Giant myoepithelial carcinoma of the nuchal region: a case report and literature review / 临床耳鼻咽喉头颈外科杂志

Myoepithelioma, also known as malignant myoepithelioma, is a rare malignant tumor originating from myoepithelial cell. This article reports a patient with a huge tumor in the neck and left elbow who underwent fine needle aspiration under local anesthesia. The pathological diagnosis was a myoepithelioma. Under general anesthesia, giant tumors in the lower neck, posterior cranial fossa, neck, and left elbow were removed, and postoperative pathology showed that they were all myoepithelial tumors. Immunohistochemistry showed AE1/AE3 (+), P63 (+), CK7 (+), CK5 (+), and CD138 (+). The clinical characteristics and diagnosis and treatment process of this case are reported and relevant literature is reviewed.

Angiomixoma agresivo pélvico: reporte de caso y revisión / Aggressive pelvic angiomyxoma: case report and revision / Angiomixoma agressivo: relato de caso e revisão

El angiomixoma agresivo pélvico es un tumor de partes blandas extremadamente raro, del cual se han reportado alrededor de 350 casos hasta la fecha. A continuación se reporta el caso clínico de una paciente que presentó dicho tumor y se describe el proceso diagnóstico y su tratamiento quirúrgico. Por otro lado, se realiza una breve revisión de la literatura disponible hasta el momento sobre el tema.

Aggressive pelvic angiomyxoma is an extremely rare soft tissue tumor, of which around 350 cases have been reported to date. This article aims at reporting the case of a patient presenting said tumor, as well as describing its diagnostic approach and its surgical treatment. On the other hand, it aims at briefly reviewing the available literature on the subject.

O angiomixoma pélvico agressivo é um tumor extremamente raro dos tecidos moles, tendo sido descritos até à data cerca de 350 casos. Relatamos o caso de uma doente que apresentava este tumor e descrevemos o processo de diagnóstico e tratamento cirúrgico. É também feita uma breve revisão da literatura disponível até à data sobre o assunto.

Calcifying Aponeurotic Fibroma in the left pectoral region in an adult: A Case report.

Calcified aponeurotic fibroma is a rare benign fibroblastic tumor. The lesion has property of local invasion and high recurrence. Because of this property, tumor should be accurately diagnosed pre-operatively. We report a case of 29 years old male, with a palpable painful mass on the anterior chest wall near left pectoral region, describes radiographic and MR findings. No skin defect was detected but patient feels discomfort. An excision procedure was done. The excised tissue was sent for biopsy and calcified aponeurotic fibroma was diagnosed

Compressive Neuropathy of the Ulnar Nerve in the Hypothenar Region by Lipoma: Case Report

Lipomas are well-defined tumors of the adipose tissue that often occur in the torso or the extremities of adult patients. These tumors usually develop painlessly and insidiously, but theymay compress adjacent structures. The objective of the present study is to describe the case of a 68-year-old female patient with a giant lipoma located at the hypothenar region, with manifestation of compression of the common palmar digital nerves, the ulnar nerve, andthe abductormuscle of theVfinger. Regarding the symptoms, the patient feltmoderate pain in the hypothenar region, with no Tinel sign, and no changes in the motor function or sensibility of the digits innervated by the ulnar nerve. Lipomasmay present a varied range of histological characteristics, and malignant tumors may be a differential diagnosis. An imaging exammay aid in the diagnosis, which is confirmed by a histopathological study. For the present case, as recommended in the literature, a surgical procedure was performed for the resection of the tumor, which resulted in the control of the symptoms.

Ultrasonography of Pediatric Superficial Soft Tissue Tumors and Tumor-Like Lesions

Ultrasonography (US) is usually the first imaging examination performed to evaluate palpable or visible superficial soft tissue lesions that are common in children. Although clinical assessments, such as age at presentation, clinical course, and overlying skin discoloration, are important for the differentiation of pediatric soft tissue lesions, US allows a specific diagnosis of some typical benign lesions and helps in guiding further investigation since it provides detailed information about the lesion location, characterization including solid versus cystic, vascularity, and compressibility. Therefore, sufficient knowledge of the normal anatomy, proper ultrasonographic techniques, and the imaging findings of common and uncommon soft tissue lesions in children are crucial for accurate assessment and management of patients. In this article, we review the techniques and imaging findings focusing on the ultrasonographic features of a variety of superficial soft tissue lesions detected in children.

Cervical Infantile Fibrosarcoma: a rare cause of paediatric parapharyngeal neck mass

Soft tissue tumors are not uncommon in childhood and comprise entities that range from common to very rare malignancies. Infantile fibrosarcoma (IFS) is a rare pediatric malignancy mainly seen in the first two years of life. The data about the incidence of infantile fibrosarcoma occurring in the neck in the Indian subcontinent is scarce. To the best of our knowledge, only one case of infant cervical IFS has been reported previously in the Indian subcontinent. We present another case of an eight-year-old male patient with a rapidly growing mass on the left side of the neck. He was successfully treated with a combined modality of surgery and chemotherapy with a good outcome. Among the soft tissue tumors of childhood, IFS is a rare entity. It has a good prognosis and lesser chance of distant metastasis as compared to adult fibrosarcoma. Though surgical excision is the mainstay of treatment, chemotherapy also has a significant role in the treatment of primary tumor and metastasis. We discuss the stated case to bring to the notice this uncommon cause, which can be considered as a differential diagnosis of upper cervical swellings. A better understanding of this entity would help in early diagnosis and aggressive treatment, reducing the overall morbidity and mortality.

Primary orbital low-grade fibromyxoid sarcoma – A case report

An 18-year-old female presented with rapidly progressive proptosis of the left eye for one month and grade II relative afferent pupillary defect. Orbital imaging showed a well-defined homogenous extraconal mass in close relation to the lateral rectus muscle and extending up to the superior orbital fissure, associated with bony erosion. An incisional biopsy was performed, with the histopathology demonstrating stellate to spindle-shaped tumor cells (fibroblasts) embedded in a richly myxoid matrix. A diagnosis of low-grade fibromyxoid sarcoma (LGFS) was made. The patient was treated by stereotactic external beam radiotherapy. Here, we report a case of LGFS which, to the best of our knowledge, is the first at an orbital location.

Clinical and pathological observation of 455 cases of orbital soft tissue tumor / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the clinic opathological features of orbital soft tissue tumors.<p>METHODS: A retrospective analysis of 455 cases of orbital soft tissue tumors in our hospital from 2003-11/2018-11 were performed to observe the clinical features, pathological classification and pathological features of rare tumors.<p>RESULTS:All 455 patients with orbital soft tissue tumors, 421(92.5%)were benign tumors. The top 5 were 258 cases of cavernous hemangioma, 58 cases of capillary hemangioma, 16 cases of neurofibroma, 15 cases of fibroid, and 14 cases of schwannoma; 27 cases(5.9%)of intermediate type, including 23 cases of solitary fibrous tumor(SFT), 2 cases of low-grade malignant fibrous histiocytoma, 2 cases of low-grade mucinous neurofibroma; 7 cases(1.5%)of malignant type, 2 cases of orbital malignant SFT, 2 cases of orbital myeloid sarcoma(MS), mucinous liposarcoma(MLS), spindle cell undifferentiated sarcoma and peripheral primitive neuroectodermal tumor(PNET)1 case. Immunohistochemistry and molecular detection of some cases revealed that the application of new antibodies such as STAT6 and molecular detection techniques can improve the diagnostic accuracy.<p>CONCLUSION:Benign tumors account for the majority of orbital soft tissue tumors. Cavernous hemangioma in vascular tumors is the first, and there are few soft tissue tumor pathological types such as Erdheim-Chester disease(ECD)and granulomatous ossifying fibers. Tumors(POF), leiomyomas and myxomas; intermediate and malignant tumors are rare; pathological types such as SFT, MLS, spindle cell undifferentiated sarcoma and MS are often difficult to diagnose, easy to miss diagnosis and misdiagnosis, new immunity histochemical antibodies and molecular detection techniques can improve the accuracy of the diagnosis.

A Case of Solitary Fibrous Tumor of Hard Palate / 대한이비인후과학회지

Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm first described and often encountered in the pleura. It has also been documented in a variety of extrapleural sites including the abdominal cavity, respiratory tract, lung, breast, and rarely in the head and neck region. SFT in the hard palate is an extremely unusual location. We present a rare case of SFT that presented as a palate mass, which was suggested as a mesenchymal cell neoplasm by preoperative punch biopsy, and finally diagnosed as STF after successful surgical excision. SFTs should be considered as a differential diagnosis of palate benign tumor when preoperative pathologic findings show mesenchymal neoplasms of fibroblastic or myofibroblastic origin. Possible malignant variants should be distinguished by evaluating the histological parameters, including high cellularity, frequent mitotic activity, nuclear pleomorphism, and presence of necrosis.

A Case of Solitary Cutaneous Myxoma / 대한피부과학회지

No abstract available.

Immunohistochemical differentiation between spindle cell lipoma and neurofibroma of oral cavity using CD34 and SOX10

Spindle cell lipoma (SCL), also called as pleomorphic adenoma, is a rare variant of lipoma histopathologically characterized by an admixture of mature fat cells with spindle cells and occasionally mast cells with myxoid connective tissue stroma and thick bends of birefringent collagen. Although buccal mucosa is the most common location for oral lipomas, for SCL, it is an exceedingly rare location. We report a case of an asymptomatic swelling of buccal mucosa that simulated the features of neurofibroma on histopathological examination, and the final diagnosis of SCL was made on the basis of immunohistochemical features. This is the first documentation of oral SCL using SOX10 to achieve the final diagnosis.

Analysis of clinicopathological characteristics and prognostic factors of foot and ankle soft tissue and bone tumors / 中华肿瘤杂志

Objective@#To evaluate the clinicopathological characteristics of foot and ankle soft tissue and bone tumor, and to analyze the prognosis and the related factors of malignant tumors in this site.@*Methods@#74 patients with soft tissue and bone tumors of foot and ankle from January 2006 to February 2017 were retrospectively analyzed. The clinicopathological characteristics, the treatment and survival status of malignant tumors were followed up, and the clinical and therapeutic factors related to prognosis were analyzed.@*Results@#Of the 74 patients, 34 were males and 40 were females. The male to female ratio was 1∶1.18; the age ranged from 12 to 64 years and the median age was 42 years. Tumors located in forefoot of 22 cases, 22 in midfoot, 10 in hind foot, 14 in ankle joint and 6 in multiple sites. 14 cases were bone tumors, including 7 benign and 7 malignant, and 60 cases were soft tissue tumors, including 14 benign and 46 malignant. The most common malignant soft tissue tumors were synovial sarcomas (13 cases), and the most common benign soft tissue tumors were hemangiomas (4 cases). 44 cases of malignant tumors underwent surgery were followed up, of which were 7 bone and 37 soft tissue malignant tumors. Limb salvage surgeries were performed in 33 cases and amputation in 11 cases. The median follow-up time was 69.8 months, and the median survival time was 40.7 months. The 1-year, 3-year and 5-year survival rate of soft tissue malignant tumors was 88.0%, 73.0%, and 63.0%, respectively. The 1-year, 3-year and 5-year survival rate of bone malignant tumors was 86.0%, 57.0% and 57.0%, respectively. Univariate analysis showed that the prognostic factors affecting 5-year survival rate were tumor size and adjuvant therapy (P<0.05). Patient′s gender, age, tumor location, histological type and surgical procedure had no effect on overall survival(P>0.05). Multivariate analysis showed that tumor size was an independent prognostic factor (RR=7.262, P=0.005).@*Conclusions@#Forefoot and midfoot are more common in foot and ankle soft tissue and bone tumors. Synovial sarcoma is the most common diagnosis in malignant soft tissue tumors, and hemangioma is the most common diagnosis in benign soft tissue tumors. The prognostic factor of malignant soft tissue and bone tumors in foot and ankle is tumor size. Patients with the tumor size of 5 cm or more have a worse prognosis.

Advances in pathology of soft tissue tumors / 中国肿瘤临床

Soft tissue tumors have specific morphologies. In many cases, differential diagnoses pose a challenge, and as such, immuno-histochemical and molecular methods are often needed. With the development of molecular genetics, the discovery of new diagnostic antibodies and genetic targets, and the emergence of further applications to clinical practice, clinically individualized and precision treatments have also been widely used. In the future, however, we must further investigate the molecular mechanisms of soft tissue tumors to improve their diagnosis and treatment.

Analysis of Traditional Chinese Medicine in Ming and Qing Dynasties / 浙江中医药大学学报

[Objective] Summary of Ming and Qing Dynasties and traditional Chinese medicine before tumor disease, to clarify the concept and to separate the tumor, and the tumor gall. [Method] Carefully read the documents of ancient Chinese medicine literature, combined with the relevant theoretical research methods of TCM, analyze the etiology and pathogenesis of neoplasia and its diagnosis and treatment system, summarize the theoretical system of the disease. [Results] The tumor is between blood stasis and phlegm stagnation. In time, the flesh skin membrane, between flesh and skin, because of its clinical and gall disease shows the organism body mass, so the ancient medical books of the two are collectively referred to as the gall disease. It is equivalent to the surface soft tissue tumor of modern medicine. [Conclusion] Before and after Ming and Qing Dynasties, Chinese medicine has formed a complete system of diagnosis and treatment of tumor, which has a good guiding effect on modern clinic.

CT and MRI features of fibrous hamartoma of infancy:Comparison with histopathology / 中国医学影像技术

Objective To discuss CT,MRI features of fibrous hamartoma of infancy (FHI) compared with pathology.Methyls Cinical data,CT and MRI findings,as well as pathological results of 15 patients with FHI were retrospectively analyzed.Results Totally,there were 17 lesions of FHI in 15 cases,including 13 cases with single lesion and 2 cases with double lesions.The lesions manifesting as subcutaneous-,skin-and mixed-type on CT or MR images accounted for 58.82％ (10/17),17.65％ (3/17) and 23.53％ (4/17),respectively.The subcutaneous-and mixed-type lesions showed " cloud sign" (including "thin-cloud sign" and "thick-cloud sign").The thin-cloud sign lesions composed mainly of mature adipose tissue,while the triphasic composition ratio of adipose,fibrous and primitive mesenchymal cells were relatively consistent in the lesions with thick-cloud sign.The skin-type lesions showed "mountain-inverted sign",which composed mainly of immature mesenchymal component.Conclusion CT and MRI features of FHI are complex,yet have certain characteristics,which can preferably reflect the histopathological features of FHI.

MRI findings of primary myxofibmsarcoma in the extremity soft-tissues / 实用放射学杂志

Objective To investigate the MRI characteristics of primary myxofibrosarcoma (MFS) in the extremity soft-tissues.Methods The MRI of 14 cases of MFS confirmed by operation and pathology were analyzed retrospectively.Results In the 14 cases,9 were in the thigh,3 in the lower leg,and 2 in the upper arm.The volumes of the tumors were relatively big and all located in the subcutaneous fat or superficial inter-muscular space.The tumor showed expanding growth and had well-defined boundary.On T1 WI,one case showed isosignal intensity,one showed equal signal intensity mostly,and 12 cases showed patch slightly low signal intensity;On fat suppression T2 WI and STIR,tumors showed high-low mixed signal intensity,which mainly showed high signal intensity;On MRI enhanced study,inhomogeneous enhancement was observed in most of the tumors,and "tail sign" was showed in 11 cases.Conclusion MFS is of characteristics on MRI,the position of tumor is shallow,the tumor is relatively big and has clear boundary.On T1 WI,most tumors show iso-low mixed signal intensity.On fat suppression T2WI and STIR,tumors show high-low mixed signal intensity;On enhanced MRI,inhomogeneous enhancement and "tail sign" are its characteristic signs.

Evaluation of performance of various histological grading systems of soft tissue sarcomas and the prognosis (metastatic risk and survival rate).

Background: Histologic grade represents the most important prognostic factor for all soft tissue sarcomas and it is strongly associated with the advent of metastasis and patients survival. The main objective of this study is to test individual grading system with metastatic risk and patients survival rate (prognosis). Methods: Soft tissue sarcomas (250) were graded by FNCLCC, NCI & Mhyre Jensens grading system. Special stains & immunohistochemistry were employed whenever necessary. Results: FNCLCC system shows Grade 1 = 50 (20%), Grade 2 = 75 (30%) & Grade 3 = 125 (50%). NCI (Costa et al.) showed Grade 1 = 70 (28%) Grade 2 = 85 (34%) & Grade 3 = 95 (38%). Myhre Jensen showed Grade 1 = 84 (33%), Grade 98 (39%) & Grade 3 = 68 (27%). Undoubtedly, FNCLCC system is the best of all grading systems which is very well supported by statistical analysis in this study. Conclusions: FNCLCC grading system of soft tissue sarcomas is the best documented and tested system. This present study strongly recommends FNCLCC grading system of soft tissue sarcomas to be internationally accepted because the grading system has well defined criteria & so least possible chances of interobserver variability. The present study & few other previous studies highly recommend the mandatory use of FNCLCC grading system in histopathology report format.

Evaluation of fine needle aspiration cytology in the diagnosis of soft tissue tumors and its correlation with histopathological findings.

Background: Fine Needle Aspiration Cytology (FNAC) is a useful, safe and cost effective tool that is used in the diagnosis of lesions in various organs. Even though the literature on FNAC of soft tissue masses is relatively scarce, a large amount of interest has developed in this area in the last few years due to the low cost of the procedure, low incidence of complications, feasibility and high therapeutic efficiency. So the present study was undertaken to study the nature of various soft tissue tumors by FNAC and to compare the cytological diagnosis with the results obtained by biopsy. Methods: All cases 713 (Prospective-217 and Retrospective 496) included in present series were taken up for study. Aspiration of soft tissue lesions were performed following the technique of Zajicek et al. Smear was prepared, stained and examined. Histopathological details were available in 140 cases. Data was compiled in MS excel and checked for its completeness, correctness and then it was analyzed. Results: Total number of 11,560 FNAC was done in six and half year’s period from 1st April 2003 to 30th September 2009. Out of the total 713 cases of soft tissue tumors, 71.25% were reported as benign and 28.75% as malignant. Soft tissue tumors were more common in males in comparison to females, with M: F-1.63:1. Accuracy of FNAC for benign and malignant soft tissue tumours was 88.1% and 92.9% respectively. Conclusion: The overall diagnostic accuracy of FNAC in the present study was found 90%. FNAC is a safe and reliable method of recognizing benign and malignant soft tissue tumors and in most instances histological sub typing is possible. Cytological diagnosis must be based on strict cytological criteria and well controlled ancillary techniques.

Useful MRI Features for Distinguishing Benign Peripheral Nerve Sheath Tumors and Myxoid Tumors in the Musculoskeletal System

PURPOSE: To identify the differential MRI findings between myxoid tumors and benign peripheral nerve sheath tumors (BPNSTs) in the musculoskeletal system. MATERIALS AND METHODS: The study participants included a total of 35 consecutive patients who underwent MRI between September 2011 and December 2013. The patients were pathologically diagnosed with myxoid tumors (22 patients) or BPNSTs (13 patients). Evaluation was done by two radiologists, based on the following characteristics: size, margin, degree of signal intensity (SI) on T2-weighted images (T2WI), homogeneity of SI on T2WI, enhancement pattern, enhancement homogeneity, presence of cystic portion, internal fat component, presence of fat split sign, presence of target sign, presence of continuation with adjacent neurovascular bundle, and presence of surrounding halo. RESULTS: Large size, high SI on T2WI, heterogeneous enhancement, and internal fat component were commonly observed in myxoid tumors, while homogenous enhancement, fat split sign, target sign were common in BPNSTs. The differences were statistically significant (P 0.05). CONCLUSION: In the differential diagnosis of myxoid tumors and BPNSTs involving the musculoskeletal system, several MRI findings such as degree of SI on T2WI, enhancement homogeneity, internal fat component, fat split sign, and target sign, may be helpful in establishing the diagnosis.

Cervical Paravertebral Osteolipoma: Case Report and Literature Review

Lipomas are the most frequent soft tissue tumors. Osteolipomas are a rare variant that can be difficult to diagnose. We report the case of a 66-year-old man consulting with a tumor of 2 years development in the right paravertebral cervical region. Neurologically, the patient had no sign of myelopathy or neurological focality. Magnetic resonance imaging showed a mass with a lipid component and calcifications inside within the right paravertebral musculature with a possible origin in the right C3 posterior root. A computed tomography scan and guided biopsy were performed, revealing hematic material and small bone spicules with no apparent neoplastic element. The tumor was totally removed, including the right C3 posterior branch, and was confirmed to be an osteolipoma on biopsy. The patient remains asymptomatic at 6-month follow-up. The osteolipoma is a benign tumor of soft tissue, characterized by lipoma areas with mature bone tissue differentiation, and even with hematopoietic marrow.