
| | - Michael T Collins
- National Institute of Dental and Craniofacial Research, Bethesda, MD
| |
Collapse
|
2
|
Abstract
INTRODUCTION Metastatic mesenchymal chondrosarcoma of the spine is a highly unusual disease without standard curative managements yet. The objective of this case report is to present a very rare case of metastatic chondrosarcoma to the spine successfully operated by surgical treatment. The management of these unique cases has yet to be well-documented. PATIENT CONCERNS A 34-year-old woman presented with a 4-month history of continuous and progressive back pain and a 1-month history of radiating pain of bilateral lower extremities. The patient, who had been diagnosed of mesenchymal chondrosarcoma of maxillary sinus for 3 years, received surgical treatment of palliative endoscopic-assisted total left maxillary resection via mini Caldwell-Luc approach, and palliative enlarged resection due to the progress of residual lesions, followed by no adjuvant therapy. Multiple lytic, expanding lesions of the spine and paraspinal region with severe epidural spinal cord compression was identified. DIAGNOSIS CT, MRI and bone scan of spine showed spinal cord compression secondary to the epidural component of the metastatic lesions. Post-operative pathology confirmed the diagnosis of metastatic spinal mesenchymal chondrosarcomas. INTERVENTIONS The patient underwent posterior spinal canal decompression, resection of T12 and L3 lesions, internal fixation of T11-L5 pedicles, and cement augmentation of T12 and L3. OUTCOMES The patient's neurological deficits improved significantly after the surgery, and the postoperative period was uneventful at the 1-year follow-up visit. There were no complications associated with the spinal surgery during the follow-up period. CONCLUSION Metastatic spinal mesenchymal chondrosarcoma, although rare, should be part of the differential diagnosis when the patient presents with back pain and radiculopathy. We recommend the posterior approach for spinal decompression and total resection of the metastatic chondrosarcoma when the tumor has caused neurological deficits or other severe symptoms. Osteoplasty by cement augmentation is also a good choice for surgical treatment in some patients.
Collapse
Affiliation(s)
- Shuzhong Liu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences,
| | - Xi Zhou
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences,
| | - An Song
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College,
| | - Zhen Huo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yipeng Wang
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences,
| | - Yong Liu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences,
| |
Collapse
|
3
|
Abstract
The iliac vein is an extremely rare site for mesenchymal chondrosarcoma, and patients with primary extraskeletal mesenchymal chondrosarcoma arising from a vein always suffer a very poor prognosis. We report a case of a 45-year-old female who presented with a 5-month history of left leg edema in 2015. Contrast-enhanced computed tomography showed a large mass in the left iliac vein with scattered calcifications. Wide-margin resection was performed, and histopathologic and immunohistochemical analyses confirmed the presence of intraluminal mesenchymal chondrosarcoma with local invasion out of the vein wall. Due to poor patient compliance, postoperative neoadjuvant chemotherapy and radiotherapy were not started, and a bone scan performed 16 weeks postoperatively showed multiple bone metastases. The patient died on the twenty-fourth postoperative week.
Collapse
Affiliation(s)
- Hua Zhang
- Department of Respiration, The First Hospital of Jilin University, Changchun, Jilin, China. E-mail.
| | | | | | | |
Collapse
|
4
|
Abstract
Secondary tumours of the thyroid gland account for 1.25 to 3 % in clinical series and reach 24 % in autopsy series. Chondrosarcoma is a rare malignant mesenchymal tumour of chondrogenic nature; the mesenchymal variant represents less than 3 % of all chondrosarcomas, being therefore extremely rare. A mesenchymal chondrosarcoma metastasis in the thyroid is exceptional; to our knowledge, only three previous cases of chondrosarcoma metastasis in the thyroid have been reported to date but none of such cases corresponded to a mesenchymal chondrosarcoma. We present the first of such a case in a 27-year-old woman with a 4-year history of mesenchymal chondrosarcoma of the sacrum that was treated by surgery and chemotherapy. At the present admission, head and neck computed tomography revealed a well-defined nodule in the thyroid gland. The diagnosis of metastasis from the mesenchymal chondrosarcoma was made in the right lobectomy specimen.
Collapse
Affiliation(s)
- Santiago Ortiz
- Centro Hospitalar Lisboa Norte, EPE-Hospital de Santa Maria, Lisbon, Portugal,
| | | | | |
Collapse
|
5
|
Pang ZG, He XZ, Wu LY, Wei W, Liu XY, Liao DY, Li FY, Zhang XL. [Clinicopathologic and immunohistochemical study of 23 cases of mesenchymal chondrosarcoma]. Zhonghua Bing Li Xue Za Zhi 2011; 40:368-372. [PMID: 21914343] [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: 05/31/2023]
Abstract
OBJECTIVE To study the clinicopathologic and immunohistochemical features of mesenchymal chondrosarcoma. METHODS The clinical and histologic features of 23 cases of mesenchymal chondrosarcoma were analyzed. Immunohistochemical study was also performed in 14 of the cases. RESULTS The age of patients ranged from 12 to 47 years. Fourteen of them occurred in males. Thirteen cases involved the bony skeleton and 5 cases affected the soft tissue. The patients presented with pain and/or swelling. Histologically, the tumor consisted of a mixture of undifferentiated small round cells and hyaline cartilage. Transition between the two components was demonstrated and growth plate-like cartilage was observed. Immunohistochemical study showed that the small round cells were positive for Sox9 (14/14), CD99 (12/14), vimentin (6/14), CD56 (4/14), CD57 (4/14), neuron-specific enolase (3/14) and desmin(1/14). They were negative for Coll-II, S-100 protein, epithelial membrane antigen, pan-cytokeratin, synaptophysin, chromogranin A, CD34 and c-erbB2. CONCLUSIONS Mesenchymal chondrosarcoma is a rare malignant tumor. Thorough histologic examination, when coupled with immunohistochemical findings, is helpful in arriving at a correct diagnosis.
Collapse
Affiliation(s)
- Zong-guo Pang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, China.
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Aksoy S, Abali H, Kiliçkap S, Güler N. Successful treatment of a chemoresistant tumor with temozolomide in an adult patient: report of a recurrent intracranial mesenchymal chondrosarcoma. J Neurooncol 2005; 71:333-4. [PMID: 15735926 DOI: 10.1007/s11060-004-1725-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
7
|
Aziz SR, Miremadi AR, McCabe JC. Mesenchymal chondrosarcoma of the maxilla with diffuse metastasis: case report and literature review. J Oral Maxillofac Surg 2002; 60:931-5. [PMID: 12149741 DOI: 10.1053/joms.2002.33865] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Shahid R Aziz
- Division of Oral and Maxillofacial Surgery, Columbia University/New York Presbyterian Hospital, New York, NY, USA.
| | | | | |
Collapse
|
8
|
Yamamoto H, Watanabe K, Nagata M, Honda I, Watanabe S, Soda H, Tatezaki S. Surgical treatment for pancreatic metastasis from soft-tissue sarcoma: report of two cases. Am J Clin Oncol 2001; 24:198-200. [PMID: 11319298 DOI: 10.1097/00000421-200104000-00019] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [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: 11/25/2022]
Abstract
We present two cases in which a soft-tissue sarcoma metastasized to the pancreas, but both patients survived as a result of repetitive surgical treatment during a 6- to 10-year period. The first case was a 29-year-old man who had a history of removal of mesenchymal chondrosarcoma in the left thigh in 1986 and who underwent distal pancreatectomy and the enucleation of a tumor in the head of the pancreas because of the development of three metastatic lesions in 1989. Afterward, although metastases were found in other organs, they were resected each time (for a total of five times) and the patient has survived over 10 years. The second case was a 40-year-old woman who had a history of the removal of synovial sarcoma in the right thigh and had 6 surgical resections of local or pulmonary recurrent tumors. She underwent pylorus-preserving pancreaticoduodenectomy in 1993 because of the development of a solitary metastatic lesion in the pancreas and survived more than 6 years after the pancreatectomy. Our report suggests, in selected cases, that long-term survival from pancreatic metastasis of soft-tissue sarcoma is expected as a result of curative resection. However, because pancreatic metastasis has a potential to recur in other organs, it is necessary to take aggressive surgical procedures repeatedly for the treatment of recurrences to improve prognosis after pancreatectomy.
Collapse
Affiliation(s)
- H Yamamoto
- Divisions of Gastroenterological Surgery, Chiba Cancer Center Hospital, Japan
| | | | | | | | | | | | | |
Collapse
|
9
|
Aramburu-González JA, Rodríguez-Justo M, Jiménez-Reyes J, Santonja C. A case of soft tissue mesenchymal chondrosarcoma metastatic to skin, clinically mimicking keratoacanthoma. Am J Dermatopathol 1999; 21:392-4. [PMID: 10446785 DOI: 10.1097/00000372-199908000-00016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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
We report the first case of metastatic involvement of the skin by a soft tissue mesenchymal chondrosarcoma (MS). A 64-year-old man presented 15 months after resection of a 7.0 cm MS from his left forearm with a rapidly growing, erythematous nodule on the left side of the upper lip. The lesion was clinically interpreted as a keratoacanthoma. The histologic appearance was identical to that of the soft tissue MS; an immunohistochemical stain for CD99 was positive. Lung and bone metastases were subsequently documented. Our case expands the differential diagnosis of malignancies with cartilaginous differentiation that can involve the skin.
Collapse
|
10
|
Komatsu T, Taira S, Matsui O, Takashima T, Note M, Fujita H. A case of ruptured mesenchymal chondrosarcoma of the pancreas. Radiat Med 1999; 17:239-41. [PMID: 10440114] [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: 02/13/2023]
Abstract
A 25-year-old woman who underwent surgical removal of a right frontal meningeal mesenchymal chondrosarcoma in 1980 manifested abdominal pain and progressive anemia after a traffic accident in April 1997. CT disclosed a well-enhanced solid mass 2.5 cm in diameter with internal calcific deposits at the tail of the pancreas and a surrounding hematoma of 5.5 cm in diameter. Surgical resection revealed a ruptured metastatic mesenchymal chondrosarcoma of the pancreas.
Collapse
Affiliation(s)
- T Komatsu
- Department of Radiology, Kanazawa University School of Medicine, Ishikawa, Japan
| | | | | | | | | | | |
Collapse
|
11
|
Abstract
A case of mesenchymal chondrosarcoma of the maxilla is reported. This rare tumour is characterized by slow growth, late metastasis (up to 20 years after first presentation) and poor prognosis. The diagnosis is often difficult to make because of the low incidence among malignant bone tumours.
Collapse
Affiliation(s)
- M Mateos
- Department of Maxillofacial Surgery, Hospital General de Catalunya, Spain
| | | | | |
Collapse
|
12
|
Kruse R, Simon RG, Stanton R, Grissom LE, Conard K. Mesenchymal chondrosarcoma of the cervical spine in a child. Am J Orthop (Belle Mead NJ) 1997; 26:279-82. [PMID: 9113295] [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: 02/04/2023]
Abstract
Mesenchymal chondrosarcoma is a rare small-cell neoplasm of bone and soft tissue. After reviewing the literature, we believe that the patient in this report is the youngest in whom mesenchymal chondrosarcoma originating in a cervical vertebra has been diagnosed.
Collapse
Affiliation(s)
- R Kruse
- Department of Orthopaedic Surgery, Alfred I. duPont Institute, Wilmington, Delaware, USA
| | | | | | | | | |
Collapse
|
13
|
Sans M, Nubiola D, Alejo M, Díaz F, Anglada A, Autonell J, Brugués J. Mesenchymal chondrosarcoma of the foot, an unusual location: case report and review of the literature. Med Pediatr Oncol 1996; 26:139-42. [PMID: 8531853 DOI: 10.1002/(sici)1096-911x(199602)26:2<139::aid-mpo13>3.0.co;2-d] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We present a case of primary mesenchymal chondrosarcoma of the proximal phalanx of the first toe. The bones of the foot represent an infrequent primary site for this neoplasm. The tumour consisted of layers of undifferentiated round cells with scanty cytoplasm and hyperchromatic nuclei. The presence of brain, lung, and left auricle metastasis was demonstrated, and the patient died due to brain edema 18 days after admission. Mesenchymal chondrosarcoma is a rare tumor that more frequently involves the pelvic bones, the femur, and the humerus. To our knowledge, only nine cases of primary mesenchymal chondrosarcoma arising from the bones of the foot have been previously reported, with none involving the phalanx of the toe.
Collapse
Affiliation(s)
- M Sans
- Liver Unit, Hospital Clínic i Provincial, Barcelona, Spain
| | | | | | | | | | | | | |
Collapse
|
14
|
Fujisawa N, Sato NL, Motoyama T. [Experimental pulmonary metastasis of Chinese hamster mesenchymal chondrosarcoma cell lines]. Exp Anim 1995; 43:761-4. [PMID: 7498344 DOI: 10.1538/expanim1978.43.5_761] [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: 01/25/2023] Open
Abstract
Pulmonary metastases of chinese hamster mesenchymal chondrosarcoma cell lines, MCS-1 (undifferentiated type) and MCS-8 (differentiated type), were examined by intravenous transplantation into athymic nude mice. The incidence of pulmonary metastasis of MCS-1 was 100% and that of MCS-8 was 33% at the 23rd day after transfer. Mean number of metastatic nodules in the lung was 41 in the former and only 3 in the latter. Mean survival time of mice with MCS-1 injection (5 x 10(4) cells) was 27 days and that with MCS-8 (5 x 10(4) cells) was 48 days after transfer. At the 42nd day after transfer of MCS-8, however, the incidence of pulmonary metastasis was 100%. These data suggest that the tumor growth rate in the metastatic lesion, as well as the affinity to the target organ, is very important for evaluation of experimental metastasis.
Collapse
Affiliation(s)
- N Fujisawa
- Institute for Laboratory Animals, Niigata University School of Medicine, Japan
| | | | | |
Collapse
|
15
|
Abstract
Orbital involvement with mesenchymal chondrosarcoma is rare. Until recently, despite the young age of the affected population, exenteration was the recommended management. We report a patient with orbital invasion by mesenchymal chondrosarcoma managed surgically without exenteration. Adjuvant chemotherapy and radiotherapy were administered. There is no evidence of local or distant tumor recurrence with 30 months of postoperative follow-up. This and other recent case reports suggest that exenteration may not be necessary for local tumor control of mesenchymal chondrosarcoma in the orbit.
Collapse
Affiliation(s)
- S A Lauer
- Department of Ophthalmology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
| | | | | | | |
Collapse
|