ABSTRACT
We report a case of a 49-year-old male patient suffering from an intraspinal tumor in the lumbar vertebra. The neoplasm was composed of mono-morphic spindle cells, arrayed in a patternless pattern in a background of prominent myxoid hyaline stroma with perivascular collagen rings in hyper-cellular regions. Instead, aggregated collagen fibers arranged into nodules and apparent calcium deposition were found in hypo-cellular regions. The tumor cells showed immunopositivity with S100 and CD34, whereas lacked SOX10 expression, which were reminiscent of a group of S100 and CD34 co-expression soft tissue spindle cell lesions having recurrent fusions including RAF1, BRAF, NTRK1/2/3, and RET genes. Interestingly, a novel anaplastic lymphoma kinase (ALK)- echinoderm microtubule-associated protein-like 4 (EML4) gene fusion was revealed. To our best knowledge, it was the first time to identify such gene fusion in the Orientals among this mentioned group, and it expands the molecular genetic spectrum of this specific group. The clinical relevance of this novel fusion requires further investigations.
ABSTRACT
Fibrosarcomas are relatively uncommon malignant tumors arising from fibrous connective tissue and are characterized by increased abnormal proliferation of malignant fibroblast. Fibrosarcoma is capable of local recurrence and metastasis with poor prognosis. Approximately 0.05% of cases are noted in the head and neck region amongst all the cases recorded in the human race. In the present case, we report a case of fibrosarcoma of the mandible in 24 years old female who was presented with small intraoral swelling in the lower anterior vestibule with the involvement of floor of the mouth. Histopathology revealed a proliferation of malignant fibroblast cells arranged in a classical herringbone pattern.
ABSTRACT
Synovial Sarcoma is a soft tissue neoplasm having incidence 6%- 10%.Malignant cells in synovial fluid aspiration is extremely rare. Only 5%cases have been reported to have joint cavity involvement. We report a case of synovial fluid malignant effusion of knee joint in a 35 year old male who presented with a left popliteal fossa swelling. Synovial fluid aspiration revealed tumor cell clusters with anaplastic morphology .Subsequent biopsy showed spindle cell tumor consistent with synovial sarcoma. This is a rare presentation of synovial sarcoma with the presence of malignant cells in synovial fluid
ABSTRACT
Inflammatory myofibroblastic (IMF) tumor is a rare solid tumor that often affects children. IMF tumors occur primarily in the lung, but the tumor may affect any organ system with protean manifestations. A 22-year-old woman was evaluated for palpable low abdominal mass that had been increasing in size since two months prior. Abdominal computed tomography showed a lobulated, heterogeneous contrast enhancing soft tissue mass, 6.5 x 5.7 cm in size in the ileal mesentery. At surgery, the mass originated from the greater omentum laying in the pelvic cavity and was completely excised without tumor spillage. Histologically, the mass was a spindle cell lesion with severe atypism and some mitosis. Immunohistochemistry for anaplastic lymphoma kinase-1 revealed that the lesion was an IMF tumor. Because of its local invasiveness and its tendency to recur, this tumor can be confused with a soft tissue sarcoma. Increasing physician awareness of this entity should facilitate recognition of its clinical characteristics and laboratory findings.
Subject(s)
Child , Female , Humans , Young Adult , Immunohistochemistry , Lung , Lymphoma , Mesentery , Mitosis , Myofibroblasts , Omentum , SarcomaABSTRACT
Inflammatory myofibroblastic tumor (IMT) of the biliary tree is extremely rare and is generally a benign condition, though malignant change is possible. Making a differential diagnosis between this lesion and other malignant conditions is very difficult on preoperative imaging studies. Hence, the final diagnosis of IMT may be made during or after operation depending on the pathologic examination. We treated a 63-year-old woman who received right hepatectomy with caudate lobectomy under the suspicion of hilar cholangiocarcinoma. Frozen biopsy during the operation showed carcinoma in situ and there were stromal cells in the bile duct's resection margins. The postoperative hospital course was uneventful except for minor bile leakage. At postoperative month 4, she developed jaundice, ascites and pleural effusion. Computed tomography images showed a mass-like lesion in the porta hepatis with portal vein thrombosis and a right chest wall mass. Excisional biopsy was done and the pathology report was malignant spindle cell tumor suggestive of an aggressive form of IMT. Her condition rapidly deteriorated regardless of the best supportive care and she expired at postoperative month 5. Further investigation is necessary to clarify the reasons for recurrence and infiltration of this disease.