An interesting case of spindle cell sarcoma of elbow

Spindle cell sarcomas are a group of aggressive malignant soft tissue tumors with a diverse clinical presentation. A 32 years old woman presented with a recurrent nerve sheath tumour, involving flexor carpi ulnaris and a portion of ulnar nerve. Wide local excision of the tumour was done creating a 4 cm gap defect in the ulnar nerve. Distal nerve transfer and Guyon’s canal release was done and anterior transposition of ulnar nerve to distal motor branch of ulnar nerve end to side (ETS) supercharge was done preserving motor function to the little and ring finger. Achieving negative surgical margins in primary soft tissue sarcoma is a critical for local disease control. The anatomical and functional compromise that can occur while giving adequate clearance margin for the tumor can be overcome by microsurgical techniques and neuroanastomosis with positive outcomes like preservation of function and better prognosis.

A Case of Maxillary Sinus Spindle Cell Sarcoma: Alert to Polyurethane Associated Malignancy / 대한이비인후과학회지

There has been no literature that reports a case of sino-nasal malignancy associated with polyurethane implants. However, several previous in vitro and animal model studies revealed that polyurethane implants may cause malignancy in body tissue. In this report, we describe a case of maxillary sinus spindle cell sarcoma diagnosed in a 59-year-old man who had undergone polyurethane nasal packing in the nasal cavity following endoscopic sinus surgery two years ago. Complete removal of the packing material was not confirmed as the patient has not returned for postoperative care. Although there are no direct evidence of association between this spindle cell sarcoma case and polyurethane nasal packing, surgeons should be alert to the complete removal of polyurethane nasal packing after sino-nasal surgery.

Sarcoma renal fusocelular de alto grado con antecedente de carcinoma de células claras / Renal sarcoma with previous clear cell carcinoma

El carcinoma renal con diferenciación sarcomatoide es una entidad rara con muy pocos casos reportados en la literatura. Se presenta un caso de un paciente masculino de 65 años que por historia de hematuria macroscópica, se le realizan estudios diagnósticos, reportándose masa renal izquierda, efectuándos ele nefrectomía radical cuyo resultado de patología fue un carcinoma de células claras. Tres meses después de la cirugía el paciente refiere dolor localizado en el mismo sitio anatómico por lo que se le realiza tomografía, reportándose masa a nivel del retroperitoneo, debido a este hallazgo se decide efectuar tumorectomía, en la que se reporta sarcoma fusocelular de alto grado. Los resultados patológicos no corresponden a dos entidades patológicas diferentes, sino al mismo origen tumoral, con progresión de la enfermedad.

Sarcomatoid diferentaton in renal cell carcinoma is a rare disease with very few cases reported in the literature. A 65 year old man with hematuria anda lef renal mass underwent radical nephrectomy. Pathology reported a clear renal cell carcinoma. Three months afer surgery, the patent presentedwith abdominal complaints and a CT scan of the abdomen revealing fndings consistent with a retroperitoneal mass. The patent underwent a secondsurgical resecton and pathology revealed a high grade spindle cell sarcoma. The two diferent pathology reports are not two diferent pathologies; sarcomatoid diferentaton in renal cell carcinoma represents a common pathway of de-diferentaton of renal tumors.

Primary Monophasic Synovial Sarcoma Arising in the Mesentery: Case Report of an Extremely Rare Mesenteric Sarcoma Confirmed by Molecular Detection of a SYT-SSX2 Fusion Transcript

Synovial sarcoma arises in the para-articular tissues, and it can also occur in various unexpected sites. We report a rare case of primary monophasic synovial sarcoma (MSS) arising in the mesentery. A 59-year-old man presented with a palpable abdominal mass. On microscopic examination, the entire tumor comprised a dense proliferation of the spindle cells without epithelial components. The tumor cells were positive for transducin-like enhancer of split 1, bcl-2, epithelial membrane antigen and CD99 but negative for CD34, CD117, alpha-smooth muscle actin, cytokeratin, and calretinin on immunohistochemistry. The reverse transcriptase-polymerase chain reaction revealed a single 151-bp fragment representing the SYT-SSX2 fusion transcript. Because mesenteric MSS is extremely rare and many cases display histologic findings that overlap with those of more frequently involved tumors such as hemangiopericytoma and gastrointestinal stromal tumor, there is a chance of making an incorrect diagnosis that can result in an inappropriate treatment.

A Case of Primary Unclassified Spindle Cell Sarcoma of the Left Atrium / 영남의대학술지

Primary cardiac tumors are very uncommon. Seventy five percent of them are benign tumors and these are mostly myxomas. The malignant cardiac tumors, the majority of which are undifferentiated sarcomas, comprise up to 25% of all cardiac tumors. A primary malignant sarcoma of the myocardium is exceedingly rare. Thus, there have been very few such cases reported in the literature. We present here a case of a 15 year old man who had complaints of orthopnea and increasing exercise intolerance over a one month period. Transthoracic echocardiography demonstrated a well demarcated huge mass with left ventricular inflow obstruction on the posterior wall of the left atrium. The patient's symptoms were relieved by surgery. The histological diagnosis was an unclassified spindle cell sarcoma.

Spindle Cell Sarcoma after Radiation Therapy for Nasopharyngeal Cancer: A Case Report / 대한이비인후과학회지

Radiation-induced sarcoma of the head and neck (RISHN) is one of long-term complications of radiotherapy. The rarity of this tumor is reflected in a few cases reported in the English language medical literature. The incidence of RISHN is, however, likely to increase due to progressive aging of the population combined with improved survival of head and neck cancer patients resulting from better treatment regimes. Diagnosis and management of this problem can be extremely challenging. We have experienced a case of spindle cell sarcoma arising in the nasopharynx of a 52-year-old who followed radiotherapy for nasopharyngeal undifferentiated carcinoma. So, we elaborate on it in our report with a review of literatures. To our knowledge, this is the first report about radiation-induced spindle cell sarcoma in Korea.