Résumé
Primary extraskeletal osteosarcoma (EOS) is an extremely rare malignancy. In this report, the clinical course of a 32-yearold man presenting with proptoses is described. Medical history included Hirschsprung disease (HD), horseshoe kidney, azoospermia, and vertebral anomalies. Imaging of the orbit showed an oval, well-defined heterogeneous mass adjacent to the lateral wall of the orbit. The patient underwent a lateral orbitotomy and complete excision of the mass. The mass was not attached to the bone. Histopathologic and immunohistochemical examination confirmed the diagnosis of an EOS. The patient received chemotherapy and radiotherapy and is free of the disease 3 years after the diagnosis. Genetic screening showed no mutations for both the RET protooncogene for HD and the p53 tumor suppressor gene for osteosarcoma.
Résumé
Objective: To explore the clinical manifestations, treatment methods, therapeutic efficacy and outcomes of soft tissue osteosarcoma. Methods: The clinical records and follow-up information of 10 patients with soft tissue osteosarcoma admitted in Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine from January 2002 to December 2014 were retrospectively analyzed. Results: Of 10 patients with soft tissue osteosarcoma, six were male, and four were female; 7 patients had tumors located in limbs, and 3 had tumors located in groin, ilium and hip, respectively; 7 tumor lesions were located in superficial layer of deep fascia, and 3 were located in deep layer; concerning tumor size, the tumor diameter was larger than 10 cm in 4 cases , 5-10 cm in 4 cases, and shorter than 5 cm in 2 cases; regarding to pathologic grading, 9 cases were high-grade osteosarcoma, and 1 case was low to medium grade. All patients underwent tumor resection, of which, 4 cases received post-operative chemotherapy, and radiotherapy was not utilized. Three cases suffered from local recurrence, in which, 4 cases also had distant metastasis; no metastasis alone was observed. Four cases died of lung metastasis. Conclusion: Soft tissue osteosarcoma is characterized by low morbidity, high malignant grade, high local recurrence rate and distant metastasis rate, as well as high mortality. Extensive resection is the most important therapeutic strategy for soft tissue osteosarcoma, and its outcomes are related to resection extent and tumor size. Chemotherapy is not a validated treatment strategy, and radiotherapy is also seldom utilized in treatment of soft tissue osteosarcoma.
Résumé
A 37-year-old woman was referred to our institution for further management of a mass lesion located in the thoracic cavity. The mass had grown by more than 10 cm over the course of a year and was initially considered to be a scar from previous pulmonary tuberculosis at another hospital. The patient had complained of left-sided flank pain for a year and experienced dyspnea for one month. Chest radiography and chest computed tomography revealed an irregular-shaped mass in the left mid to lower pleural cavity. The mass was widely excised through left thoracotomy. Pathologic examination of the biopsy specimen revealed a malignant spindle cell tumor, which consisted of components of osteosarcoma, pleomorphic sarcoma, and leiomyosarcoma. The patient underwent adjuvant chemotherapy and has been doing well without any evidence of recurrence for 14 months.
Sujets)
Adulte , Femelle , Humains , Biopsie , Traitement médicamenteux adjuvant , Cicatrice , Dyspnée , Douleur du flanc , Léiomyosarcome , Ostéosarcome , Plèvre , Cavité pleurale , Radiographie , Récidive , Sarcomes , Cavité thoracique , Thoracotomie , Thorax , Tuberculose pulmonaireRésumé
Extraskeletal osteosarcoma is a rare malignant tumor of soft tissue. In addition, there are only several cases of osteosarcoma of the mediastinum as a primary site in the world. We report a case of extraskeletal osteosarcoma arising in the posterior mediastinum. A 54-year-old man visited our hospital because of chest pain. Chest CT showed a 12 cm sized huge mediastinal mass. The mass revealed solid and ivory-colored cut surface with multifocally ovoid cystic spaces and hemorrhage. Microscopically, the tumor consisted of polygonal stromal cells, giant cells and varying amounts of neoplastic new bone, and mitotic figures were frequently observed. There were no distant metastasis and regional lymph node involvement.
Sujets)
Humains , Adulte d'âge moyen , Douleur thoracique , Cellules géantes , Hémorragie , Noeuds lymphatiques , Médiastin , Métastase tumorale , Ostéosarcome , Cellules stromales , TomodensitométrieRésumé
Extraskeletal osteosarcoma is an uncommon tumor originated from soft tissue without evidence of skeletal involvement. It usually affects adults and its common locations are extremity, buttock, and retroperitoneum. Although the histologic feature of this tumor is well known, there have been few reports on the fine needle aspiration cytologic findings. We report the imprint cytologic feature of extraskeletal osteosarcoma. The patient was a 49-year-old man with a mass of the left anterior chest for 2 years. On the imprint preparation, the smears showed malignant round, polygonal or spindle cells with coarsely clumped chromatin and occasionally prominent nucleoli. The malignant cells occur singly, in clusters, or associated with amorphous eosinophilic osteoid. Mitotic figures are also seen.
Sujets)
Adulte , Humains , Adulte d'âge moyen , Cytoponction , Fesses , Chromatine , Granulocytes éosinophiles , Membres , Ostéosarcome , ThoraxRésumé
The case of a 44-year-old female with extraskeletal osteosarcoma is reported. She had been treated by low anterior resection and radiation therapy due to rectal cancer (Modified Duke's classification B2) about 35 months ago. Also, she had a history of hematoma formation in a previous incision scar of the low mid-abdomen due to a fall. The patient developed a hard, nontender, fixed mass in the low abdominal wall after the hematoma. Treatment consisted of a wide surgical excision and local advanced flap. To our knowledge, an osteosarcoma of the abdominal wall is very rare, but the outlook for recovery is grave.
Sujets)
Adulte , Femelle , Humains , Paroi abdominale , Cicatrice , Classification , Hématome , Ostéosarcome , Tumeurs du rectumRésumé
The case of a 44-year-old female with extraskeletal osteosarcoma is reported. She had been treated by low anterior resection and radiation therapy due to rectal cancer (Modified Duke's classification B2) about 35 months ago. Also, she had a history of hematoma formation in a previous incision scar of the low mid-abdomen due to a fall. The patient developed a hard, nontender, fixed mass in the low abdominal wall after the hematoma. Treatment consisted of a wide surgical excision and local advanced flap. To our knowledge, an osteosarcoma of the abdominal wall is very rare, but the outlook for recovery is grave.
Sujets)
Adulte , Femelle , Humains , Paroi abdominale , Cicatrice , Classification , Hématome , Ostéosarcome , Tumeurs du rectumRésumé
We report a case of extraskeletal osteosarcoma in view of rarity, and a brief review of the literature related to this type of tumor is presented. The patient was a 31-year-old Korean woman, who had noticed a bean-sized hard mass in the right thigh progressively enlarged to become egg-size during about 7 months, followed by pain and tenderness. There was neither recognizable previous lesion nor causable agent about the mass on history taking. Physical examination revealed another palpable mass on the inguinal area. The right thigh and inguinal masses were simply excised and histologically confirmed to be an extraskeletal osteosarcoma and metastatic one, respectively.