ABSTRACT
Se presentó un enfermo de 73 años en el Hospital Clínico Quirúrgico Docente "Amalia Simoni" de la ciudad de Camagüey, Cuba, que fue intervenido quirúrgicamente hace cinco años y cuyo resultado fue desconocido. En aquel entonces presentó dolor y limitación funcional del miembro inferior derecho, lo que motivó la resección de un tumor en el fémur ipsilateral; cinco años después recidiva, esta vez con invasión de la pelvis ósea y del recto, evidenciándose trastornos miccionales y constipación. La radiografía de pelvis ósea, tomografía computarizada y resonancia magnética de dicha región evidenciaron una imagen tumoral mixta con lesiones líticas que invadió y desplazó los órganos de la cavidad pélvica. El paciente fue sometido a exéresis del tumor, el cual fue de 173×156 mm, con un peso de aproximadamente 1 380 g. El análisis histopatológico de la pieza quirúrgica evidenció un mesenquimoma pélvico maligno.
It was reported a case of a 73 years old patient with a history of an unknown outcomes surgical procedure 5 years ago at the Hospital Clínico Quirúrgico Docente "Amalia Simoni" in Camaguey, Cuba. He presented pain and functional limitation of the right lower limb, which led to the resection of a tumor in the ipsilateral femur; five years later the tumor present signs of recurrence, this time with invasion of the bony pelvis and rectum and resulting in urinary disorders and constipation. Pelvis bone radiology, computed tomography scan and magnetic resonance imaging of the pelvis showed a mixed tumor with lytic lesions that invaded and displaced the organs in the pelvic cavity. The patient underwent excision of the tumor, which was 173×156 mm, weighing approximately 1.380 g. Histopathological analysis of the surgical resection specimen revealed a pelvic malignant mesenchymoma.
Apresentou-se um paciente de 73 anos, operado há 5 anos no Hospital Provincial Amalia Simoni, na cidade de Camagüey, Cuba, cujo resultado era desconhecido. Na época, apresentava dor e limitação funcional do membro inferior direito, o que levou à ressecção de tumoração no fêmur ipsilateral; cinco anos depois, recidiva, desta vez com invasão de pelve óssea e reto, evidenciando distúrbios miccionais e constipação. A radiografia óssea da pelve, a tomografia computadorizada e a ressonância magnética da referida região revelaram uma imagem tumoral mista com lesões líticas que invadiam e deslocavam os órgãos da cavidade pélvica. A paciente foi submetida à exérese do tumor, que media 173×156 mm, com peso aproximado de 1380 g. A análise histopatológica da peça cirúrgica revelou um mesenquimoma pélvico maligno.
ABSTRACT
El mesenquimoma fibrocartilaginoso (MFC) es un tumor raro, que afecta principalmente a los huesos largos. Se han reportado pocos casos desde su descripción. Presentamos un caso de un niño de 4 años de edad con MFC situado en el húmero. Las radiografías mostraron una lesión lítica expansiva situada en la región metafisaria del húmero proximal. La resonancia magnética objetivó expansión del tumor a partes blandas. La anatomía patológica fue confirmatoria de MFC. El paciente fue tratado con curetaje, fenolización adyuvante y sustituto óseo mezclado con aspirado de médula ósea. A los dos años de seguimiento, no se evidenció recidiva. El MFC debe ser tenido en cuenta entre los diagnósticos diferenciales en lesiones óseas líticas en niños y adolescentes.
Fibrocartilaginous mesenchymoma (FCM) is a rare tumor that primarily affects the long bones. Few cases have been reported since its description. A case of a 4-year-old boy with FCM located in the humerus is presented. Radiological examination showed an expansive lytic lesion located in the metaphyseal proximal humerus. Magnetic resonance imaging showed soft tissue expansion. Histopathological diagnosis was confirmatory of FCM. Curettage, adjuvant phenolization, and bone grafting with bone substitute, and autologous bone marrow was performed. During a follow-up period of 2 years, there was no evidence of disease progression. FCM should be considered in the differential diagnosis of lytic bone lesions in children and adolescents.
Subject(s)
Child, Preschool , Humans , Male , Bone Neoplasms/pathology , Humerus , Mesenchymoma/pathology , FibrocartilageABSTRACT
Malignant mesenchymoma is composed by two or more unrelated mesenchymal elements ,it is rare in clinic.Both domestic and abroad have few case reports ,it tends to occur in older people and the incidence of mesenchymoma is higher in males than in females .The malignant tumor in young female genital is more rare . Malignant mesenchymoma often appears in limbs ,it is difficult to be diagnosed before surgical operation .It is con-firmed by pathological examination .The degree of this malignant is higher and the recurrence rate is high .There is no specificity in clinic .The imaging characteristics are so less that it can not be taken seriously .We report a case of malignant mesenchymoma in vulva which is confirmed by pathology .
ABSTRACT
Objective To study the pathological and immunohistochemical features of alimentary tract mesenchymal tumors and compare with computed tomographic virtue endoscopy (CTVE) imaging technology to evaluate the diagnostic value of CTVE in alimentary tract mesenchymal tumors. Methods Seventy-four pathological specimens of alimentary tract mesenchymal tumors were collected. The pathological features and the expression of CD117, CD34, SMA and S-100 were observed by immunohistochemical method with light microscope. The pathological types and characteristics were determined by pathologists and compared with CTVE imaging technology. Results In the 74 cases of alimentary tract mesenchymal tumors,40 cases were diagnosed as stromal tumor with pathological and immunohistochemical methods (54. 1%).Sixteen of them were malignant, accounting for 40% of the stromal tumor while 33 cases were diagnosed as leiomyoma(44. 6%)and 1 case as schwannoma(1.4%) . In the 74 GIMTs cases ,33 were jejunum GIMTs,21 were ileum GIMTs and 20 were large intestine GIMTs. Immunohistochemistry assay in the 74 GIMTs cases showed that 51.4% GIMTs were positive for CD117, approximately 36. 5% were positive for CD34 , 62.2% were positive for smooth-muscle actin (SMA) and 1. 4% were positive for S-100 protein. In the 74 GIMTs cases,69 cases were diagnosed right in the accuracy for location with CTVE(93. 2%) with 51 cases in small intestinal (94. 4%) and 18 cases in large intestinal (90. 0%). The sensitivity and the specificity of CTVE to distinguish benign from malignant stromal tumors by CTVE characteristics were 84. 2% and 85. 7%respectively. Conclusions GIST is common in GIMTs and is often originated from the small intestinal. The immunohistochemistry has great value in diagnosing alimentary tract mesenchymal tumors. The CTVE imaging technology also has great value in diagnosing alimentary tract mesenchymal tumors which can show the localization, shape size and artery of the tumor clearly. The diagnostic sensitivity and specificity of CTVE are high to distinguish benign from malignant alimentary tract GISTs. CTVE plays an important role in guiding the clinical management of GISTs.
ABSTRACT
ostic sensitivity and specificity of EUS are high in distinguishing benign and malignant character of upper digestive tract GIMTs. EUS plays an important role in guiding the clinical management of upper digestive tract GIMTs.
ABSTRACT
Objective:To investigate the imaging features of gastrointestinal stromal tumors(GIST)and their diagnostic value,so as to improve the diagnosis of GIST.Methods:The clinical and imaging data of 19 cases with GIST proved by operation and pathology were analyzed retrospectively.Of the 19 cases,19 cases were diagnosed by imaging examination,18 cases by gastrointestinal barium,14 cases by CT,3 cases by MRI,and 8 cases by DSA.Results:Of the 19 cases with GIST,8 were located in stomach,2 in duodenum,3 in jejunum,2 in ileum,2 in colon,2 in mesentery;5 were benign and 14 malignant;3 cases was with hepatic metastasis and 2 with peritoneal lymphoid node metastasis.Conclusion:Imaging examinations have respectively features and advantages,which are helpful to the correct diagnosis of the disease;Gastrointestinal radiograph,CT,MRI and DSA play important roles in precise location,judging benign and malignant and differential diagnosis;The final diagnosis of GIST depends on immunohistochemical and electromicroscopic examination.
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Objective To evaluate the diagnosis and treatment of malignant rectal gastrointestinal stromal tumor.Methods The clinical and pathological data of 26 patients with malignant rectal gastrointestinal stromal tu- mor were retrospectively analyzed.Results All the patients underwent operation.In 13 cases Miles operation was done and 3 cases Park operation was done.The 10 patients received Dixon resection.The 3-,5-year survival rate were 73% and,54 %,respectively.The median survival time for 26 patients was 52 months.Immunohistochemical analysis displayed positive reactivity for CD117(96%) and CD34(85%).Conclusion For the malignant rectal gas- trointestinal stromal tumor,the most worthwhile diagnostic criterion was the presence of CD117 and CD34 cells and surgical radical resection is the principal treatment.
ABSTRACT
A malignant mesenchymoma is a rare soft tissue neoplasm that show at least two types of malignant mesenchymal differentiation, in addition to poorly differentiated fibrosarcomatous elements. They grow rapidly, recur frequently, and can be found in a wide variety of location, with most occurring in the extremities. A primary malignant mesenchymoma of the heart is extremely rare, with only 20 cases having been reported worldwide in the English literature up to 2002. We experienced a case of primary cardiac malignant mesenchymoma in a 59 year old female patient, who was admitted due to exertional dyspnea. This case is reported, with a review of the relevant literature.
Subject(s)
Female , Humans , Middle Aged , Dyspnea , Extremities , Heart Neoplasms , Heart , Mesenchymoma , Soft Tissue NeoplasmsABSTRACT
Malignant mesenchymoma is an interesting but very rare tumor in which malignant differentiation has occurred twice or more. We report a case of retroperitoneal malignant mesenchymoma consisting of osteosarcoma, leiomyosarcoma, liposarcoma and fibrosarcoma. Abdominal CT showed a large retroperitoneal mass with two separate and distinct parts, namely an area of prominent calcification and one of clearly enhancing solid components. The mass contained histologically distinct tumorous components with no histologic admixure at the interfaces. The densely calcified nodule corresponded to osteosarcoma, and the noncalcified clearly enhancing nodules to leiomyosarcoma, liposarcoma and fibrosarcoma.
Subject(s)
Humans , Male , Fibrosarcoma/diagnostic imaging , Leiomyosarcoma/diagnostic imaging , Liposarcoma/diagnostic imaging , Mesenchymoma/diagnostic imaging , Middle Aged , Osteosarcoma/diagnostic imaging , Retroperitoneal Neoplasms/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Primary hepatic sarcomas are uncommon, representing less than 1% of the primary malignant lesions of the liver. Three patients underwent resection for primary hepatic sarcoma at the Department of Surgery, Inje University Paik Hospital, Seoul: a 6 year-old girl with malignant mesenchmoma, a 74 year-old man with malignant fibrous histiocytoma and a 53 year-old man with rhabdomyosarcoma. Abdominal mass, fever with chills, and abdominal pain were the presenting symptoms, respectively. The patient with rhabdomyosarcoma was positive for HBsAg and had chronic active hepatitis. AFP level was elevated in this patient. CA 19-9 level was elevated in the patient with malignant fibrous histiocytoma. CEA levels were normal in all cases. All these tumors were hypodense on computed tomography. Malignant mesenchymoma was hypovascular and rhabdomyosarcoma was hypervascular on angiography. Immunohistochemical stains of the tumors were positive for vimentin but negative for epithelial markers, differentiating these lesions from other hepatic tumors. Electron microscopic examination was helpful in the diagnosis of the specific type of primary hepatic sarcoma. None had postoperative adjuvant chemotherapy or radiotherapy. The patient with malignant mesenchymoma, who underwent right hepatic trisegmentectomy, was disease free at 32 months. The patient with malignant fibrous histiocytoma, who underwent non-curative excision, died of the tumor at 2 months. The patient with rhabdomyosarcoma, who underwent posterior segmentectomy, was alive at 4 months. Resection of primary hepatic sarcoma should be executed if feasible, with potential survival measured in years, in view of the lack of other effective treatment modalities.
Subject(s)
Aged , Child , Female , Humans , Middle Aged , Abdominal Pain , Angiography , Chemotherapy, Adjuvant , Chills , Coloring Agents , Diagnosis , Fever , Hepatitis B Surface Antigens , Hepatitis, Chronic , Histiocytoma, Malignant Fibrous , Liver , Mastectomy, Segmental , Mesenchymoma , Radiotherapy , Rhabdomyosarcoma , Sarcoma , Seoul , VimentinABSTRACT
Malignant mesenchymomas by definition are composed of two or more cellular types that would ordinarily derive from primitive mesenchyme. They grow rapidly, recur frequently, metastasize, and can be found in a wide variety of locations. Malignant mesenchymomas as primary cardiac tumor are extremely rare with poor prognosis. Only 15 cases of cardiac malignant mesenchymoma were reported in worldwide literature in 1961-1992. We report a case of primary cardiac malignant mesenchymoma in 58 year-old female patient admitted due to hemoptysis and mild exertional dyspnea.
Subject(s)
Female , Humans , Middle Aged , Dyspnea , Heart Neoplasms , Heart , Hemoptysis , Mesenchymoma , Mesoderm , PrognosisABSTRACT
The benign mesenchymoma, in which fibrous tissue is accompanied by two or more mesencymal components, occurs very rarely in the head and neck area. The majority appear in patients under 25 years of age, most commonly in the subcutaneous scalp, cheek, or tongue. There is a 20% recurrence rate. Wide surgical excision is the treatment of choice. We report a case of mesenchymoma in the nasopharynx which was removed by transpalatine approach with a brief review of literature.
Subject(s)
Humans , Cheek , Head , Mesenchymoma , Nasopharynx , Neck , Recurrence , Scalp , TongueABSTRACT
Malignant mesenchymoma is a rare soft tissue neoplasm showing two or more separate and distinct types of malignant mesenchymal differentiation in addition to an undifferentiated sarcomatous component. Occasional cases of malignant mesenchymoma have been reported in the spermatic cord and paratesticular area. However, documented reports have been seldom found in Korea. We report a case in which there was evidence of lipo-, rhabdomyo-, osteosarcomatous differentiation in the same neoplasm with brief review of the literatures.
Subject(s)
Korea , Liposarcoma , Mesenchymoma , Osteosarcoma , Rhabdomyosarcoma , Soft Tissue Neoplasms , Spermatic CordABSTRACT
Objective To analyze imaging of gastrointestinal stromal tumors(GIST),and to compare their imaging features with operational and pathological findings.Methods Clinical,imaging,and pathological data of 20 patients with GIST were collected.Results Imaging findings were endophytic or exophytic tumors with heterogeneous density or signal intensity,corresponding to hemorrhage,necrosis,and cystic changes.Imaging was correct for the location of the lesion in 11 of 16 primary GIST and 4 cases of relapsed tumors.Preoperational CT did not detect mesenteric,peritoneal,and omental metastasis in 5 cases. Hepatic metastases detected at CT (3 cases )were identified by operational findings.Conclusions GIST has some imaging features.CT is a useful tool in detecting and characterizating of lesions rather than detecting mesenteric,peritoneal,and omental metastasis.
ABSTRACT
Objective:To investigate the clinical and pathologic morphological features,immunohistochemical speciality of the gastrointestinal stromal tumors(GISTs) and their histogenesis,treatment and prognosis as well.Methods:The morphologic characteristics of GISTs were studied in 51 cases using light microscopy.The expression of c-kit(CDll7),CD34,vimentin,actin,S-100 were detected in all the cases with SP immunohistochemistry staining.Results:Among 51 cases of GISTs,40 were spindle cell type,4 epithelioid cell type and 17 mixturetype.Almost all of the stromal tumors were strongly positive for vimentin(99%),48 out of 51 tumors positive for CD117 (c-kit)(95.0 %) and 41 positive for CD34(78.5%).Some cases also expressed actin,S-100.Conclusion:GISTs are the most frequent mesenchymal tumor seen in the gastrointestinal tract.Under light microscope,the morphology of stromal tumors looks sometimes like that of a leiomyoma and Schwannoma.Application of immunohistochemical markers (particularly CD117 and CD34)is considered necessary for the differential diagnosis.GISTs may originate from the pluripotential stem cell of the interstium.